Thus, it would seem to be essential to develop an estimate of the PAF of risk factors for cancer that are specific to each region of the world.Ĭancer is the leading cause of death in Korea one in every four Koreans becomes a victim of this life-threatening disease. This raises an important question regarding whether it would be appropriate to apply the PAF estimated from studies performed in Western populations to other countries. The lung cancer mortality rates among non-smokers in the Asian population (rate = 35.6 in Japanese men and 24.6 in Japanese women) were indeed shown to be higher than those in the US (rate =15.7 in a CPS-I study and 14.7 in a CPS-II study). They are a longer duration of heavy smoking in Americans, a more toxic formulation of American-manufactured cigarettes, a higher efficiency of filters in Japanese cigarettes, lower alcohol consumption by Japanese males, differences in genetic susceptibility to tobacco carcinogens, and a higher background risk of lung cancer among non-smokers. Several possible explanations for the differences in RRs among Asians and individuals in Western countries have been suggested.
The relative risks (RRs) of lung cancer observed among Asian smokers are generally lower than those in the Western population. Smoking patterns and the magnitude of the increased risk of lung cancer among smokers are very different in Asian populations compared with those in Western populations. Most previous estimates of attributable cancers have been conducted in high-resource countries, primarily Western countries and only a few studies were conducted in Asian countries. Since then, only a few studies have attempted to estimate the relative importance of cancer risk factors including the updated estimates of year 2000. The first attempt to estimate the global burden of cancer was performed by Doll and Peto using US data, which provided the population-attributable fraction (PAF) of smoking for cancer mortality.
According to the International Agency for Research on Cancer (IARC), tobacco smoking causes cancers of the oral cavity, pharynx, esophagus, stomach, colon, rectum, liver, pancreas, larynx, lung, cervix, kidney, bladder, ureter, and bone marrow. Smoking is by far the most important single cause of cancer in high-income countries.
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