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Wolfson Institute of Population Health

Effect of four risk factors on years of life lost to cancer

The impact of alcohol consumption, smoking, excess body weight, and human papillomavirus (HPV) infection on cancer mortality and years of life lost (YLLs) are calculated across seven countries in new study. Researchers found that in 2020 in the UK, US, Brazil, Russia, India, China and South Africa, YLLs attributable to these preventable risk factors were 5.9 million for alcohol, 20.8 million for smoking, 3.1 million to excess body weight, and 4 million to HPV.


The seven countries together have a population of over 3.5 billion people, and represent more than half of the global burden of cancer deaths each year. Smoking tobacco was by far the biggest driver of preventable cancer deaths, causing 1.3 million deaths (over two-thirds of preventable cancer deaths).

Risk factors were associated with different cancer types in different countries. In India, more premature deaths were due to head and neck cancer in men, and gynaecological cancer in women, but in every other country, tobacco caused the most YLLs to lung cancer. Researchers suggest this is due to between-country differences. Less comprehensive cervical screening in India and South Africa could account for more premature deaths to gynaecological cancers, due to HPV infection in these 2 countries, than in the UK and US. The higher YLLs to head and neck cancer in men in India could be due to the general population smoking different tobacco products and using chewing tobacco in addition to smoking tobacco.

Co-authors Judith Offman and Peter Sasieni say that their findings show the importance of cancer control efforts to reduce the burden of cancer deaths and YLLs due to modifiable cancer risk factors, and promote the use of YLLs to summarise disease burden.


Harriet Rumgay, Citadel J. Cabasag, Judith Offman, Marianna de Camargo Cancela, Anton Barchuk, Prashant Mathur, Shaoming Wang, Wenqiang Wei, Peter Sasieni, Isabelle Soerjomataram. International burden of cancer deaths and years of life lost from cancer attributable to four major risk factors: a population-based study in Brazil, Russia, India, China, South Africa, the United Kingdom, and United States. eClinicalMedicine, 2023, 102289, ISSN 2589-5370,




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