Global and regional cancer burden attributable to modifiable risk factors to inform prevention

Abstract

Cancer remains a leading cause of morbidity globally, largely attributable to modifiable risks. We estimated the 2022 global and national cancer burden attributable to 30 such factors, including tobacco smoking, alcohol consumption, high body mass index, insufficient physical activity, smokeless tobacco and areca nut, suboptimal breastfeeding, air pollution, ultraviolet radiation, 9 infectious agents and 13 occupational exposures, to inform prevention efforts. Using GLOBOCAN data for 36 cancer sites in 185 countries, we applied prevalence data from around 2012 to reflect exposure-cancer latency and estimated Levin-based or Miettinen-based population-attributable fractions (PAFs) or direct estimates where applicable. Combined PAFs accounting for overlapping exposures were derived by cancer, sex, country and region. In 2022, an estimated 7.1 million of 18.7 million new cancer cases (37.8%) were attributable to 30 modifiable risk factors-2.7 million (29.7%) in women and 4.3 million (45.4%) in men. The proportion of preventable cancers ranged from 24.6% to 38.2% in women and from 28.1% to 57.2% in men across regions. Smoking (15.1%), infections (10.2%) and alcohol consumption (3.2%) were the leading contributors to cancer burden. Lung, stomach and cervical cancers represented nearly half of preventable cancers. Strengthening efforts to reduce modifiable exposures remains central to global cancer prevention.