The fraction of cancer attributable to modifiable risk factors in Turkey in 2018

Cancer is the second leading cause of death in Turkey, with nearly one in six deaths attributed to the disease. In 2018, Turkey recorded 211,273 new cancer cases. Many cancers are linked to modifiable lifestyle risk factors, such as tobacco use, alcohol consumption, obesity, and inadequate diet and physical activity. Modifying these risk factors could potentially prevent 30%-50% of cancer cases and deaths. This study aims to estimate the population attributable fraction (PAF) of cancer cases and deaths due to various modifiable risk factors in Turkey. Modifiable cancer risk factors were identified as smoking, infections, obesity, physical inactivity, alcohol consumption, inadequate intake of fruits, vegetables, fiber, and calcium. Data on exposure prevalence and cancer incidence were sourced from national surveys and reports. Relative risks (RRs) were obtained from global studies. PAFs were calculated using Levin's equation, accounting for overlaps between risk factors. In 2018, 32% of the cancer cases were attributable to lifestyle risk factors. Smoking was the most significant factor, accounting for 28.4% of cases in men, while high BMI was the leading factor in women, contributing to 11.5% of cases. Lifestyle risk factors were responsible for 41.6% of cancer deaths, with smoking being the leading cause. Lifestyle risk factors contribute significantly to cancer incidence and mortality in Turkey. Prioritizing interventions to reduce tobacco use and obesity could substantially lower the cancer burden. These results are crucial for developing effective cancer prevention strategies and informing public health policies.