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dc.contributor.authorArriaga, ME
dc.contributor.authorVajdic, CM
dc.contributor.authorCanfell, K
dc.contributor.authorMacInnis, R
dc.contributor.authorHull, P
dc.contributor.authorMagliano, DJ
dc.contributor.authorBanks, E
dc.contributor.authorGiles, GG
dc.contributor.authorCumming, RG
dc.contributor.authorByles, JE
dc.contributor.authorTaylor, AW
dc.contributor.authorShaw, JE
dc.contributor.authorPrice, K
dc.contributor.authorHirani, V
dc.contributor.authorMitchell, P
dc.contributor.authorAdelstein, B-A
dc.contributor.authorLaaksonen, MA
dc.date.accessioned2021-02-04T01:40:53Z
dc.date.available2021-02-04T01:40:53Z
dc.date.issued2017-06-01
dc.identifierpii: bmjopen-2017-016178
dc.identifier.citationArriaga, M. E., Vajdic, C. M., Canfell, K., MacInnis, R., Hull, P., Magliano, D. J., Banks, E., Giles, G. G., Cumming, R. G., Byles, J. E., Taylor, A. W., Shaw, J. E., Price, K., Hirani, V., Mitchell, P., Adelstein, B. -A. & Laaksonen, M. A. (2017). The burden of cancer attributable to modifiable risk factors: the Australian cancer-PAF cohort consortium. BMJ OPEN, 7 (6), https://doi.org/10.1136/bmjopen-2017-016178.
dc.identifier.issn2044-6055
dc.identifier.urihttp://hdl.handle.net/11343/259442
dc.description.abstractPURPOSE: To estimate the Australian cancer burden attributable to lifestyle-related risk factors and their combinations using a novel population attributable fraction (PAF) method that accounts for competing risk of death, risk factor interdependence and statistical uncertainty. PARTICIPANTS: 365 173 adults from seven Australian cohort studies. We linked pooled harmonised individual participant cohort data with population-based cancer and death registries to estimate exposure-cancer and exposure-death associations. Current Australian exposure prevalence was estimated from representative external sources. To illustrate the utility of the new PAF method, we calculated fractions of cancers causally related to body fatness or both tobacco and alcohol consumption avoidable in the next 10 years by risk factor modifications, comparing them with fractions produced by traditional PAF methods. FINDINGS TO DATE: Over 10 years of follow-up, we observed 27 483 incident cancers and 22 078 deaths. Of cancers related to body fatness (n=9258), 13% (95% CI 11% to 16%) could be avoided if those currently overweight or obese had body mass index of 18.5-24.9 kg/m2. Of cancers causally related to both tobacco and alcohol (n=4283), current or former smoking explains 13% (11% to 16%) and consuming more than two alcoholic drinks per day explains 6% (5% to 8%). The two factors combined explain 16% (13% to 19%): 26% (21% to 30%) in men and 8% (4% to 11%) in women. Corresponding estimates using the traditional PAF method were 20%, 31% and 10%. Our PAF estimates translate to 74 000 avoidable body fatness-related cancers and 40 000 avoidable tobacco- and alcohol-related cancers in Australia over the next 10 years (2017-2026). Traditional PAF methods not accounting for competing risk of death and interdependence of risk factors may overestimate PAFs and avoidable cancers. FUTURE PLANS: We will rank the most important causal factors and their combinations for a spectrum of cancers and inform cancer control activities.
dc.languageEnglish
dc.publisherBMJ PUBLISHING GROUP
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0
dc.titleThe burden of cancer attributable to modifiable risk factors: the Australian cancer-PAF cohort consortium
dc.typeJournal Article
dc.identifier.doi10.1136/bmjopen-2017-016178
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleBMJ Open
melbourne.source.volume7
melbourne.source.issue6
dc.rights.licenseCC BY-NC
melbourne.elementsid1215019
melbourne.contributor.authorMacInnis, Robert
melbourne.contributor.authorMagliano, Dianna
melbourne.contributor.authorGiles, Graham
dc.identifier.eissn2044-6055
melbourne.accessrightsOpen Access


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