Objectives: To estimate the cancer burden attributable to potentially modifiable risk factors in Australia to inform national cancer prevention strategies.
Methods: We analysed results from the Global Burden of Diseases (GBD) 2021 study. We estimated cancer-related deaths and disability-adjusted life years (DALYs) lost attributable to various risk factors, both for the broader GBD risk categories (behavioural, metabolic, and environmental/occupational) and more specific risks (e.g., smoking, alcohol use, dietary risks, high body mass index (BMI), occupational carcinogens, etc).
Results: In 2021, about 20,409 cancer deaths (37.5%) and 431,575 cancer DALYs lost (37.9%) in Australia were attributable to potentially modifiable risk factors. Behavioural risks contributed most, accounting for 13,600 (25.0%) of cancer deaths and 302,471 (26.5%) of DALYs lost. Metabolic risks and environmental/occupational risks accounted for 9.4% and 9.3% of deaths, respectively. Environmental/occupational risks contributed more among males than females (12.3% vs 5.1% deaths and 10.8% vs 4.4% DALYs lost), while metabolic risks contributed less (7.9% vs 11.4% deaths and 8.1% vs 11.0% DALYs lost). Smoking remained the leading attributable risk factor, accounting for 12.2% cancer deaths and 13.1% DALYs lost. Dietary risks accounted for 40% of colorectal cancer deaths and DALYs lost. High BMI contributed more to female cancer deaths and DALYs lost. Mesothelioma, cervical, larynx, liver, lung and colorectal cancers had high proportion of deaths and DALYs lost attributed to modifiable risks. Liver and nasopharyngeal cancers had the highest burden attributed to alcohol use (39.1%; and 39.0%, respectively), while a high proportion of liver cancer deaths (21.3%) and DALYs lost (22.4%) could be attributed to drug use.
Conclusions: A substantial proportion of cancer burden in Australia is attributable to modifiable risk factors. Strengthening public health interventions to address modifiable risks, such as multi-disciplinary approaches to promote healthy lifestyle, are required.