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The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019
Open accessAbstract
BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. FUNDING: Bill & Melinda Gates Foundation.
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- Tran, K. B., Lang, J. J., Compton, K., Xu, R., Acheson, A. R., Henrikson, H. J., Kocarnik, J. M., Penberthy, L., Aali, A., Abbas, Q., Abbasi, B., Abbasi-Kangevari, M., Abbasi-Kangevari, Z., Abbastabar, H., Abdelmasseh, M., Abd-Elsalam, S., Abdelwahab, A. A., Abdoli, G., Abdulkadir, H. A., Abedi, A., Abegaz, K. H., Abidi, H., Aboagye, R. G., Abolhassani, H., Absalan, A., Abtew, Y. D., Abubaker Ali, H., Abu-Gharbieh, E., Achappa, B., Acuna, J. M., Addison, D., Addo, I. Y., Adegboye, O. A., Adesina, M. A., Adnan, M., Adnani, Q. E. S., Advani, S. M., Afrin, S., Afzal, M. S., Aggarwal, M., Ahinkorah, B. O., Ahmad, A. R., Ahmad, R., Ahmad, S., Ahmad, S., Ahmadi, S., Ahmed, H., Ahmed, L. A., Ahmed, M. B., Ahmed Rashid, T., Aiman, W., Ajami, M., Akalu, G. T., Akbarzadeh-Khiavi, M., Aklilu, A., Akonde, M., Akunna, C. J., Al Hamad, H., Alahdab, F., Alanezi, F. M., Alanzi, T. M., Alessy, S. A., Algammal, A. M., Al-Hanawi, M. K., Alhassan, R. K., Ali, B. A., Ali, L., Ali, S. S., Alimohamadi, Y., Alipour, V., Aljunid, S. M., Alkhayyat, M., Al-Maweri, S. A. A., Almustanyir, S., Alonso, N., Alqalyoobi, S., Al-Raddadi, R. M., Al-Rifai, R. H. H., Al-Sabah, S. K., Al-Tammemi, A. B., Altawalah, H., Alvis-Guzman, N., Amare, F., Ameyaw, E. K., Aminian Dehkordi, J. J., Amirzade-Iranaq, M. H., Amu, H., Amusa, G. A., Ancuceanu, R., Anderson, J. A., Animut, Y. A., Anoushiravani, A., Anoushirvani, A. A., Ansari-Moghaddam, A., Ansha, M. G., Antony, B., Antwi, M. H., Anwar, S. L., Anwer, R., Anyasodor, A. E., Arabloo, J., Arab-Zozani, M., Aremu, O., Argaw, A. M., Ariffin, H., Aripov, T., Arshad, M., Artaman, A., Arulappan, J., Aruleba, R. T., Aryannejad, A., Asaad, M., Asemahagn, M. A., Asemi, Z., Asghari-Jafarabadi, M., Ashraf, T., Assadi, R., Athar, M., Athari, S. S., Atout, M. M. W., Attia, S., Aujayeb, A., Ausloos, M., Avila-Burgos, L., Awedew, A. F., Awoke, M. A., Awoke, T., Ayala Quintanilla, B. P., Ayana, T. M., Ayen, S. S., Azadi, D., Azadnajafabad, S., Azami-Aghdash, S., Azanaw, M. M., Azangou-Khyavy, M., Azari Jafari, A., Azizi, H., Azzam, A. Y. Y., Babajani, A., Badar, M., Badiye, A. D., Baghcheghi, N., Bagheri, N., Bagherieh, S., Bahadory, S., Baig, A. A., Baker, J. L., Bakhtiari, A., Bakshi, R. K., Banach, M., Banerjee, I., Bardhan, M., Barone-Adesi, F., Barra, F., Barrow, A., Bashir, N. Z., Bashiri, A., Basu, S., Batiha, A.-M. M., Begum, A., Bekele, A. B., Belay, A. S., Belete, M. A., Belgaumi, U. I., Bell, A. W., Belo, L., Benzian, H., Berhie, A. Y., Bermudez, A. N. C., Bernabe, E., Bhagavathula, A. S., Bhala, N., Bhandari, B. B., Bhardwaj, N., Bhardwaj, P., Bhattacharyya, K., Bhojaraja, V. S., Bhuyan, S. S., Bibi, S., Bilchut, A. H., Bintoro, B. S., Biondi, A., Birega, M. G. B., Birhan, H. E., Bjørge, T., Blyuss, O., Bodicha, B. B. A., Bolla, S. R., Boloor, A., Bosetti, C., Braithwaite, D., Brauer, M., Brenner, H., Briko, A. N., Briko, N. I., Buchanan, C. M., Bulamu, N. B., Bustamante-Teixeira, M. T., Butt, M. H., Butt, N. S., Butt, Z. A., Caetano dos Santos, F. L., Cámera, L. A., Cao, C., Cao, Y., Carreras, G., Carvalho, M., Cembranel, F., Cerin, E., Chakraborty, P. A., Charalampous, P., Chattu, V. K., Chimed-Ochir, O., Chirinos-Caceres, J. L., Cho, D. Y., Cho, W. C. S., Christopher, D. J., Chu, D.