Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Departmant of Etiological Research, Cancer Registry of Norway, Oslo, Norway; Department of Genetic Epidemiology, Folkhalsan Research Center, Helsinki, Finland;
ABSTRACT
The main behavioural and environmental risk factors for cancer mortality in the world are related to diet and physical inactivity, use of addictive substances, sexual and reproductive health, exposure to air pollution and use of contaminated needles. The population attributable fraction for all cancer sites worldwide considering the joint effect of these factors is about 35% (34 % for low-and middle-income countries and 37% for high-income countries). Seventy-one percent(71%) of lung cancer deaths are caused by tobacco use (lung cancer is the leading cause of cancer death globally). The combined effects of tobacco use, low fruit and vegetable intake, urban air pollution, and indoor smoke from household use of solid fuels cause 76% of lung cancer deaths. Exposure to these behavioural and environmental factors is preventable; modifications in lifestyle could have a large impact in reducing the cancer burden worldwide (WHO, 2009). The evidence of association between lifestyle factors and cancer, as well as the main international recommendations for prevention are briefly reviewed and commented upon here.
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