What are modifiable risk factors for cancer?

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“An estimated one third to one half of cancers could be prevented by healthy lifestyle choices: eliminating tobacco use, maintaining a healthy body mass index (BMI), moderating alcohol consumption, and maintaining an active lifestyle.”
Arem, Hannah, & Loftfield, Erikka. (2018). Cancer Epidemiology: A Survey of Modifiable Risk Factors for Prevention and Survivorship. American Journal of Lifestyle Medicine., 12(3), 200-210.

Lifestyle-Related Cancer Risk Factors (From Arem & Loftfield)

  • Tobacco: A 2014 Surgeon General’s report documenting 50 years of evidence after the initial report found that numerous cancers, including acute myeloid leukemia and cancers of the head and neck, bronchus and lung, stomach, liver, pancreas, kidney and ureter, cervix, bladder, colon, and rectum, are causally linked to smoking
  • Obesity: A 2002 handbook on cancer prevention published by the International Agency for Research on Cancer (IARC) presents estimates suggesting that obesity explains 11% of colon cancer cases, 9% of postmenopausal breast cancer cases, 39% of endometrial cancer cases, 25% of kidney cancer cases, and 37% of esophageal cancer cases.
  • Physical (In)Activity:Physical inactivity has been recognized as a global pandemic that causes an estimated 10% of breast and colon cancers, and 9% of premature mortality overall.Consequently, the health burden from physical inactivity has been compared to that from smoking or obesity.
  • Sedentary Time: A 2015 meta-analysis of 14 studies reported that sedentary time was positively associated with a cancer risk (relative risk [RR] = 1.13 for all cancers.
  • Diet: A  commentary on Doll and Peto’s 1981 report was published, reiterating their uncertainty but approximating that 20% of cancers could be attributed to diet and related factors, including obesity.

Additional resources: 

Gapstur, Susan M, Drope, Jeffrey M, Jacobs, Eric J, Teras, Lauren R, McCullough, Marjorie L, Douglas, Clifford E, . . . Brawley, Otis W. (2018). A blueprint for the primary prevention of cancer: Targeting established, modifiable risk factors. CA : A Cancer Journal for Clinicians., 68(6), 446-470.
For Emory Users

Chen, Wanqing, Xia, Changfa, Zheng, Rongshou, Zhou, Maigeng, Lin, Chunqing, Zeng, Hongmei, . . . He, Jie. (2019). Disparities by province, age, and sex in site-specific cancer burden attributable to 23 potentially modifiable risk factors in China: A comparative risk assessment. The Lancet., 7(2), E257-E269.
For Emory Users

Islami, Farhad, Goding Sauer, Ann, Miller, Kimberly D, Siegel, Rebecca L, Fedewa, Stacey A, Jacobs, Eric J, . . . Jemal, Ahmedin. (2018). Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA : A Cancer Journal for Clinicians., 68(1), 31-54.
For Emory Users

Brenner, Darren R, Friedenreich, Christine M, Ruan, Yibing, Poirier, Abbey E, Walter, Stephen D, King, Will D, . . . De, Prithwish. (2019). The burden of cancer attributable to modifiable risk factors in Canada: Methods overview. Preventive Medicine., 122, 3-8.
For Emory Users

Arriaga, M., Vajdic, C., Canfell, K., MacInnis, R., Hull, P., Magliano, D., . . . Laaksonen, M. (2017). The burden of cancer attributable to modifiable risk factors: The Australian cancer-PAF cohort consortium. BMJ Open., 7(6), E016178.

Al-Bayati, Osamah, Hasan, Aws, Pruthi, Deepak, Kaushik, Dharam, & Liss, Michael A. (2019). Systematic review of modifiable risk factors for kidney cancer. Urologic Oncology : Seminars and Original Investigations, 37(6), 359-371.
For Emory Users

Soori, Mehrnoosh, Platz, Elizabeth A, & Kanarek, Norma. (2020). Inclusion of Evidence-Based Breast Cancer Control Recommendations and Guidelines in State Comprehensive Cancer Control Plans. Preventing Chronic Disease, 17, Preventing chronic disease , 2020, Vol.17.
For Emory Users

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