Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France; Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada.
Eur J Cancer. 2018 Dec;105:103-113. doi: 10.1016/j.ejca.2018.09.009. Epub 2018 Nov 14.
Cancer is a major cause of premature illness and death in France. To quantify how cancer prevention could reduce the burden, we present estimates of the contribution of lifestyle and environmental risk factors to cancer incidence in France in 2015, comparing these with other high-income countries.
Prevalences of, and relative risks for tobacco smoking, alcohol consumption, inadequate diet, overweight and obesity, physical inactivity, exogenous hormones, suboptimal breastfeeding, infectious agents, ionising radiation, air pollution, ultraviolet exposure, occupational exposures, arsenic in drinking water and indoor benzene were obtained to estimate the population attributable fraction (PAF) and the number of attributable cancers by the cancer site and sex.
In 2015, 41% (or 142,000 of 346,000) of all new cancers diagnosed in France could be attributed to the aforementioned risk factors. The numbers and PAF were slightly higher in men than in women (84,000 versus 58,000 cases and 44% versus 37%, respectively). Smoking (PAF: 20%), alcohol consumption (PAF: 8%), dietary factors (PAF: 5%) and excess weight (PAF: 5%) were the most important factors. Infections and occupational exposures each contributed to an additional 4% of the cancer cases in 2015.
Today, two-fifths of cancers in France are attributable to preventable risk factors. The variations in the key amenable factors responsible in France relative to other economically similar countries highlight the need for tailored approaches to cancer education and prevention. Reducing smoking and alcohol consumption and the adoption of healthier diet and body weight remain important targets to reduce the increasing number of new cancer patients in France in the decades to follow.
癌症是法国导致早逝和患病的主要原因。为了量化癌症预防对疾病负担的影响，我们对 2015 年法国癌症发病率与生活方式和环境风险因素的关系进行了评估，并与其他高收入国家进行了比较。
通过对烟草使用、饮酒、饮食不当、超重和肥胖、缺乏运动、激素替代疗法、母乳喂养不足、传染性病原体、电离辐射、空气污染、紫外线照射、职业暴露、饮用水砷和室内苯等因素的流行率及相对风险进行评估，计算了各癌症部位和性别的归因分数（PAF）和归因癌症的数量。
2015 年，法国新诊断出的所有癌症中有 41%（346000 例中的 142000 例）可归因于上述风险因素。男性归因病例数和 PAF 略高于女性（分别为 84000 例和 44%，58000 例和 37%）。吸烟（PAF：20%）、饮酒（PAF：8%）、饮食因素（PAF：5%）和超重（PAF：5%）是最重要的因素。2015 年，感染和职业暴露分别导致另外 4%的癌症病例。
目前，法国五分之二的癌症是可以预防的。法国与其他经济水平相似的国家在主要可改变因素方面的差异突出表明，需要采取有针对性的方法进行癌症教育和预防。减少吸烟和饮酒，以及采取更健康的饮食和控制体重，仍然是减少未来几十年法国新增癌症患者数量的重要目标。
