Pader Joy, Ruan Yibing, Poirier Abbey E, Asakawa Keiko, Lu Chaohui, Memon Saima, Miller Anthony, Walter Stephen, Villeneuve Paul J, King Will D, Volesky Karena D, Smith Leah, De Prithwish, Friedenreich Christine M, Brenner Darren R
Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada.
Statistics Canada, Government of Canada, Ottawa, Ontario, Canada.
Can J Public Health. 2021 Dec;112(6):1069-1082. doi: 10.17269/s41997-020-00455-7. Epub 2021 May 25.
Modifiable lifestyle, environmental, and infectious risk factors associated with cancer impact both cancer incidence and mortality at the population level. Most studies estimating this burden focus on cancer incidence. However, because these risk factors are associated with cancers of disparate mortality rates, the burden associated with cancer incidence could differ from cancer mortality. Therefore, estimating the cancer mortality attributable to these risk factors provides additional insight into cancer prevention. Here, we estimated future cancer deaths and the number of avoidable deaths in Canada due to modifiable risk factors.
The projected cancer mortality data came from OncoSim, a web-based microsimulation tool. These data were applied to the methodological framework that we previously used to estimate the population attributable risks and the potential impact fractions of modifiable risk factors on Canadian cancer incidence.
We estimated that most cancer deaths will be attributed to tobacco smoking with an average of 27,900 deaths annually from 2024 to 2047. If Canada's current trends in excess body weight continue, cancer deaths attributable to excess body weight would double from 2786 deaths in 2024 to 5604 deaths in 2047, becoming the second leading modifiable cause of cancer death. Applying targets to reduce these risk factors, up to 34,600 cancer deaths could be prevented from 2024 to 2047.
Our simulated results complement our previous findings on the cancer incidence burden since decreasing the overall burden of cancer will be accelerated through a combination of decreasing cancer incidence and improving survival outcomes through improved treatments.
与癌症相关的可改变生活方式、环境和感染风险因素在人群层面影响癌症发病率和死亡率。大多数评估这一负担的研究都聚焦于癌症发病率。然而,由于这些风险因素与死亡率不同的癌症相关,与癌症发病率相关的负担可能与癌症死亡率不同。因此,评估这些风险因素导致的癌症死亡率能为癌症预防提供更多见解。在此,我们估算了加拿大因可改变风险因素导致的未来癌症死亡人数及可避免死亡人数。
预计的癌症死亡率数据来自基于网络的微观模拟工具OncoSim。这些数据被应用于我们之前用于估算可改变风险因素对加拿大癌症发病率的人群归因风险和潜在影响分数的方法框架。
我们估计,大多数癌症死亡将归因于吸烟,2024年至2047年期间平均每年有27,900人死亡。如果加拿大目前超重的趋势持续下去,超重导致的癌症死亡人数将从2024年的2786人翻倍至2047年的5604人,成为可改变的第二大癌症死亡原因。应用降低这些风险因素的目标,从2024年到2047年可预防多达34,600例癌症死亡。
我们的模拟结果补充了我们之前关于癌症发病率负担的研究结果,因为通过降低癌症发病率和通过改进治疗提高生存结果相结合,将加速降低癌症的总体负担。