-T., Chukwu, I. S., Cohen, A. J., Conde, J., Cortés, S., Costa, V. M., Cruz-Martins, N., Culbreth, G. T., Dadras, O., Dagnaw, F. T., Dahlawi, S. M. A., Dai, X., Dandona, L., Dandona, R., Daneshpajouhnejad, P., Danielewicz, A., Dao, A. T. M., Darvishi Cheshmeh Soltani, R., Darwesh, A. M., Das, S., Davitoiu, D. V., Davtalab Esmaeili, E., De la Hoz, F. P., Debela, S. A., Dehghan, A., Demisse, B., Demisse, F. W., Denova-Gutiérrez, E., Derakhshani, A., Derbew Molla, M., Dereje, D., Deribe, K. S., Desai, R., Desalegn, M. D., Dessalegn, F. N., Dessalegni, S. A. A., Dessie, G., Desta, A. A., Dewan, S. M. R., Dharmaratne, S. 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K., Mehmood, K., Mehrabi Nasab, E., Mehrotra, R., Melese, A., Mendoza, W., Menezes, R. G., Mengesha, S. D., Mensah, L. G., Mentis, A.-F. A., Mera-Mamián, A. Y. M., Meretoja, T. J., Merid, M. W., Mersha, A. G., Meselu, B. T., Meshkat, M., Mestrovic, T., Miao Jonasson, J., Miazgowski, T., Michalek, I. M., Mijena, G. F. W., Miller, T. R., Mir, S. A., Mirinezhad, S. K., Mirmoeeni, S., Mirza-Aghazadeh-Attari, M., Mirzaei, H., Mirzaei, H. R., Misganaw, A. S., Misra, S., Mohammad, K. A., Mohammadi, E., Mohammadi, M., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mohammed, A., Mohammed, S., Mohan, S., Mohseni, M., Moka, N., Mokdad, A. H., Molassiotis, A., Molokhia, M., Momenzadeh, K., Momtazmanesh, S., Monasta, L., Mons, U., Montasir, A. A., Montazeri, F., Montero, A., Moosavi, M. A., Moradi, A., Moradi, Y., Moradi Sarabi, M., Moraga, P., Morawska, L., Morrison, S. D., Morze, J., Mosapour, A., Mostafavi, E., Mousavi, S. 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R., Pakbin, B., Pakshir, K., Pakzad, R., Palicz, T., Pana, A., Pandey, A., Pandey, A., Pant, S., Pardhan, S., Park, E.-C., Park, E.-K., Park, S., Patel, J., Pati, S., Paudel, R., Paudel, U., Paun, M., Pazoki Toroudi, H., Peng, M., Pereira, J., Pereira, R. B., Perna, S., Perumalsamy, N., Pestell, R. G., Pezzani, R., Piccinelli, C., Pillay, J. D., Piracha, Z. Z., Pischon, T., Postma, M. J., Pourabhari Langroudi, A., Pourshams, A., Pourtaheri, N., Prashant, A., Qadir, M. M. F., Quazi Syed, Z., Rabiee, M., Rabiee, N., Radfar, A., Radhakrishnan, R. A., Radhakrishnan, V., Raeisi, M., Rafiee, A., Rafiei, A., Raheem, N., Rahim, F., Rahman, M. O., Rahman, M., Rahman, M. A., Rahmani, A. M., Rahmani, S., Rahmanian, V., Rajai, N., Rajesh, A., Ram, P., Ramezanzadeh, K., Rana, J., Ranabhat, K., Ranasinghe, P., Rao, C. R., Rao, S. J., Rashedi, S., Rashidi, A., Rashidi, M., Rashidi, M.-M., Ratan, Z. A., Rawaf, D. L., Rawaf, S., Rawal, L., Rawassizadeh, R., Razeghinia, M. S., Rehman, A. U., Rehman, I. U., Reitsma, M. B., Renzaho, A. M. N., Rezaei, M., Rezaei, N., Rezaei, N., Rezaei, N., Rezaei, S., Rezaeian, M., Rezapour, A., Riad, A., Rikhtegar, R., Rios-Blancas, M., Roberts, T. J., Rohloff, P., Romero-Rodríguez, E., Roshandel, G., Rwegerera, G. M., S, M., Saber-Ayad, M. M., Saberzadeh-Ardestani, B., Sabour, S., Saddik, B., Sadeghi, E., Saeb, M. R., Saeed, U., Safaei, M., Safary, A., Sahebazzamani, M., Sahebkar, A., Sahoo, H., Sajid, M. R., Salari, H., Salehi, S., Salem, M. R., Salimzadeh, H., Samodra, Y. L., Samy, A. M., Sanabria, J., Sankararaman, S., Sanmarchi, F., Santric-Milicevic, M. M., Saqib, M. A. N., Sarveazad, A., Sarvi, F., Sathian, B., Satpathy, M., Sayegh, N., Schneider, I. J. C., Schwarzinger, M., Šekerija, M., Senthilkumaran, S., Sepanlou, S. G., Seylani, A., Seyoum, K., Sha, F., Shafaat, O., Shah, P. A., Shahabi, S., Shahid, I., Shahrbaf, M. A., Shahsavari, H. R., Shaikh, M. A., Shaka, M. F., Shaker, E., Shannawaz, M., Sharew, M. M. 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- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 400
