Cancer preventability estimates for diet, nutrition, body fatness, and physical activity

Updated estimates of cancer preventability (PAF%) by appropriate diet, nutrition, physical activity, and body fatness in four countries.

Cancer site USA UK BRAZIL CHINA
Mouth, pharynx, larynx
Non-starchy vegetables 34 34 37 12
Fruits 23 17 29 30
Alcoholic drinks 27 41 17 10
Totals 63 67 63 44
Oesophagus(1)
Mate (squamous cell carcinoma) n/a n/a < 1 n/a
Alcoholic drinks (squamous cell carcinoma) 37 48 21 15
Body fatness (adenocarcinoma) 35 31 23 17
Totals 33 34 25 20
Lung
Fruits 36 33 36 38
Stomach(2)
Alcohol 3 4 1 < 1
Processed meat (non-cardia) 7 8 2 < 1
Body fatness (cardia) 22 19 14 10
Totals 15 17 6 4
Pancreas(3)
Body fatness 19 15 11 8
Gallbladder(4)
Body fatness 22 17 11 6
Liver(5)
Alcoholic drinks 3 3 1 1
Body fatness 28 20 12 6
Totals 30 23 13 7
Colorectum(6)
Foods containing fibre 11 12 11 n/a
Red meat 5 5 7 7
Processed meat 12 10 5 1
Alcoholic drinks 5 7 2 1
Physical activity (colon) 15 12 15 7
Body fatness 16 14 10 8
Totals 47 45 41 22
Breast(4)
Alcoholic drinks 11 22 6 1
Physical activity (postmenopausal) 17 12 11 8
Body fatness (postmenopausal) 17 16 14 12
Totals 33 38 22 11
Ovary(7)
Body fatness 5 4 3 1
Endometrium(8)
Physical activity 18 10 11 5
Body fatness 50 38 29 17
Totals 59 44 37 21
Prostate (advanced)(9)
Body fatness 11 9 5 4
Kidney(4)
Body fatness 24 19 13 8
Total for these cancers combined 29 29 22 19
Total for all cancers 20 22 15 15

n/a Data were not available
(1) CUP - Revised estimate for alcohol using Steevens et al. Gut 2010 Jan; 59(1): 39-48.
(2) CUP - New conclusions for alcohol; using Duell et al. Am J Clin Nutr 2011; 94:1226-75. New conclusion for processed meat (non-cardia); using Kesezi et al. Annals of Oncology 2012; 23: 2319-2326. New conclusions for body fatness (cardia); using Linblad et al. Cancer causes and control 2005; 16: 285-294
(3) CUP - Revised estimate for body fatness using Genkinger et al. Int J Cancer 2011; 129: 1708-17.
(4) No revisions required based on CUP gallbladder, breast or kidney cancer reports
(5) CUP - New conclusion for body fatness using Calle et al. N Engl J Med 2003; 348: 1625-38 and revised estimates for alcohol, estimate uses from Yang et al. Int J Epidemiol 2012; 41:1101-13.
(6) CUP - Revised estimate for body fatness using Adams et al. Am J Epidemiol 2007; 166: 36-45.
(7) CUP - New conclusion for body fatness; using Reeves et al. BMJ 2007; 335: 1134.
(8) CUP - Revised estimates for physical activity using Patel et al. Int J Cancer 2008; 123: 1877-82 and body fatness using Park et al. Int J Cancer 2010; 126: 490-9.
(9) CUP - New conclusion for body fatness for advanced prostate cancer; using Rodriguez et al. Cancer Epidemiol Biomarkers Prev 2001; 10: 345-53.

The table shows estimates for each cancer for the four countries. Totals are given for the 13 cancers (common cancers) studied as well as for all cancers.

The estimate for all cancers assumes that cancers not listed in the tables are not related to cancer risk.

For the 13 common cancers about 29 per cent of cases in the USA are preventable through a healthy diet, being physically active and maintaining a healthy weight. The estimates for the other countries are 29 per cent for the UK, 22 per cent for Brazil and 19 per cent for China.

Using numbers of new cases of cancer diagnosed annually from GLOBOCAN 2012 this translates to about 320,000 preventable cases of cancer in the USA, about 72,000 for the UK, 66,000 for Brazil and about 460,000 for China.

The updated figures confirm that about a third of the most common cancers in higher-income countries and about a quarter in lower-income countries could be prevented through eating healthily, being physically active and maintaining a healthy weight.

Limitations

These figures are estimates and not precise values. They may be underestimates as only cancers with evidence judged to be convincing or probable by the Continuous Update Project or Second Expert Report Panels are included.