The Fraction Of Cancers Attributable To Tobacco In Wales, In 2013

Dyfed HUWS, Health Intelligence, Public Health Wales, United Kingdom
DUNLOP C. 2 , BROWN K. 2 , ORMISTON-SMITH N. 2 , WHITE C. 1

1 Welsh Cancer Intelligence and Surveillance Unit
2 Cancer Research UK

Purpose:
In 2011, a landmark study estimated that 42.7% of all cancers each year were attributable to lifestyle and environmental factors in the UK (Parkin et al. 2011). This information has been an important component in influencing public health decisions. However, there is a wide variation in exposure prevalence between UK-constituent countries. In addition, the cancer epidemiology evidence-base is constantly changing – new aetiological effect sizes have emerged, or become more robust, since 2010.
New calculations are required to establish UK country-specific estimates to inform local public health decisions, and incorporate the most up-to-date risk factor evidence.

Methods:
The proportion of cancers attributable to tobacco in Wales was calculated. Cancer types with sufficient evidence in humans for smoking, voluntary and involuntary, as judged by the International Agency for Research on Cancer (IARC) were used.
Smoking exposure data was obtained from 2002 to estimate attributable cancers in 2012 – for current smokers, cohabitation with a smoker and workplace exposure. Systematic reviews were conducted to identify the highest-quality evidence available for tobacco aetiological effect sizes.

Results:
We expect there will be some differences in the proportion of cancers caused by tobacco in Wales compared to the UK; these differences will be explored for multiple cancer types. Research is ongoing at Cancer Research UK to establish estimates for further lifestyle and environmental factors in Wales.

Conclusions:
By using country-specific exposure prevalence, and the latest risk factor estimates, local estimates of the proportion of cancers caused by lifestyle and environmental factors can be derived. These specific estimates will provide valuable information for health organisations in how to tailor public health interventions, and help predict areas for greatest impact.