Skip to main content Accessibility help
×
Home

New cancer cases attributable to diet among adults aged 30–84 years in France in 2015

  • Kevin D. Shield (a1), Heinz Freisling (a2), Marie-Christine Boutron-Ruault (a3), Mathilde Touvier (a4), Claire Marant Micallef (a1), Mazda Jenab (a2), Valérie Deschamps (a5) (a6), Catherine Hill (a7), Pietro Ferrari (a2), Irène Margaritis (a8), Freddie Bray (a1) and Isabelle Soerjomataram (a1)...

Abstract

This study aimed to estimate the number of new cancer cases attributable to diet among adults aged 30–84 years in France in 2015, where convincing or probable evidence of a causal association exists, and, in a secondary analysis, where at least limited but suggestive evidence of a causal association exists. Cancer cases attributable to diet were estimated assuming a 10-year latency period. Dietary intake data were obtained from the 2006 French National Nutrition and Health Survey. Counterfactual scenarios of dietary intake were based on dietary guidelines. Corresponding risk relation estimates were obtained from meta-analyses, cohort studies and one case–control study. Cancer incidence data were obtained from the French Network of Cancer Registries. Nationally, unfavourable dietary habits led to 16 930 new cancer cases, representing 5·4 % of all new cancer cases. Low intake of fruit and dietary fibre was the largest contributor to this burden, being responsible for 4787 and 4389 new cancer cases, respectively. If this is expanded to dietary component and cancer pairs with at least limited but suggestive evidence of a causal association, 36 049 new cancer cases, representing 11·6 % of all new cancer cases, were estimated to be attributable to diet. These findings suggest that unfavourable dietary habits lead to a substantial number of new cancer cases in France; however, there is a large degree of uncertainty as to the number of cancers attributable to diet, including through indirect mechanisms such as obesity, and therefore additional research is needed to determine how diet affects cancer risk.

