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2021/12/25
上周，美國癌症學會（ACS）發布的一項最新報告顯示，有超過一半的男性癌症死亡與超過1/3的女性癌症死亡都源於各種可以避免的因素：吸煙、飲酒、飲食、體重管理、運動和感染。並且總結道，通過避免這些不利因素，可以有效地降低癌症帶來的負擔。
在，癌症是導致死亡的主要原因之一。每年約有4300萬人被診斷為癌症，有2800萬人死於癌症。而在未來十年間，受人口老齡化和現代生活方式的影響，這一數字還會繼續增長。
為了深入調查導致癌症死亡的原因，來自美國癌症學會的多機構研究團隊，加上美國國家癌症中心、醫學科學院和北京協和醫學院、悉尼大學、倫敦帝國學院等多個著名研究機構的科學家，共同分析了2013年全國代表性調查和癌症登記的數據，估算了由於一些可避免的因素而導致的癌症死亡的人數和比例。這些可避免的因素包括：吸煙、二手煙、飲酒、水果蔬菜攝入不足、體重超重、不運動和感染。
結果發現，有47%的男性癌症發病和28%的女性癌症發病死亡都要歸因於這些可避免的風險因素；而在癌症死亡人群中，有52%的男性死亡和35%的女性死亡是由這些可控因素引起。如果不分性別統計的話，有39%的癌症發病或接近一半的癌症死亡或都要歸因於這些可以避免的因素。
具體到每一種可控因素，導致男性死亡的主要因素是吸煙，佔到26%；其次是乙肝病毒感染，佔12%；然後是蔬果攝入不足，佔7%。在女性中，導致死亡的主因是乙肝病毒感染，佔7%；然後是蔬果攝入不足和吸入二手煙，分別佔6%和5%。
對於這一結果，主要研究者Farhad Islami博士說：「我們的分析還是低估了可變因素導致的癌症數量，因為我們無法包括所有的潛在可變風險因素，特別是使用煤炭進行烹飪和取暖導致的室內空氣污染，這是導致女性肺癌的主要風險因素。」
最後研究者呼籲，應該廣泛實施已知可行的干預措施，比如針對吸煙、二手煙和感染的公共政策，同時制定新的策略避免過度飲酒、體重超標和鍛煉不足。
從個人角度來講，這份報告也給予我們提示。雖然有很多不可控因素（衰老、遺傳）會促發癌症，但我們應該更多地關注在那些可控因素上。這份報告也給我們更多的理由和信心，來改善生活習慣，對抗癌症。（葯明康德/報道，整理自「e葯環球」）
Nearly half of China cancer deaths attributable to potentially modifiable risk factors
Date:
July 6, 2017
Source:
American Cancer Society
Summary:
More than half of all cancer deaths in men in 2013 in China and more than a third of those in women were attributable to a group of potentially modifiable risk factors.
A new report finds more than half of all cancer deaths in men in 2013 in China and more than a third of those in women were attributable to a group of potentially modifiable risk factors: smoking, alcohol, nutrition, weight, physical activity, and infections. The study appears in Annals of Oncology, and concludes that effective public health interventions to eliminate or reduce exposure from these risk factors can have considerable impact on reducing the cancer burden in China.
Cancer is the leading cause of death in China, with 4.3 million new cancer cases and 2.8 million cancer deaths estimated to occur each year. That burden is expected to increase in the coming decades because of aging of the population as well as changes in lifestyle that increase cancer risk, such as excessive calorie intake and physical inactivity.
To investigate further, a multi-agency team of researchers led by Farhad Islami, M.D., Ph.D. of the American Cancer Society estimated the number and proportion of cancer deaths and cases attributable to ever-smoking, second-hand smoking, alcohol drinking, low fruit/vegetable intake, excess body weight, physical inactivity, and infections in China, using contemporary data from nationally representative surveys and cancer registries. Other investigators were from the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Cancer Council NSW, Sydney, Australia, the University of Sydney, Emory University, and Imperial College London.
They found 717,910 (52%) cancer deaths in men and 283,130 (35%) in women in 2013 in China were attributable to the risk factors considered in the analysis. The corresponding numbers for cancer cases were 952,520 (47%) in men and 442,650 (28%) in women. Among both sexes combined, nearly one million (approximately 996,000) or almost half of all cancer deaths and 1,388,800, or 39% of all cancer cases in China in 2013 were attributable to the studied risk factors.
"Our analysis likely underestimates the number of cancers attributable to modifiable risk factors because we were not able to include all potentially modifiable risk factors, notably indoor air pollution from using coal for cooking and heating, which is a major risk factor for lung cancer in women in China," said Dr. Islami.
By risk factor, the greatest attributable proportions of cancer deaths in men were for ever-smoking (26%), hepatitis B (HBV) infection (12%), and low fruit/vegetable intake (7%). In women, HBV infection (7%), low fruit/vegetable intake (6%), and second-hand smoke exposure (5%) were the largest contributors.
They conclude: "Our findings reinforce the need for broad implementation of known interventions and the development of new strategies to reduce exposures to established (smoking and carcinogenic infections) and emerging (alcohol drinking, excess body weight, and physical inactivity) risk factors in the country."
Story Source:
Materials provided by American Cancer Society. Note: Content may be edited for style and length.
Journal Reference:
F. Islami, W. Chen, X. Q. Yu, J. Lortet-Tieulent, R. Zheng, W. D. Flanders, C. Xia, M. J. Thun, S. M. Gapstur, M. Ezzati, A. Jemal. Cancer deaths and cases attributable to lifestyle factors and infections in China, 2013. Annals of Oncology, 2017; DOI: 10.1093/annonc/mdx342
（英文部分來自sciencedaily.com）
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