It has been well established that certain lifestyle habits relate to the risk of certain cancers (e.g., smoking and lung cancer). In a well-done analysis, the authors estimate the proportion of cancer in the population associated with a variety of lifestyle and environmental factors. They find that smoking has, by far, the largest effect on the risk of cancer, with 19.4% of cancer cases in the UK attributable to tobacco use. A poor diet (less intake of fruits and vegetables and fibre and greater intake of meat and salt), obesity, and alcohol are the next most important factors that relate to cancer, with alcohol being calculated to relate to 4.0% of cancer cases in the UK.

Forum reviewers considered this to be a well-done paper that used epidemiologic methods that are preferable to those used in some previous such analyses. Generally, they disagreed with the authors that no alcohol consumption was the theoretical "optimum exposure level," as the risk of certain cancers seems to increase primarily from heavy drinking. Further, they found reason to believe that the purported effects related to diet may have been over-estimated.

Nevertheless, this paper provides considerable new information on lifestyle and environmental factors that may relate to the risk of cancer. It puts into perspective the importance of targeting certain behaviours for the potential reduction in the risk of cancer.

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Reference: Parkin DM, Boyd L, Walker LC. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Summary and conclusions. British Journal of Cancer 2011;105:S77 - S81.

Comments on this critique by the International Scientific Forum on Alcohol Research were provided by the following members:

Erik Skovenborg, MD, Scandinavian Medical Alcohol Board, Practitioner, Aarhus, Denmark

Creina Stockley, clinical pharmacology, Health and Regulatory Information AWRI, South Australia, Australia

Harvey Finkel, MD, Hematology/Oncology, Boston University Medical Center, Boston, MA, USA

Arne Svilaas, MD, PhD, general practice and lipidology, Oslo University Hospital, Oslo, Norway

David Van Velden, MD, Dept. of Pathology, Stellenbosch University, Stellenbosch, South Africa

Luc Djoussé, MD, DSc, Dept. of Medicine, Division of Aging, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA

Gordon Troup, MSc, DSc, School of Physics, Monash University, Victoria, Australia;

R. Curtis Ellison, MD, Section of Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA

For the detailed critique of this paper by the International Scientific Forum on Alcohol Research, go to www.bu.edu/alcohol-forum and click on Recent Reports.

The specialists who are members of the Forum are happy to respond to questions from Health Editors regarding emerging research on alcohol and health and will offer an independent opinion in context with other research on the subject

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Critique 064: Association of lifestyle and environmental factors with the risk of cancer -- 13 December 2011

Read the full critique here: http://www. bu. edu/ alcohol-forum/ critique-064-association-of-lifestyle-and-environmental-factors-with-the-risk-of-cancer-13-december-2011/

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