Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Int J Cancer. 2023 Nov 15;153(10):1758-1765. doi: 10.1002/ijc.34659. Epub 2023 Aug 7.
In the current study, we aimed to calculate the fraction of cancer attributable to modifiable risk factors in Iran in 2020. Population attributable fractions (PAFs) were calculated for established cancer risk factors using three data sources: the national cancer incidence reports, relative risks extracted from global and national meta-analyses, and exposure prevalence from national/subnational population-based surveys. In addition to overall cancers, the PAFs were estimated separately for each cancer site among men and women. Overall, 32.6% of cancers in 2020 in Iran were attributable to known risk factors. The PAF in men (40.2%) was twice as high as in women (21.1%). Cigarette smoking (15.4%), being overweight (5.0%), opium use (3.9%) and H. pylori infection (3.8%) were the leading causes of cancers. For men, the highest PAFs belonged to cigarette smoking (26.3%), opium use (6.8%) and being overweight (3.1%), while for women, the highest PAFs belonged to being overweight (7.2%), H. pylori infection (2.7%) and cigarette smoking (2.7%). Among Iranian men and women, the PAFs of waterpipe smoking were 2% and 0.9%, respectively. A third of incident cancers in Iran are due to modifiable exposures, mainly cigarette smoking, being overweight, and H. pylori infection. Opium consumption and waterpipe smoking collectively accounted for 8.8% of cancer occurrence in men and 1.3% in women in Iran. These emerging risk factors should be taken into consideration in future PAF studies.
在本研究中，我们旨在计算 2020 年伊朗可归因于可改变风险因素的癌症比例。使用三种数据源计算了已确定的癌症风险因素的人群归因分数（PAF）：国家癌症发病率报告、全球和国家荟萃分析中提取的相对风险以及国家/国家基于人群的调查中的暴露流行率。除了所有癌症外，还分别估计了男性和女性中每个癌症部位的 PAF。总体而言，2020 年伊朗有 32.6%的癌症可归因于已知的风险因素。男性的 PAF（40.2%）是女性的两倍（21.1%）。吸烟（15.4%）、超重（5.0%）、鸦片使用（3.9%）和 H. pylori 感染（3.8%）是癌症的主要原因。对于男性来说，最高的 PAF 归因于吸烟（26.3%）、鸦片使用（6.8%）和超重（3.1%），而对于女性来说，最高的 PAF 归因于超重（7.2%）、H. pylori 感染（2.7%）和吸烟（2.7%）。在伊朗男性和女性中，水烟的 PAF 分别为 2%和 0.9%。伊朗有三分之一的新发癌症是由可改变的暴露引起的，主要是吸烟、超重和 H. pylori 感染。鸦片使用和水烟共占伊朗男性癌症发生的 8.8%和女性的 1.3%。在未来的 PAF 研究中，应考虑这些新出现的风险因素。