Copyright

Corresponding author

*Corresponding author: K. D. Shield, email kevin.david.shield@gmail.com

References

Hide All
1. Aune, D, Giovannucci, E, Boffetta, P, et al. (2016) Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality – a systematic review and dose–response meta-analysis of prospective studies. Int J Epidemiol 46, 10291056.
2. Institut national de prévention et d'éducation pour la santé (2002) La santé vient en mangeant: le guide alimentaire pour tous (Health Comes with Eating: The Food Guide for All). Paris: Institut national de prévention et d'éducation pour la santé.
3. Ministère du Travail de l’Emploi et de la Santé (2011) Programme national nutrition santé 2011–2015. Paris: Ministère du Travail, de l’Emploi et de la Santé.
4. Forouzanfar, MH, Alexander, L, Anderson, HR, et al. (2015) Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386, 22872323.
5. World Cancer Research Fund and American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, DC: American Institute for Cancer Research.
6. International Agency for Research on Cancer (2008) IARC Working Group Reports Volume 5: Vitamin D and Cancer. Lyon: International Agency for Research on Cancer.
7. Demeyer, D, Mertens, B, De Smet, S, et al. (2015) Mechanisms linking colorectal cancer to the consumption of (processed) red meat: a review. Crit Rev Food Sci Nutr 56, 27472766.
8. Lock, K, Pomerleau, J, Causer, L, et al. (2005) The global burden of disease attributable to low consumption of fruit and vegetables: implications for the global strategy on diet. Bull World Health Organ 83, 100108.
9. Nishida, C, Uauy, R, Kumanyika, S, et al. (2004) The joint WHO/FAO expert consultation on diet, nutrition and the prevention of chronic diseases: process, product and policy implications. Public Health Nutr 7, 245250.
10. World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Diseases: WHO Technical Report Series 916. Geneva: World Health Organization.
11. Murray, CJ & Lopez, AD (1997) Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 349, 14361442.
12. Key, TJ, Schatzkin, A, Willett, WC, et al. (2004) Diet, nutrition and the prevention of cancer. Public Health Nutr 7, 187200.
13. Doll, R & Peto, R (1981) The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 66, 11921308.
14. Armstrong, B & Doll, R (1975) Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 15, 617631.
15. Hedrick, VE, Dietrich, AM, Estabrooks, PA, et al. (2012) Dietary biomarkers: advances, limitations and future directions. Nutr J 11, 109.
16. Levin, ML (1953) The occurrence of lung cancer in man. Acta Unio Int Contra Cancrum 9, 531541.
17. Bouvard, V, Loomis, D, Guyton, KZ, et al. (2015) Carcinogenicity of consumption of red and processed meat. Lancet Oncol 16, 15991600.
18. World Cancer Research Fund International, American Institute for Cancer Research (2016) Continuous Update Project Report: Diet, Nutrition, Physical Activity and Oesophageal Cancer. London: World Cancer Research Fund International.
19. World Cancer Research Fund International, American Institute for Cancer Research (2016) Continuous Update Project Report: Food, Nutrition, Physical Activity, and Stomach Cancer. London: World Cancer Research Fund International.
20. World Cancer Research Fund International, American Institute for Cancer Research (2011) Continuous Update Project Report: Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer. London: World Cancer Research Fund International.
21. World Cancer Research Fund International, American Institute for Cancer Research (2015) Continuous Update Project Report: Food, Nutrition, Physical Activity, and the Prevention of Liver Cancer. London: World Cancer Research Fund International.
22. World Cancer Research Fund International, American Institute for Cancer Research (2015) Continuous Update Project Report: Diet, Nutrition, Physical Activity and Gallbladder Cancer. London: World Cancer Research Fund International.
23. World Cancer Research Fund International, American Institute for Cancer Research (2012) Continuous Update Project Report: Food, Nutrition, Physical Activity, and the Prevention of Pancreatic Cancer. London: World Cancer Research Fund International.
24. World Cancer Research Fund International, American Institute for Cancer Research (2011) Continuous Update Project Report: Food, Nutrition, Physical Activity, and the Prevention of Breast Cancer. London: World Cancer Research Fund International.
25. World Cancer Research Fund International, American Institute for Cancer Research (2013) Continuous Update Project Report: Diet, Nutrition, Physical Activity and the Prevention of Endometrial Cancer. London: World Cancer Research Fund International.
26. World Cancer Research Fund International, American Institute for Cancer Research (2014) Continuous Update Project Report: Food, Nutrition, Physical Activity, and the Prevention of Ovarian Cancer 2014. London: World Cancer Research Fund International.
27. World Cancer Research Fund International, American Institute for Cancer Research (2014) Continuous Update Project Report: Food, Nutrition, Physical Activity, and Prostate Cancer. London: World Cancer Research Fund International.
