The number of cancers attributable to tobacco by sex, in mainland Portugal, in 2008

Abstract

Abstract Background In Portugal, cancer incidence increases annually about 3%. In 2016, cancer was the first cause of premature death, corresponding to 5 296.8 DALYs/100,000 inhabitants. The aim of this study is to estimate the number of cancers attributable to tobacco in mainland's Portugal by sex. Methods An observational, ecological, analytic study was performed. Data was collected by sex: tobacco consumption (current or past) in mainland Portugal resident population older than 20 years, in 1998; incidence of 12 types of cancer, by location: Esophagus (C15), Stomach (C16), Colon (C18), Rectum (C20), Liver (C22), Pancreas (C25), Larynx (C32), Lung (C34), Kidney (C64) and Bladder (C67), according to the ICD-10 classification, in 2008. The population attributable fraction (PAF), for each type of cancer, was calculated with Levin's formula. The confidence intervals (CI) were estimated by Monte Carlo simulation. Results The prevalence of tobacco consumption in population between 20-79 years old was 33.41% (CI 95% 32.44-34.38) and 9.88% (CI 95% 9.29-10.54) for men and women, respectively. Higher values of PAF were estimated to lung cancer (76.32% in men, 46.99% in women) followed by larynx cancer (69.55% in men, 39.13% in women).The largest number of attributed cases was estimated for lung cancer (1211 in men, 368 in women) and bladder cancer (827 in men, 114 in women). Total cancers attributable to tobacco were superior in men (3776 vs. 677). Conclusions In 2008, 4453 of the total common cancers in both sexes could have been avoided if there was no tobacco consumption (current and past). More cancers would have been prevented in men because they smoked more, but also because in most cancers' RR is higher in men. Actually, tobacco consumption has been increasing in women, thus, it is expected that its number of avoided cancers will approximate the one in men. Campaigns with well-defined target populations are important to increase its health level. Key messages Tobacco is a modifiable risk factor which can be prevented; thus it is important to promote campaigns in order to prevent early consumption. Secondary data must be used to provide evidence that will help Public Health in taking better decisions regarding interventions.