Avoidable Lifestyle factors implicated in 2,500 cancer cases a week that could be prevented

More than 2,500 cancer cases a week could be avoided | Cancer Research UK  |  March 2018 

Cancer Research UK has published findings which demonstrate that almost 4 in 10 ( 37.7 per cent) of cancers could have been prevented. The landmark study highlights that many lifestyle factors could contribute to an individual’s risk of developing cancer.  The study identifies 135, 500 cases of cancer a year in the UK that could be prevented through lifestyle changes. The research findings have been published this month in the British Journal of Cancer  (the full abstract at the end of the post).

cancer research
Image source: cancerresearchuk.org

While smoking was to blame for the largest percentage of preventable cancer cases, using data from 2015 the researchers observed,  tobacco smoke caused around 32,200 cases of cancer in men (17.7% of all male cancer cases) and around 22,000 (12.4%) in women.

Obesity is the second highest contributory risk to developing cancer: around 22,800 (6.3%) cases of cancer a year are down to being overweight or obese. This is equivalent to around 13,200 (7.5%) cases of cancer in women and around 9,600 (5.2%) in men. The results imply that 5% (1 in 20) cancer cases might possibly be prevented by maintaining a health weight. Obesity has been linked to 13 different types of cancer, such as cancers of the bowel, breast and kidney.

The third greatest factor in preventable cancers was overexposure to UV radiation from the sun and sunbeds, associated with around 13,600 cases of melanoma skin cancer a year, 3.8% of all cancer cases.

Other preventable lifestyle risks outlined in the study were eating too little fibre causing around 11,900 cases equivalent to 3.3% each, drinking too much alcohol (attributed to causing 11,700 cases or 3.3% each.

In repsonse to the findings of the research, Sir Harpal Kumar, Cancer Research UK’s chief executive, said: “Leading a healthy life doesn’t guarantee that a person won’t get cancer, but it can stack the odds in your favour. These figures show that we each can take positive steps to help reduce our individual risk of the disease.” (Cancer Research UK)

Full press release from Cancer Research UK here 

Full reference: Brown, K. F., et al   | 2018 |  The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015  |British Journal of Cancer | doi:10.1038/s41416-018-0029-6



Changing population-level exposure to modifiable risk factors is a key driver of changing cancer incidence. Understanding these changes is therefore vital when prioritising risk-reduction policies, in order to have the biggest impact on reducing cancer incidence. UK figures on the number of risk factor-attributable cancers are updated here to reflect changing behaviour as assessed in representative national surveys, and new epidemiological evidence. Figures are also presented by UK constituent country because prevalence of risk factor exposure varies between them.


Population attributable fractions (PAFs) were calculated for combinations of risk factor and cancer type with sufficient/convincing evidence of a causal association. Relative risks (RRs) were drawn from meta-analyses of cohort studies where possible. Prevalence of exposure to risk factors was obtained from nationally representative population surveys. Cancer incidence data for 2015 were sourced from national data releases and, where needed, personal communications. PAF calculations were stratified by age, sex and risk factor exposure level and then combined to create summary PAFs by cancer type, sex and country.


Nearly four in ten (37.7%) cancer cases in 2015 in the UK were attributable to known risk factors. The proportion was around two percentage points higher in UK males (38.6%) than in UK females (36.8%). Comparing UK countries, the attributable proportion was highest in Scotland (41.5% for persons) and lowest in England (37.3% for persons). Tobacco smoking contributed by far the largest proportion of attributable cancer cases, followed by overweight/obesity, accounting for 15.1% and 6.3%, respectively, of all cases in the UK in 2015. For 10 cancer types, including two of the five most common cancer types in the UK (lung cancer and melanoma skin cancer), more than 70% of UK cancer cases were attributable to known risk factors.


Tobacco and overweight/obesity remain the top contributors of attributable cancer cases. Tobacco smoking has the highest PAF because it greatly increases cancer risk and has a large number of cancer types associated with it. Overweight/obesity has the second-highest PAF because it affects a high proportion of the UK population and is also linked with many cancer types. Public health policy may seek to mitigate the level of harm associated with exposure or reduce exposure levels—both approaches may effectively impact cancer incidence. Differences in PAFs between countries and sexes are primarily due to varying prevalence of exposure to risk factors and varying proportions of specific cancer types. This variation in turn is affected by socio-demographic differences which drive differences in exposure to theoretically avoidable ‘lifestyle’ factors. PAFs at UK country level have not been available previously and they should be used by policymakers in devolved nations. PAFs are estimates based on the best available data, limitations in those data would generally bias toward underestimation of PAFs. Regular collection of risk factor exposure prevalence data which corresponds with epidemiological evidence is vital for analyses like this and should remain a priority for the UK Government and devolved Administrations.



Cancer survival trends

Little evidence for any direct impact of national cancer policies on short-term survival in England and no evidence for a reduction in socioeconomic inequalities in cancer survival. Findings emphasise that socioeconomic inequalities in survival remain a major public health problem. |  London School of Hygiene & Tropical Medicine | British Medical Journal

New research from the London School of Hygiene and Tropical Medicine found that despite overall improvements in cancer survival, the gap in survival between the most affluent and most deprived groups of patients remains unchanged for most cancers.