- Issue
- 10352
- Pages
- 563-591
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4293276539
- Cited by
- 954
- References
- 8
- FWCI
- 75.04
- Type
- journal article
- Language
- en
- Open access
- hybrid
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- creativecommons.org/licenses/by/4.0/ (vor)
- Funders
- Kasturba Medical College, Manipal
- African-German Network of Excellence in Science
- Syöpäsäätiö
- National Health and Medical Research Council
- Manipal Academy of Higher Education
- Research Management Centre, International Islamic University Malaysia
- University Grants Commission
- Department of Anthropology, University of California, Los Angeles
- Sistema Nacional de Investigadores
- National Institute for Genetic Engineering and Biotechnology
- Lung Foundation Australia
- Ministério da Ciência, Tecnologia e Ensino Superior
- University of New South Wales
- Alexander von Humboldt-Stiftung
- Sigrid Juséliuksen Säätiö
- Secretaría Nacional de Ciencia, Tecnología e Innovación
- Indian Council of Medical Research
- King's College London
- European Regional Development Fund
- Autoritatea Natională pentru Cercetare Stiintifică
- Chandigarh University
- Institute for Advanced Studies in Basic Sciences
- Bundesministerium für Bildung und Forschung
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Secretaria Nacional de Ciencia y Tecnología
- Health Effects Institute
- Applied Molecular Biosciences Unit (LA/P/0140/2020)
- Bill & Melinda Gates Foundation
- Ministry of Higher Education, Malaysia (FRGS/1/2021/SKK0/UM/01/1)
- European Research Council (ERC-StG-2019-848325, 17/590,061, 62/334538)
- Novo Nordisk Fonden (NNF16OC0021856)
- Science, Technology and Innovation Commission of Shenzhen Municipality (KQTD20190929172835662)
- The Wellcome Trust DBT India Alliance (IA/CPHI/18/1/503927)
- University of Oxford (W81XWH1810605, R21 CA235139-01)
- University of Tasmania
- Ain Shams University
- Syöpäjärjestöt
- National Institute for Health Research Southampton Biomedical Research Centre
- Ministero della Salute
- Kuwait University
- Marga und Walter Boll-Stiftung
- European Social Fund
- Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja
- Conselho Nacional de Desenvolvimento Científico e Tecnológico (CENTRO-04-3559-FSE-000162, 309589/2021-5)
- Hellenic Foundation for Research and Innovation (MIMS-860)
- Engineering Research Centers (SFRH/BHD/110001/2015, 848325)
- National Institute for Health and Care Research (NIHR300175)
- National Institutes of Health (K43TW010704)
- Eesti Teadusagentuur (PRG722)
- Fogarty International Center (K43TW011416)
- National Natural Science Foundation of China (82173626, 72122001)
- Ministerul Cercetării, Inovării şi Digitalizării (ID-585-CTR-42-PFE-2021)
- Fundação para a Ciência e a Tecnologia (DL57/2016/CP1334/CT0006, CEECINST/00049/2018)
- Ministry of Science and Technology, Taiwan (110-2314-B-003-001)
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019. https://app.cochat.ai/papers/10.1016/s0140-6736(22)01438-6
- The paper
- Tran, K. B., Lang, J. J., Compton, K., Xu, R., Acheson, A. R., Henrikson, H. J., Kocarnik, J. M., Penberthy, L., Aali, A., Abbas, Q., Abbasi, B., Abbasi-Kangevari, M., Abbasi-Kangevari, Z., Abbastabar, H., Abdelmasseh, M., Abd-Elsalam, S., Abdelwahab, A. A., Abdoli, G., Abdulkadir, H. A., . . . Murray, C. J. L. (2022). The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. https://doi.org/10.1016/s0140-6736(22)01438-6
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.