Format

Send to

Choose Destination
Int J Epidemiol. 2018 Dec 1;47(6):1772-1783. doi: 10.1093/ije/dyy136.

The future burden of lung cancer attributable to current modifiable behaviours: a pooled study of seven Australian cohorts.

Author information

1
Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia.
2
Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia.
3
School of Public Health, University of Sydney, Sydney, NSW, Australia.
4
Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.
5
Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.
6
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
7
ANU College of Medicine, Biology and Environment, Australian National University, Canberra, ACT, Australia.
8
Diabetes and Population Health Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
9
ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia.
10
Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW, Australia.
11
Centre for Vision Research, Westmead Institute for Medical research, University of Sydney, Sydney, NSW, Australia.
12
Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
13
School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
14
Lung Foundation Australia, Milton, QLD, Australia.
15
Clinical Diabetes Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.

Abstract

Background:

Knowledge of preventable disease and differences in disease burden can inform public health action to improve health and health equity. We quantified the future lung cancer burden preventable by behavioural modifications across Australia.

Methods:

We pooled seven Australian cohort studies (n = 367 058) and linked them to national registries to identify lung cancers and deaths. We estimated population attributable fractions and their 95% confidence intervals (CIs) for modifiable risk factors, using risk estimates from the cohort data and risk factor exposure distribution from contemporary national health surveys.

Results:

During the first 10-year follow-up, there were 2025 incident lung cancers and 20 349 deaths. Stopping current smoking could prevent 53.7% (95% CI, 50.0-57.2%) of lung cancers over 40 years and 18.3% (11.0-25.1%) in 10 years. The smoking-attributable burden is highest in males, those who smoke <20 cigarettes per day, are <75 years of age, unmarried, of lower educational attainment, live in remote areas or are healthy weight. Increasing physical activity and fruit consumption, if causal, could prevent 15.6% (6.9-23.4%) and 7.5% (1.3-13.3%) of the lung cancer burden, respectively. Jointly, the three behaviour modifications could prevent up to 63.0% (58.0-67.5%) of lung cancers in 40 years, and 31.2% (20.9-40.1%) or 43 300 cancers in 10 years. The preventable burden is highest among those with multiple risk factors.

Conclusions:

Smoking remains responsible for the highest burden of lung cancer in Australia. The uneven burden distribution distinguishes subgroups that could benefit the most from activities to control the world's deadliest cancer.

PMID:
29982519
DOI:
10.1093/ije/dyy136

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center