Cancer types with high numbers of driver events are largely preventable

PeerJ. 2022 Jan 5:10:e12672. doi: 10.7717/peerj.12672. eCollection 2022.

Abstract

There is a long-standing debate on whether cancer is predominantly driven by extrinsic risk factors such as smoking, or by intrinsic processes such as errors in DNA replication. We have previously shown that the number of rate-limiting driver events per tumor can be estimated from the age distribution of cancer incidence using the gamma/Erlang probability distribution. Here, we show that this number strongly correlates with the proportion of cancer cases attributable to modifiable risk factors for all cancer types except the ones inducible by infection or ultraviolet radiation. The correlation was confirmed for three countries, three corresponding incidence databases and risk estimation studies, as well as for both sexes: USA, males (r = 0.80, P = 0.002), females (r = 0.81, P = 0.0003); England, males (r = 0.90, P < 0.0001), females (r = 0.67, P = 0.002); Australia, males (r = 0.90, P = 0.0004), females (r = 0.68, P = 0.01). Hence, this study suggests that the more driver events a cancer type requires, the more of its cases are due to preventable anthropogenic risk factors.

Keywords: Epidemiology; External risk; Modifiable risk; Population attributable fraction; Preventable cause.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Incidence
  • Male
  • Neoplasms* / epidemiology
  • Risk Factors
  • Smoking
  • Ultraviolet Rays*

Grants and funding

Aleksey V. Belikov received MIPT 5-100 program support for early career researchers. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.