In 2018, the authors reported estimates of the number and proportion of cancers attributable to potentially modifiable risk factors in 2014 in the United States. These data are useful for advocating for and informing cancer prevention and control. Herein, based on up-to-date relative risk and cancer occurrence data, the authors estimated the proportion and number of invasive cancer cases (excluding nonmelanoma skin cancers) and deaths, overall and for 30 cancer types among adults who were aged 30 years and older in 2019 in the United States, that were attributable to potentially modifiable risk factors. These included cigarette smoking; second-hand smoke; excess body weight; alcohol consumption; consumption of red and processed meat; low consumption of fruits and vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and seven carcinogenic infections. Numbers of cancer cases and deaths were obtained from data sources with complete national coverage, risk factor prevalence estimates from nationally representative surveys, and associated relative risks of cancer from published large-scale pooled or meta-analyses. In 2019, an estimated 40.0% (713,340 of 1,781,649) of all incident cancers (excluding nonmelanoma skin cancers) and 44.0% (262,120 of 595,737) of all cancer deaths in adults aged 30 years and older in the United States were attributable to the evaluated risk factors. Cigarette smoking was the leading risk factor contributing to cancer cases and deaths overall (19.3% and 28.5%, respectively), followed by excess body weight (7.6% and 7.3%, respectively), and alcohol consumption (5.4% and 4.1%, respectively). For 19 of 30 evaluated cancer types, more than one half of the cancer cases and deaths were attributable to the potentially modifiable risk factors considered in this study. Lung cancer had the highest number of cancer cases (201,660) and deaths (122,740) attributable to evaluated risk factors, followed by female breast cancer (83,840 cases), skin melanoma (82,710), and colorectal cancer (78,440) for attributable cases and by colorectal (25,800 deaths), liver (14,720), and esophageal (13,600) cancer for attributable deaths. Large numbers of cancer cases and deaths in the United States are attributable to potentially modifiable risk factors, underscoring the potential to substantially reduce the cancer burden through broad and equitable implementation of preventive initiatives.

中文翻译：

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2019 年美国可归因于潜在可改变风险因素的癌症病例和死亡的比例和数量


2018 年，作者报告了 2014 年美国可归因于潜在可改变风险因素的癌症数量和比例的估计。这些数据对于倡导和指导癌症预防和控制非常有用。在此，根据最新的相对风险和癌症发生数据，作者估计了 30 岁以上成年人中 30 种癌症类型的总体侵袭性癌症病例（不包括非黑色素瘤皮肤癌）和死亡的比例和数量。 2019 年在美国较早，这可归因于潜在的可改变的风险因素。其中包括吸烟；二手烟；体重过重；饮酒量；食用红肉和加工肉类；水果和蔬菜、膳食纤维和膳食钙的摄入量低；缺乏身体活动；紫外线辐射；和七种致癌感染。癌症病例和死亡人数来自完全覆盖全国的数据源、全国代表性调查的危险因素患病率估计以及已发表的大规模汇总或荟萃分析的相关癌症相对风险。 2019 年，美国 30 岁及以上成年人中估计有 40.0%（1,781,649 例中的 713,340 例）癌症（不包括非黑色素瘤皮肤癌）和所有癌症死亡的 44.0%（595,737 例中的 262,120 例）归因于评估的癌症风险因素。吸烟是导致癌症病例和死亡的主要危险因素（分别为 19.3% 和 28.5%），其次是体重过重（分别为 7.6% 和 7.3%）和饮酒（分别为 5.4% 和 4.1%） ）。 对于 30 种评估的癌症类型中的 19 种，超过一半的癌症病例和死亡可归因于本研究中考虑的潜在可改变的风险因素。根据评估的危险因素，肺癌的癌症病例数（201,660 例）和死亡数（122,740 例）最多，其次是女性乳腺癌（83,840 例）、皮肤黑色素瘤（82,710 例）和结直肠癌（78,440 例）。结直肠癌（25,800 例死亡）、肝癌（14,720 例）和食管癌（13,600 例）死亡。美国的大量癌症病例和死亡可归因于潜在的可改变的风险因素，这凸显了通过广泛和公平地实施预防措施来大幅减少癌症负担的潜力。