Abstract
BackgroundCancer rates in Africa are projected to double by 2030 due to aging and increased exposure to cancer risk factors, including modifiable risk factors. We assessed adherence to 5 modifiable cancer risk factors across 18 African countries.MethodsData on adults 18 years and older were obtained from the 2002–2004 World Health Survey. Adherence to current World Cancer Research Fund guidelines on smoking, alcohol, body weight, physical activity, and nutrition was assessed. Adherence scores ranged from 0 (no guideline met) to 5 (all guidelines met). Determinants of adherence were assessed using multivariable linear regression adjusted for individual and country level characteristics.ResultsAcross all countries, adherence to the guidelines among adults was high for smoking (72%–99%) and alcohol (85%–100%), but low for body weight (1.8%–78%), physical activity (3.4%–84%) and nutrition (1.4%–61%). Overall adherence score ranged from 2.32 in Mali to 3.72 in Comoros. In multivariable models, residing in low versus high SES households was associated with reduced adherence by 0.24 and 0.21 points for men and women respectively after adjusting for age, gender, education, and marital status (p<0.001). Every % increase in GDP spent on health was associated with increased adherence by 0.03 in men and 0.09 in women (p<0.001).ConclusionsThe wide variation in adherence to cancer prevention guidelines observed across countries and between population sub-groups suggests the need for targeted public health efforts to improve behaviors related to body weight, physical activity and nutrition.
Highlights
Cancer rates in Africa are predicted to increase in the coming decades [1]
There is a rapid adoption of Western lifestyle patterns, characterized by tobacco use, low physical activity, high fat/calorie dense diet, lower parity, and shorter duration of breastfeeding [1,4,6]
The purpose of this study is to assess the level of adherence to the 2007 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention guidelines in African countries, and to examine individual and country level predictors of adherence
Summary
Cancer rates in Africa are predicted to increase in the coming decades [1]. According to the International Agency for Research on Cancer, in 2008 there were approximately 681,000 new cancer cases and 512,000 cancer deaths in Africa [2]. By 2030, 1.28 million new cancer cases and 970,000 cancer deaths are expected, an 88% increase from 2008 [2]. There is a rapid adoption of Western lifestyle patterns, characterized by tobacco use, low physical activity, high fat/calorie dense diet, lower parity, and shorter duration of breastfeeding [1,4,6]. These modifiable lifestyle risk factors have been associated with many chronic diseases, including colorectal, breast, and prostate cancer [7,8,9,10,11]. We assessed adherence to 5 modifiable cancer risk factors across 18 African countries
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