Major avoidable risk factors of cancer

doi:10.1016/S0304-3835(99)90005-8

Cancer Letters

Volume 143, Supplement 1, September 1999, Pages S19-S23

https://doi.org/10.1016/S0304-3835(99)90005-8 Get rights and content

Abstract

With an aim of promoting primary prevention of cancer, major avoidable risk factors as well as protective factors of cancer are reviewed based on previous epidemiological studies. Among various risk factors of cancer, tobacco is the most important avoidable risk factor for cancers of the oral cavity, larynx, lung, pharynx, esophagus, stomach, liver, pancreas, kidney (pelvis), ureter, bladder, and cervix. Tobacco accounts for some 20–30% of all sites of cancer. Betel quid and tobacco chewing is an important risk factor for cancer of the oro-pharynx in some parts of South-East Asia. Diet also plays an important role in the etiology of cancer, but its relation to cancer is complicated. An excess or insufficient intake of some food components elevates risk of cancer of several sites. Eating habits, available foods, methods of food processing may vary from country to country. Infection of oncogenic viruses (especially, HBV, HVC, HPVs) is an important avoidable risk factor of cancer where liver cancer and cervical cancer are common. Infection of Helicobacter pylori could also be an important risk factor of stomach cancer. Attributable risks of other avoidable risk factors, such as occupation, environmental pollution, sun light, radiation, food additives, pesticides, drugs, etc. are relatively small compared to those of tobacco, diet and infection. Exercise and stress are also manageable risk factor of cancer.

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Citation Excerpt :
Other conditions, such as liver cirrhosis, chronic pancreatitis, haemorrhagic stroke and various cancers are consequences of chronic alcohol use17 (Table 2). In people who use betel there can be changes in the mouth and also pancreas and many other organs (Table 3).18–21 The European Code against Cancer,22 outlines recommendations as shown in Box 1.
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Prevention of cancer involves lifestyle decisions which afford protection not only against cancers in many sites, but also against a wide range of other conditions, many of which are equally life-threatening.
The paper also highlights areas of controversy in the early diagnosis of oral cancer. Earlier diagnosis is likely to be achieved reliably only with the introduction of molecular studies.
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There are about 600 million betel quid chewers in the world. Betal quid chewing is one of the major risk factors of hepatocarcinoma, oropharyngeal and esophagus cancers. Arecoline, the main Areca alkaloid of the betel nut is reported to have cytotoxic, genotoxic and mutagenic effects in various cells. It shows strong correlation to the incidence of oral submucosal fibrosis, leukoplakia and oral cancer, and has also been found to impose toxic manifestations in immune, hepatic and other defense systems of the recipient.
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Major avoidable risk factors of cancer

Abstract

Contribution of the environment to caner incidence: an epidemiologic exercise

J. Natl. Cancer Inst.

The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today

J. Natl. Cancer Inst.

Cancer: causes, occurrence and control