Interview
Article
Study Estimates
One Third Of Cancer Cases In Canada Can Be Prevented By Tackling 20
Preventable Risk Factors
“Collaborative
Action Oriented Research” Carried Out To Help Guarantee Use Of The
Data
A multidisciplinary
team of Canadian epidemiologists and other public health professionals
have examined the proportion of cancer diagnosed in 2015 in Canada
attributable to lifestyle and environmental factors, and infections.
In this study called The Canadian Population Attributable Risk of
Cancer (ComPARe) study funded by the Canadian Cancer Society (CCS),
investigators found that between 33 and 37% (up to 70,000 cases) of
incident cancer cases among adults aged 30 years
and over in 2015 were attributable to preventable risk factors.
Tobacco smoking and a lack of physical activity were associated with
the highest proportions of cancer cases. Cancers with the highest
number of preventable cases were lung (20,100), colorectal (9800) and
female breast (5300) cancer.
In order to learn more
about the findings, and their potential use to prevent disease, we
questioned Leah Smith,
Senior Manager, Surveillance at the Canadian Cancer Society. As a
co-investigator on the ComPARe study, she took a lead role in the
knowledge translation and dissemination of the study findings. She
holds an MSc and PhD in epidemiology.
Following are her
responses which have been edited slightly for this interview article.
Co-Investigator
Interview
Epi Monitor:
In looking over the results, it seems that tobacco is the largest
preventable cause of cancer by far. Have you proposed any kind of
prioritization for tackling the preventable causes of cancer?
Smith:
Smoking tobacco is by far the leading cause of preventable cancer. It
accounts for almost half of the preventable cancer cases in Canada in
2015. There are still 5 million Canadians who smoke, representing 16%
of the population (2017), and an unacceptably high number of youth who
begin smoking every month. An enormous amount of work needs to be
done. Tobacco control measures to implement include plain packaging,
higher tobacco taxes, smoke-free places, minimum age 21, e-cigarette
regulation and increased government funding for cessation and
other tobacco control programs.
Earlier in May 2019,
CCS applauded Canada’s global leadership with the adoption of new
national regulations for tobacco plain packaging. These regulations
are the most effective tobacco plain packaging requirements in the
world.
Epi Monitor:
Were there any surprises among the preventable factors in terms of
their relative importance or lack thereof?
Smith:
One of the interesting findings is that excess weight is expected to
become the second leading preventable cause of cancer in Canada,
following tobacco. Between 2015 and 2042, the number of new cancer
cases due to excess weight is expected to nearly triple, increasing
from 7,200 to 21,200.
We also learned that
about 4 in 10 cancer cases can be prevented through healthy living and
policies that protect the health of Canadians. Currently, the top 5
leading preventable causes of cancer are smoking tobacco, followed by
physical inactivity, excess weight, low fruit consumption and sun
exposure.
Epi Monitor:
How do the percentages for risk factors in Canada differ from those in
the US or other European countries where these preventable factors
have been examined. Any big differences between countries that you are
aware of?
Smith:
Recent studies from the US and UK show that tobacco is also the
leading cause of preventable cancer in those countries. In the US and
UK, however, excess weight is already the second leading cause, and in
the US, it is expected to overtake tobacco as the leading preventable
cause. This is not the case in Canada and the UK, which both have much
lower rates of excess weight than the US.
Epi Monitor:
Ignoring impact or percentage of preventable cancer, which preventable
factor do you believe would be the easiest factor to reduce? Has it
been discussed in your work that getting an early win or an easy win
against cancer would be worth doing?
Smith:
There are many things Canadians can do to reduce their risk of
cancer. For example, thanks to HPV vaccination and cervical cancer
screening, we now have the tools we need to virtually eliminate
cervical cancer. This is an exciting possibility. The Canadian Cancer
Society is currently evaluating the ComPARe study results and it will
influence our policy and program activities moving forward.
Epi Monitor:
Do you think that lack of information about these factors is what has
truly hindered making progress or creating targeted programs?
Smith:
Results from this study have provided us with insight into where we
can make the biggest impact on reducing the future burden of cancer.
The results from the ComPARe study will guide further research, inform
program development, influence behavior and assist in advocacy for new
policies and programs aimed at decreasing the burden of cancer in
Canada.
Epi Monitor:
What action plans are expected to be developed following publication
of these results? Are you and the other researchers affiliated or tied
to any group that is capable of taking action to reduce the factors?
Who has been or is listening to these results in your opinion?
Smith:
The ComPARe study
results are for anyone interested in cancer prevention. Cancer
researchers can use this information to support their work. Healthcare
providers can use it to educate their patients. Healthcare
decision-makers can use it to determine which programs and services to
prioritize. And individuals can use it to understand what they can do
to reduce cancer risk.
This study has been
developed with the Canadian Cancer Society (CCS), and the information
generated will be widely disseminated within CCS and to other key
stakeholders in the cancer and chronic diseases communities.
An integrated knowledge translation strategy was developed to support
immediate and ongoing uptake of the study findings. The Canadian
Cancer Society is currently evaluating the ComPARe study results and
determining how it will influence our policy and program
activities moving forward.
Epi Monitor:
How did this study come about? Was there a specific trigger?
Smith:
The ComPARe study
was made possible through funding from a CCS-Partner Prevention
Research Grant of almost $800,000 over 5 years. This
study was developed in partnership with CCS, and the information
generated will be widely disseminated within CCS and to other key
stakeholders in the cancer and chronic diseases communities.
Epi Monitor:
Is there a paper in your series that gives an overview of the project
and its results?
Smith:
The articles appear in Preventive
Medicine,
Volume 122 (May 2019) published by Elsevier. All articles in this
Special Issue are openly available at:
https://bit.ly/2WdZvHJ
There is a summary paper that gives an overview of the project and its
results:
https://bit.ly/2WBOvRk
Other useful
sources of information are listed below
·
Website: https://prevent.cancer.ca/
·
Canadian
Cancer Society press release: https://bit.ly/2Hvnh8Q
·
Twitter: #ComPAReStudy
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