Abstract：
In 2018, the authors reported estimates of the number and proportion of cancers attributable to potentially modifiable risk factors in 2014 in the United States. These data are useful for advocating for and informing cancer prevention and control. Herein, based on up-to-date relative risk and cancer occurrence data, the authors estimated the proportion and number of invasive cancer cases (excluding nonmelanoma skin cancers) and deaths, overall and for 30 cancer types among adults who were aged 30 years and older in 2019 in the United States, that were attributable to potentially modifiable risk factors. These included cigarette smoking; second-hand smoke; excess body weight; alcohol consumption; consumption of red and processed meat; low consumption of fruits and vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and seven carcinogenic infections. Numbers of cancer cases and deaths were obtained from data sources with complete national coverage, risk factor prevalence estimates from nationally representative surveys, and associated relative risks of cancer from published large-scale pooled or meta-analyses. In 2019, an estimated 40.0% (713,340 of 1,781,649) of all incident cancers (excluding nonmelanoma skin cancers) and 44.0% (262,120 of 595,737) of all cancer deaths in adults aged 30 years and older in the United States were attributable to the evaluated risk factors. Cigarette smoking was the leading risk factor contributing to cancer cases and deaths overall (19.3% and 28.5%, respectively), followed by excess body weight (7.6% and 7.3%, respectively), and alcohol consumption (5.4% and 4.1%, respectively). For 19 of 30 evaluated cancer types, more than one half of the cancer cases and deaths were attributable to the potentially modifiable risk factors considered in this study. Lung cancer had the highest number of cancer cases (201,660) and deaths (122,740) attributable to evaluated risk factors, followed by female breast cancer (83,840 cases), skin melanoma (82,710), and colorectal cancer (78,440) for attributable cases and by colorectal (25,800 deaths), liver (14,720), and esophageal (13,600) cancer for attributable deaths. Large numbers of cancer cases and deaths in the United States are attributable to potentially modifiable risk factors, underscoring the potential to substantially reduce the cancer burden through broad and equitable implementation of preventive initiatives.
摘要：
2018年，作者报告了2014年美国潜在可改变的危险因素导致的癌症数量和比例的估计。这些数据对于倡导和告知癌症预防和控制是有用的。在这里，根据最新的相对风险和癌症发生数据，作者估计了侵袭性癌症病例（不包括非黑色素瘤皮肤癌）和死亡的比例和数量，2019年美国30岁及以上成年人的总体和30种癌症类型，这归因于潜在的可改变的风险因素。其中包括吸烟;二手烟;体重超标;饮酒;食用红肉和加工肉类;水果和蔬菜的低消费,膳食纤维，和膳食钙；缺乏运动；紫外线辐射；和七种致癌感染。癌症病例和死亡人数来自全国完全覆盖的数据来源，来自全国代表性调查的风险因素患病率估计，以及已发表的大规模汇总或荟萃分析的相关癌症相对风险。2019年，在美国30岁及以上的成年人中，估计有40.0％（713340/1,781,649）的所有癌症（不包括非黑色素瘤皮肤癌）和44.0％（262,120/595,737）的所有癌症死亡归因于评估的风险因素。吸烟是导致癌症病例和死亡的主要危险因素（19.3%和28.5%，分别)，其次是超重(7.6%和7.3%，分别)，和酒精消费量(5.4%和4.1%，分别)。对于30种评估的癌症类型中的19种，超过一半的癌症病例和死亡归因于本研究中考虑的潜在可改变的危险因素.由于评估的危险因素，肺癌的癌症病例数（201,660）和死亡人数（122,740）最高。其次是女性乳腺癌（83,840例），皮肤黑色素瘤（82,710），和结直肠癌(78,440)的归因病例和结直肠癌(25,800例死亡)，肝脏（14,720），和食管癌（13,600）为可归因死亡。在美国，大量的癌症病例和死亡可归因于潜在的可改变的危险因素。强调通过广泛和公平地实施预防举措来大幅减轻癌症负担的潜力。