28. World Cancer Research Fund International, American Institute for Cancer Research (2015) Continuous Update Project Report: Diet, Nutrition, Physical Activity and Kidney Cancer. London: World Cancer Research Fund International.
29. World Cancer Research Fund International, American Institute for Cancer Research (2015) Continuous Update Project Report: Diet, Nutrition, Physical Activity and Bladder Cancer. London: World Cancer Research Fund International.
30. Institut National Du Cancer (2015) Nutrition et prévention primaire des cancers: actualisation des données synthèse (Nutrition and Primary Prevention of Cancer: Update of Summary Data). Boulogne-Billancourt: Institut National du Cancer.
31. Unité de surveillance et d’épidémiologie nutritionnelle (2007) Étude nationale nutrition santé: situation nutritionnelle en France en 2006 selon les indicateurs d’objectif et les repères du Programme national nutrition santé (PNNS) (National Nutrition and Health Study: Nutritional Situation in France in 2006 According to the Target Indicators and the Benchmarks of the National Health and Nutrition Program (PNNS)). Paris: Institut de veille sanitaire, Université de Paris.
32. Dubuisson, C, Lioret, S, Touvier, M, et al. (2010) Trends in food and nutritional intakes of French adults from 1999 to 2007: results from the INCA surveys. Br J Nutr 103, 10351048.
33. Le Moullec, N, Deheeger, M, Preziosi, P, et al. (1996) Validation du manuel-photos utilisé pour l’enquête alimentaire de l'étude SU.VI.MAX (Validation of photographic document used to estimate the amounts of foods eaten by subjects in the SU.VI.MAX study) . Cahe Nutr Diet 31, 158164.
34. Hercberg, S, Arnault, N & Astorg, P (2005) Tables de composition des aliments SU.VI.MAX (Food Composition Tables: SU.VI.MAX Study). Paris: Anthropos Economica.
35. Black, AE (2000) Critical evaluation of energy intake using the Goldberg cut-off for energy intake: basal metabolic rate. A practical guide to its calculation, use and limitations. Int J Obes 24, 11191130.
36. World Cancer Research Fund International (2017) Our cancer prevention recommendations: plant foods. http://www.webcitation.org/6pCMU6siU (accessed March 2017).
37. World Cancer Research Fund International (2017) Our cancer prevention recommendations: animal foods. http://www.webcitation.org/6pCMLmdTN (accessed March 2017).
38. World Cancer Research Fund International (2017) Our cancer prevention recommendations: preservation, processing, preparation. http://www.webcitation.org/6pCM7Vs76 (accessed March 2017).
39. Parkin, D (2011) 5. Cancers attributable to dietary factors in the UK in 2010: I. Low consumption of fruit and vegetables. Br J Cancer 105, S24S26.
40. Haut Conseil de la santé publique (2017) Révision des repères alimentaires pour les adultes du futur programme national nutrition santé 2017–2021 (Review of Food Benchmarks for Adults in the Future National Nutrition and Health Program 2017–2021). Paris: Haut Conseil de la santé publique.
41. Shield, KD, Parkin, DM, Whiteman, DC, et al. (2016) Population attributable and preventable fractions: cancer risk factor surveillance, and cancer policy projection. Curr Epidemiol Rep 3, 201211.
42. Santé Pays de la Loire (2015) Le réseau FRANCIM: Les registres des cancers en France (The FRANCIM Network: Cancer Registries in France). Nantes: Santé Pays de la Loire.
43. Institut national de la statistique et des études économiques (2015) Statistical Operation: Population Estimates. Paris: Institut national de la statistique et des études économiques.
44. Parkin, DM (2011) 1. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 105, Suppl. 2, S2S5.
45. Nagle, CM, Wilson, LF, Hughes, MCB, et al. (2015) Cancers in Australia in 2010 attributable to inadequate consumption of fruit, non‐starchy vegetables and dietary fibre. Aust N Z J Public Health 39, 422428.
46. Nagle, CM, Wilson, LF, Hughes, MCB, et al. (2015) Cancers in Australia in 2010 attributable to the consumption of red and processed meat. Aust N Z J Public Health 39, 429433.
47. Abnet, CC (2007) Carcinogenic food contaminants. Cancer Invest 25, 189196.
48. Loomis, D, Guyton, KZ, Grosse, Y, et al. (2016) Carcinogenicity of drinking coffee, mate, and very hot beverages. Lancet Oncol 17, 877878.
49. Temple, NJ & Gladwin, KK (2003) Fruit, vegetables, and the prevention of cancer: research challenges. Nutrition 19, 467470.
50. Key, TJ, Allen, NE, Spencer, EA, et al. (2002) The effect of diet on risk of cancer. Lancet 360, 861868.
51. Ma, Y, Bertone, ER, Stanek, EJ, et al. (2003) Association between eating patterns and obesity in a free-living US adult population. Am J Epidemiol 158, 8592.
52. French Agency for Food, Environmental and Occupational Health and Safety (2015) Opinion of the French Agency for Food, Environmental and Occupational Health and Safety on the Updating of the PNNS Guidelines: Revision of the Guidelines Relating to Physical Activity and Sedentarity. Maisons-Alfort: French Agency for Food, Environmental and Occupational Health and Safety.
