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Annals of Oncology Advance Access originally published online on September 2, 2008
Annals of Oncology 2009 20(3):550-555; doi:10.1093/annonc/mdn597
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

epidemiology

The causes of cancer in France

P. Boffetta1,*, M. Tubiana2,3, C. Hill2,4, M. Boniol1, A. Aurengo5,6,7, R. Masse7, A.-J. Valleron3,5,8,9, R. Monier2,3, G. de Thé7,10, P. Boyle1 and P. Autier1

1 International Agency for Research on Cancer, Lyon
2 Institut Gustave Roussy, Villejuif
3 The Academy of Sciences of the Institute of France
4 Fédération Nationale des Centres de Lutte contre le Cancer
5 Pierre & Marie Curie University
6 Pitié-Salpêtrière Hospital, Assistance Publique de Paris
7 The Academy of Medicine
8 National Institute for Health and Medical Research
9 Saint Antoine Hospital, Assistance Publique de Paris
10 The Institut Pasteur, Paris, France

* Correspondence to: P. Boffetta MD, Genetics and Epidemiology Cluster, International Agency for Research on Cancer, 150 cours Albert Thomas, 69008 Lyon, France. Tel: +33-472738554; Fax: +33-472738320; E-mail: boffetta{at}iarc.fr

Background: While external factors are responsible for many human cancers, precise estimates of the contribution of known carcinogens to the cancer burden in a given population have been scarce.

Methods: We estimated the proportion of cancer deaths which occurred in France in 2000 attributable to known risk factors, based on data on frequency of exposure around 1985.

Results: In 2000, tobacco smoking was responsible for 23.9% of cancer deaths (33.4% in men and 9.6% in women), alcohol drinking for 6.9% (9.4% in men and 3.0% in women) and chronic infections for 3.7%. Occupation is responsible for 3.7% of cancer deaths in men; lack of physical activity, overweight/obesity and use of exogenous hormones are responsible for 2%–3% of cancer deaths in women. Other risk factors, including pollutants, are responsible for <1% of cancer deaths. Thus, known risk factors explain 35.0% of cancer deaths, and 15.0% among never smokers.

Conclusions: While cancer mortality is decreasing in France, known risk factors of cancer explain only a minority of cancers, with a predominant role of tobacco smoking.

Key words: alcohol, epidemiology, lifestyle factors, smoking

Received for publication June 19, 2008. Accepted for publication July 30, 2008.


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