[生活方式因素对癌症的影响：2010年荷兰数据的二次分析及2020年预测]

[Contribution of lifestyle factors to cancer: secondary analysis of Dutch data over 2010 and a projection for 2020].

作者信息

Lanting Caren I, de Vroome Ernest M M, Elias Sjoerd G, van den Brandt Piet A, van Leeuwen Flora E, Kampman Ellen, Kiemeney Lambertus A, Peeters Petra H M, de Vries Esther, Bausch-Goldbohm R A Sandra

机构信息

TNO, Leiden.

出版信息

Ned Tijdschr Geneeskd. 2014;159:A8085.

PMID:25515397

Abstract

OBJECTIVE

To calculate the proportion of cancer cases in the Netherlands in 2010 that were attributable to lifestyle factors by using the most recent data.

DESIGN

Secondary analysis.

METHOD

Lifestyle risk factors studied were tobacco smoking, alcohol consumption, overweight, lack of physical exercise, and six elements of diet (consumption of vegetables, fruit, processed meat and red meat, and calcium and fibre intake). The lifestyle factors were organised so that the group with the highest risk (e.g. smokers) could be compared with the groups with the lowest risk (e.g. ex-smokers, non-smokers). Cut-off points were in line with Dutch public health messages. We obtained prevalence data on risk factors from national databases. Relative risks for the relationship between lifestyle and cancer were based on the international literature. Incidence and mortality data for cancer in 2010 were obtained through the Netherlands Cancer Registry. We calculated percentages of new cancer cases and deaths for men and women and for each type of cancer individually; these were then summed.

RESULTS

We estimated that of the 98,971 newly-diagnosed cases of cancer among persons aged ≥ 20 years in the Netherlands in 2010, 29,938 (30%) were attributable to the above-mentioned lifestyle factors. Smoking was the most important contributory risk factor (19% of all new cancer cases), followed by sub-optimal dietary habits (10%), overweight (4%), alcohol consumption (3%), and lack of physical activity (2%). Of cancer deaths in 2010, an estimated 38% were attributable to lifestyle factors. Projections for 2020 show that lack of exercise and consumption of alcohol and meat will contribute less to the development of cancer while overweight and a reduction in inadequate dietary fibre intake and inadequate fruit and vegetable consumption will contribute more.

CONCLUSION

Almost one-third of all cases of cancer and almost 40% of deaths from cancer can be attributed to a less healthy lifestyle.

摘要

目的

利用最新数据计算2010年荷兰因生活方式因素导致的癌症病例比例。

设计

二次分析。

方法

所研究的生活方式风险因素包括吸烟、饮酒、超重、缺乏体育锻炼以及饮食的六个要素（蔬菜、水果、加工肉类和红肉的摄入，以及钙和纤维的摄入量）。对生活方式因素进行整理，以便将风险最高的群体（如吸烟者）与风险最低的群体（如已戒烟者、不吸烟者）进行比较。切点与荷兰公共卫生信息一致。我们从国家数据库中获取了风险因素的患病率数据。生活方式与癌症之间关系的相对风险基于国际文献。2010年癌症的发病率和死亡率数据通过荷兰癌症登记处获得。我们分别计算了男性和女性以及每种癌症类型的新癌症病例和死亡的百分比；然后将这些百分比相加。

结果

我们估计，2010年荷兰20岁及以上人群中98,971例新诊断癌症病例中，有29,938例（30%）可归因于上述生活方式因素。吸烟是最重要的促成风险因素（占所有新癌症病例的19%），其次是不良饮食习惯（10%）、超重（4%）、饮酒（3%）和缺乏体育活动（2%）。2010年癌症死亡病例中，估计38%可归因于生活方式因素。2020年的预测表明，缺乏锻炼以及饮酒和肉类消费对癌症发展的影响将减小，而超重以及膳食纤维摄入不足和水果与蔬菜消费不足的情况增加将对癌症发展产生更大影响。