Global cancer incidence and mortality caused by behavior and infection

J Public Health (Oxf). 2011 Jun;33(2):223-33. doi: 10.1093/pubmed/fdq076. Epub 2010 Oct 8.


Objective: The objective is to systematically estimate the current cancer incidence and mortality from the six leading cancer types globally and by sub-regions resulting from exposure to known risk factors such as tobacco use, elevated body weight, alcohol consumption, inadequate physical activity, unhealthy diet and infections.

Methods: Cancer incidence, mortality and burden of disease caused by the main cancer risk factors were calculated using comparative risk assessment methods and updated data on mortality and risks.

Results: Lung cancer was the most common cancer in men and breast cancer the most common cancer in women, both in terms of incidence and mortality. The five leading behavioral and dietary risks--high body mass index, low fruit and vegetable intake, physical inactivity, tobacco use and alcohol use--were responsible for 24% of new cancer cases and 30% of cancer deaths. Cancers with the largest proportions attributable to preventable risk factors were cervical cancer (100%) and lung cancer (71%). Seventy percent of liver cancers and 60% of stomach cancers were due to infectious agents. A higher proportion of cancer deaths was attributed to infections in low- and middle-income than in high-income countries.

Conclusions: The cancer burden is driven by changes in exposure to influential risk factors and can be influenced by preventive interventions aimed at reducing these exposures.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Diet / adverse effects
  • Female
  • Health Behavior
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / etiology*
  • Neoplasms / mortality*
  • Neoplasms / virology
  • Overweight / complications
  • Registries
  • Risk Assessment
  • Risk Factors
  • Sex Distribution
  • Smoking / adverse effects
  • Virus Diseases / complications
  • World Health Organization
  • Young Adult