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Int J Cancer. 2018 Sep 1;143(5):1128-1133. doi: 10.1002/ijc.31406. Epub 2018 Apr 16.

Smoking, alcohol and cancer mortality in Eastern European men: Findings from the PrivMort retrospective cohort study.

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Department of Epidemiology and Public Health, University College London, London, United Kingdom.
Department of Sociology, University of Cambridge, Cambridge, United Kingdom.
Department of Social Policy, London School of Economics, London, United Kingdom.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Department of Economics, University of Massachusetts, Amherst, MA, United States.


Eastern European men have among the highest cancer mortality rates globally. Prevalence of smoking and alcohol intake in this region is also high. The aim of our study was to calculate population attributable risk fraction (PARF) of cancer deaths from smoking and alcohol in Russia, Belarus and Hungary, and to examine the contribution of these lifestyle factors to differences in male cancer mortality in the three countries. Data were collected as part of the PrivMort retrospective cohort study. Randomly selected participants living in mid-size towns in Russia, Belarus and Hungary provided information on smoking habits, alcohol consumption, vital status and cause of death (if applicable) of male relatives (fathers, siblings and partners). PARF of cancer deaths (age 35-79) due to smoking, alcohol consumption and both combined was estimated between 2001 and 2013. Among 72,190 men, 4,702 died of cancer. Age standardized cancer mortality rates were similar to official data in all three countries. The estimated PARF (95% CI) associated with measures of smoking, alcohol consumption, both combined, and overall smoking or drinking were 25% (19-30), 2% (0-4), 29% (19-39), 43% (32-53) in Russia, 18% (8-28), 2% (-1 to 6), 28% (20-35), 38% (25-50) in Belarus and 17% (13-20), 1% (0-3), 25% (20-30), 35% (28-42) in Hungary, respectively. These results suggest that in Eastern Europe, at least one third of cancer deaths in males may have been attributable to smoking and/or alcohol consumption in recent years. Health policies targeting these lifestyle factors can have a major impact on population health.


Eastern Europe; alcohol consumption; cancer; mortality rate; smoking

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