Carcinogenic changes occur due to interactions between genetic, lifestyle-related, and environmental factors. Anti-cancer efforts should evaluate preventable risk factors to maintain a healthy life. Tobacco and obesity are the major preventable causes of cancer. We aimed to evaluate the contribution of them on cancer burden in Turkey.
Population-attributable fractions were calculated according to Peto-Lopez, and Comparative Risk Assessment Collaborative Group Methods. Geographical distributions of PAFs were analyzed with ArcMap 10.4 GIS software. Tobacco- and obesity-related cancers were determined according to IARC, and WCRF reports, respectively. Sex-specific relative risks were obtained from CPS-II, and standardized meta-analysis estimates and the Continuous Update Project. National cancer incidences in 2013 were used for calculating PAF cases. Since a 10-years of lag time was considered for the progression of cancer for obesity, prevalence rates were obtained from National Burden of Diseases and Cost-Effectiveness-Turkey 2003 Study. Duration from tobacco exposure to cancer is higher, but no previous qualified data was present, and same study was used to obtain smoking prevalence.
PAFs for tobacco and obesity were 60.4% (59.6-62.7%), and 11% (9.8-13.7%), respectively. Site-specific PAFs ranged between 29.8-91.7% and 2.2-67.9% for tobacco; and between 5.7-13.1% and 3.0-25.9% for obesity in males and females, respectively. PAFs showed geographical distribution variations. Western and southern parts of Turkey were found to have greater numbers of preventable cancers. PAFs of tobacco- and obesity-related cancers
|Tobacco (PAF %)||Obesity (PAF %)|
Determining possible interactions between geographical factors, distribution of risk factors, and prevalent cancers should guide preventive tasks against this important public health problem. According to our results western and southern parts of Turkey have the largest preventable numbers of tobacco and obesity related cancers.
Clinical trial identification
Legal entity responsible for the study
All authors have declared no conflicts of interest.