{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:28:51Z","timestamp":1787837331644,"version":"build-2784847793"},"reference-count":48,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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%\u201350% 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.<\/jats:p>","DOI":"10.1002\/ijc.35317","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T03:15:43Z","timestamp":1735010143000},"page":"2140-2147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The fraction of cancer attributable to modifiable risk factors in Turkey in 2018"],"prefix":"10.1002","volume":"156","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0372-6280","authenticated-orcid":false,"given":"Busra","family":"Tozduman","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Public Health, Division of Epidemiology Dokuz Eylul University  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gul","family":"Ergor","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Public Health, Division of Epidemiology Dokuz Eylul University  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization.Global cancer burden growing amidst mounting need for services. February 1 2024.2024https:\/\/www.who.int\/news\/item\/01\u201002\u20102024\u2010global\u2010cancer\u2010burden\u2010growing\u2010\u2010amidst\u2010mounting\u2010need\u2010for\u2010services"},{"key":"e_1_2_9_3_1","unstructured":"Turkish Statistical Institute.Causes of Death Statistics 2022.2023https:\/\/data.tuik.gov.tr\/Bulten\/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2022-49679"},{"key":"e_1_2_9_4_1","unstructured":"World Health Organization.Cancer.2024https:\/\/www.who.int\/health-topics\/cancer"},{"key":"e_1_2_9_5_1","unstructured":"National Cancer Statistics: 2018.Ministry of Health general Directorate of Public Health Turkey.2022."},{"key":"e_1_2_9_6_1","unstructured":"WildCP WeiderpassE StewartBW.World Cancer Report: Cancer Research for Cancer Prevention. International Agency for Research on Cancer.2020."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k757"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20101\u20104419\u20101497\u20102"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010018\u20100029\u20106"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201004564\u20102"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191710521"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(18)30488\u20101"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2019.01.021"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21858"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5455\/annalsmedres.2022.06.188"},{"key":"e_1_2_9_16_1","unstructured":"Interactive Cancer Risk Matrix.WCRF International.2024https:\/\/www.wcrf.org\/diet-activity-and-cancer\/interactive-cancer-risk-matrix\/"},{"key":"e_1_2_9_17_1","unstructured":"List of Classifications.International Agency for Research on Cancer.2024https:\/\/monographs.iarc.who.int\/list-of-classifications"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32284"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34806"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.35772\/ghm.2021.01037"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34659"},{"key":"e_1_2_9_22_1","volume-title":"National Household Health Survey in Turkey, Prevelance of Non\u2010Communicable Disease Risk Factors, 2017","author":"Uner S","year":"2018"},{"key":"e_1_2_9_23_1","unstructured":"National Health and Nutrition Examination Survey.Ministry of Health General Directorate of Public Health.2019."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.06.028"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102458\u201013\u20101215"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2020.04.698"},{"key":"e_1_2_9_27_1","first-page":"531","article-title":"The occurrence of lung cancer in man","volume":"9","author":"Levin ML","year":"1953","journal-title":"Acta Unio Int Contra Cancrum"},{"key":"e_1_2_9_28_1","unstructured":"World Health Organization International Agency For Research on Cancer.Attributable causes of cancer in France in the year 2000."},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13968-2"},{"key":"e_1_2_9_30_1","unstructured":"Turkey Health Research.2022.Turkish Statistical Institute.https:\/\/data.tuik.gov.tr\/Bulten\/Index?p=Turkiye-Saglik-Arastirmasi-2022-49747"},{"key":"e_1_2_9_31_1","unstructured":"Tobacco Control Strategy Document and Action Plan 2018\u20102023.2018.https:\/\/hsgm.saglik.gov.tr\/depo\/birimler\/tutun\u2010ve\u2010madde\u2010bagimliligi\u2010ile\u2010mucadele\u2010db\/dokumanlar\/Tutun_Kontrolu_Strateji_Belgesi_ve_Eylem_Plani.pdf"},{"key":"e_1_2_9_32_1","unstructured":"The challenge of obesity.2024https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/the-challenge-of-obesity"},{"key":"e_1_2_9_33_1","unstructured":"WHO EMRO|Double burden of nutrition | Nutrition site.World Health Organization: Regional Office for the Eastern Mediterranean.2024http:\/\/www.emro.who.int\/nutrition\/double\u2010burden\u2010of\u2010nutrition\/index.html"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)01169\u20107"},{"key":"e_1_2_9_35_1","unstructured":"Smoking and tobacco.2024https:\/\/www.healthdata.org\/research-analysis\/health-risks-issues\/smoking-and-tobacco"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v10.i1.51"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.12.022"},{"key":"e_1_2_9_38_1","unstructured":"Cancer Today.International Agency for Research on Cancer.2024https:\/\/gco.iarc.who.int\/today\/"},{"key":"e_1_2_9_39_1","unstructured":"GBD Results.Institute for Health Metrics and Evaluation.2024https:\/\/vizhub.healthdata.org\/gbd-results"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43016\u2010022\u201000594\u20109"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.04.007"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010020\u201007187\u20104"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010024\u201012219\u20104"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01438-6"},{"key":"e_1_2_9_45_1","unstructured":"Turkey Cancer Control Programme.T.R. Ministry of Health.2021."},{"key":"e_1_2_9_46_1","unstructured":"Obesity and overweight.2024https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight"},{"key":"e_1_2_9_47_1","unstructured":"Nearly 1.8 billion adults at risk of disease from not doing enough physical activity.World Health Organization.https:\/\/www.who.int\/news\/item\/26\u201006\u20102024\u2010nearly\u20101.8\u2010billion\u2010adults\u2010at\u2010risk\u2010of\u2010disease\u2010from\u2010not\u2010doing\u2010enough\u2010physical\u2010activity"},{"key":"e_1_2_9_48_1","unstructured":"The State of Food Security and Nutrition in the World. FAO IFAD UNICEF WFP and WHO.2024https:\/\/openknowledge.fao.org\/server\/api\/core\/bitstreams\/dc4a2fdf\u20107f8b\u20104093\u2010899e\u2010ed5ea24e4889\/content"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20210084"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.35317","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.35317","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.35317","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:01:37Z","timestamp":1787760097000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.35317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":48,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,6,1]]}},"alternative-id":["10.1002\/ijc.35317"],"URL":"https:\/\/doi.org\/10.1002\/ijc.35317","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,24]]},"assertion":[{"value":"2024-08-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}