Survival trends were examined for 21 cancers in men and 20 cancers in women.

For each cancer, the chances of survival at one year after diagnosis were estimated separately for men and women in five levels of socio-economic deprivation, from the most affluent to the most deprived, and in each of the three calendar periods.

Researchers focused on one-year survival because most of the inequalities in cancer survival in England arise shortly after diagnosis. The survival estimates were corrected for the risk of dying from other causes of death. Estimates were also adjusted for differences in the age profile of cancer patients between men and women, and over time.

The “deprivation gap” in survival between the most affluent and most deprived groups of patients remained unchanged for most cancers. There was a clear and persistent pattern of lower survival among more deprived patients. It narrowed slightly for some cancers, where one-year survival was already more than 65% in 1996, such as cervical cancer and skin melanoma in men. By contrast, the deprivation gap in survival widened between the late 1990s and 2013 for brain tumours in men and lung cancer in women.

Full story at London School of Hygiene and Tropical Medicine

Link to the research: Aimilia Exarchakou et al.  (2018). Impact of national cancer policies on cancer survival trends and socioeconomic inequalities in England, 1996-2013: population based study. BMJ.

Patient data saves lives: Cancer

Better use of data is essential to speed up diagnosis, research new treatments, plan better NHS services and monitor the safety of drugs. However, most patients feel they don’t know how their data are used in the NHS.

Understanding Patient Data have developed a series of animations to address this gap in knowledge.

Watch the video, Patient data saves lives: Cancer below:

Other titles in this series include:

  • Patient data saves lives: The bigger picture (watch)
  • Patient data saves lives: Dementia (watch)
  • Patient data saves lives: Asthma (watch)
  • Patient data saves lives: Heart attack (watch)
  • Patient data saves lives: Diabetes (watch)

For further information about how and why patient data is used, visit the UPD website: www.patientdata.org.uk

PSA Screening for Prostate Cancer

This article by Scott Gavura discusses the findings of a recent study which concluded that PSA screening for prostate cancer offers no survival benefits | via Science based Medicine

In this article, the author discusses the controversy surrounding PSA testing, and the findings of a new study, “Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality”

The study included over 400,000 British men aged 50-69. Men were randomized into an RN appointment, where they were offered information on a PSA test, and if they chose, the test. The other group didn’t invite men for testing. After a 10 year period, the study found that there were more prostate cancers detected from this one-time testing. However, this group was no less likely to die from prostate cancer.

Given there was no difference in mortality between the two groups Gavura asks the question as to whether to PSA screen or not?

Image source: Cancer Research UK

Full article: Gavura, S | PSA Screening for Prostate Cancer | Science based Medicine

Link to the research: Martin, R. et al .| Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer MortalityThe CAP Randomized Clinical Trial  | JAMA | 2018 Vol 319(9) p883–895


Related: Why a one-off PSA test for prostate cancer is doing men more harm than good | Cancer Research UK

Bowel cancer screening programme: standards

Public Health England | March 2018 | Bowel cancer screening programme: standards 

Public Health England (PHE)  has published screening standards for the NHS bowel cancer screening programme (BCSP). 

Screening standards ensure that stakeholders have access to:

  • reliable and timely information about the quality of the screening programme
  • data at local, regional and national level
  • quality measures across the screening pathway without gaps or duplications

 The most recent standards apply to data collected from 1 April 2018 and replace previous versions.


The sceening standards can be found at PHE
Bowel cancer screening programme standards valid for data collected from 1 April 2018 can be accessed from PHE 


National Lung Cancer Audit 2017- Key findings for patients and carers

Royal College of Physicians | National Lung Cancer Audit 2017-  Key findings for patients and carers | March 2018

The audit is a patient-focused report from the  National Lung Cancer Audit (NLCA), commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England and the Welsh government.

It provides a a summary of key results from the 2017 National Lung Cancer Audit  (NLCA) annual report, which looked at patients who were diagnosed with lung cancer during 2016. The results are based on data from 140  English NHS trusts and 13 Welsh hospital sites.
national lung cancer audit 2017This booklet specifically looks at how organisations performed in key areas  of the patient pathway. It does not include information on the types of treatment or drugs that are available to patients with lung cancer.

Further information is available from HQIP  here 
The full booklet can be accessed via HQIP

Full details of the findings are available from the Royal College of Physicians website


Faster and more accurate diagnosis for prostate cancer

NHS ‘one stop shop’ for prostate cancer means faster and more accurate diagnosis | NHS England

The NHS is using cutting edge technology to help slash diagnosis times for prostate cancer from six weeks to one day in a world-leading new approach that virtually eliminates the risk of deadly sepsis.

The new scanning and diagnosis method means a ‘one-stop-shop’ for suspected prostate cancer, the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year.

The NHS is determined to cut the mortality rate for prostate cancer in the same way that has seen breast cancer rates decline by 10%.

The usual process is an MRI scan followed by a biopsy where around a dozen samples may have to be taken with a needle through the rectum, in order to locate suspect growths on the prostate.

Under the new ‘rapid pathway’ approach, which is being developed in three hospitals across West London, men have a scan, get their results and can have any necessary biopsy, using new FUSION technology, in one day, rather than multiple outpatient visits over four to six weeks.

Full story at NHS England