7 september 2022: The Lancet

Bijna de helft van de sterfgevallen door kanker wereldwijd kan worden voorkomen door verandering van levensstijl, waarbij roken en alcohol en de laatste tien jaar ook overgewicht de voornaamste boosdoeners zijn. Dat blijkt uit een berekening door een grote groep onderzoekers (de GBD 2019 Cancer Risk Factors Collaborators).

Volgens de onderzoekers die gegevens uit 204 landen gebruikten voor hun berekening, stierven wereldwijd bijna 4,5 miljoen mensen aan kanker in het jaar 2019. Zij stellen dat 44 procent van deze 4,5 miljoen te voorkomen zou zijn geweest met een gezonde leefstijl. Meer dan de helft van alle sterfgevallen bij mannen door kanker en meer dan een derde bij vrouwen was volgens de onderzoekers direct gerelateerd aan roken en alcohol. Ook ongezonde voeding, onveilige seks en blootstelling op het werk aan schadelijke producten, zoals asbes  speelden een rol. 

Tussen 2010 en 2019 was het aantal sterfgevallen door genoemde risicofactoren wereldwijd met ongeveer 20 procent  gestegen. Opvallend is dat vooral kanker krijgen en ovelrijden daaraan gerelateerd aan overgewicht sterk stijgt de laatste decennia.

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ARTICLES| VOLUME 400, ISSUE 10352P563-591, AUGUST 20, 2022

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

Open AccessPublished:August 20, 2022DOI:https://doi.org/10.1016/S0140-6736(22)01438-6

Summary

Background

Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally.

Methods

The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented.

Findings

Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]).

Interpretation

The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden.

Funding

Bill & Melinda Gates Foundation.

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Figures

  • Figure thumbnail gr1
    Figure 1Cancer DALYs attributable to 11 Level 2 risk factors globally in 2019
  • Figure thumbnail gr2
    Figure 2Global deaths from cancers attributable to risk factors in 2019 by sex and SDI
  • Figure thumbnail gr3a
    Figure 3Global map of age-standardised DALY rate quintiles for risk-attributable cancer burden, both sexes combined, 2019
  • Figure thumbnail gr3b
    Figure 3Global map of age-standardised DALY rate quintiles for risk-attributable cancer burden, both sexes combined, 2019
  • Figure thumbnail gr4
    Figure 4Estimates of age-specific rates of risk-attributable cancer DALYs, SDI quintiles, both sexes combined, 2019
  • Figure thumbnail gr5
    Figure 5Percentage change of risk-attributable cancer DALY counts and age-standardised DALY rates for Level 1 risk factors by SDI quintile, both sexes combined, 2010–19
  • Figure thumbnail gr6
    Figure 6Leading risk factors at the most detailed level for risk-attributable cancer age-standardised DALY rates globally, both sexes combined, 2010–19

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The Global Burden of Disease study provides the most comprehensive global health estimates, examining worldwide, national, and regional trends for mortality and morbidity from major diseases, injuries, and risk factors to understand the health challenges of the 21st century.


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