53. World Health Organization (2006) Global Strategy on Diet, Physical Activity and Health: A Framework to Monitor and Evaluate Implementation. Geneva: World Health Organizaiton.
54. Popkin, BM & Gordon-Larsen, P (2004) The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes 28, S2S9.
55. Institute of Medicine (US) Subcommittee on Interpretation and Uses of Dietary Reference Intakes, Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (2000) DRI Dietary Reference Intakes: Applications in Dietary Assessment. Washington, DC: National Academies Press.
56. World Health Organization (2017) 5. Population Nutrient Intake Goals for Preventing Diet-related Chronic Diseases. Geneva: World Health Organization.
57. World Health Organization (2012) Guideline: Sodium Intake for Adults and Children. Geneva: World Health Organization.
58. Scientific Advisory Committee on Nutrition (2015) Carbohydrates and Health. Norwich: The Stationery Office.
59. Food Standards Agency (2007) FSA Nutrient and Food Based Guidelines for UK Institutions. London: Food Standards Agency.
60. National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: Commonwealth of Australia.
61. US Department of Agriculture, US Department of Health and Human Services (2010) Dietary Guidelines for Americans, 2010 , 7th ed. Washington, DC: US Government Printing Office.
62. US Department of Agriculture, US Department of Health and Human Services (2016) Dietary Guidelines for Americans, 2015–2020 , 8th ed. Washington, DC: US Government Printing Office.
63. Jacques, PF & Tucker, KL (2001) Are dietary patterns useful for understanding the role of diet in chronic disease? Am J Clin Nutr 73, 12.
64. Kant, AK (2004) Dietary patterns and health outcomes. J Am Dent Assoc 104, 615635.
65. Kesse, E, Clavel-Chapelon, F & Boutron-Ruault, M-C (2006) Dietary patterns and risk of colorectal tumors: a cohort of French women of the National Education System (E3N). Am J Epidemiol 164, 10851093.
66. Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
67. Bertin, M, Touvier, M, Dubuisson, C, et al. (2016) Dietary patterns of French adults: associations with demographic, socio‐economic and behavioural factors. J Hum Nutr Diet 29, 241254.
68. Miller, AB & Linseisen, J (2010) Achievements and future of nutritional cancer epidemiology. Int J Cancer 126, 15311537.
69. Ruiz, RB & Hernández, PS (2014) Diet and cancer: risk factors and epidemiological evidence. Maturitas 77, 202208.
70. Englyst, H, Bingham, S, Runswick, S, et al. (1988) Dietary fibre (non‐starch polysaccharides) in fruit, vegetables and nuts. J Hum Nutr Diet 1, 247286.
71. Fiolet, T, Srour, B, Sellem, L, et al. (2018) Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 360, k322.
72. Bonifacj, C, Gerber, M, Scali, J, et al. (1997) Comparison of dietary assessment methods in a southern French population: use of weighed records, estimated-diet records and a food-frequency questionnaire. Eur J Clin Nutr 51, 217231.
73. Schatzkin, A, Kipnis, V, Carroll, RJ, et al. (2003) A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: results from the biomarker-based Observing Protein and Energy Nutrition (OPEN) study. Int J Epidemiol 32, 10541062.
74. Guo, Y, Kopec, JA, Cibere, J, et al. (2016) Population survey features and response rates: a randomized experiment. Am J Public Health 106, 14221426.
75. Groves, RM (2004) Survey Errors and Survey Costs. Hoboken, NJ: John Wiley & Sons.
76. Korkeila, K, Suominen, S, Ahvenainen, J, et al. (2001) Non-response and related factors in a nation-wide health survey. Eur J Epidemiol 17, 991999.
77. Van Loon, AJM, Tijhuis, M, Picavet, HSJ, et al. (2003) Survey non-response in the Netherlands: effects on prevalence estimates and associations. Ann Epidemiol 13, 105110.
78. Parkin, D, Boyd, L & Walker, L (2011) 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010: summary and conclusions. Br J Cancer 105, S77S81.
79. Grundy, A, Poirier, AE, Khandwala, F, et al. (2017) Cancer incidence attributable to insufficient fibre consumption in Alberta in 2012. CMAJ Open 5, E7E13.
80. Grundy, A, Poirier, AE, Khandwala, F, et al. (2016) Cancer incidence attributable to red and processed meat consumption in Alberta in 2012. CMAJ Open 4, E768E775.
81. Grundy, A, Poirier, AE, Khandwala, F, et al. (2016) Cancer incidence attributable to insufficient fruit and vegetable consumption in Alberta in 2012. CMAJ Open 4, E760E767.
82. Rothman, KJ, Greenland, S & Lash, TL (2008) Modern Epidemiology. Philadelphia, PA: Lippincott Williams & Wilkins.
83. Aune, D, Lau, R, Chan, D, et al. (2012) Dairy products and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. Ann Oncol 23, 3745.
84. Freedman, ND, Park, Y, Subar, AF, et al. (2008) Fruit and vegetable intake and head and neck cancer risk in a large United States prospective cohort study. Int J Cancer 122, 23302336.
85. Bradbury, KE, Appleby, PN & Key, TJ (2014) Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 100, 394S398S.
86. Freedman, ND, Park, Y, Subar, AF, et al. (2007) Fruit and vegetable intake and esophageal cancer in a large prospective cohort study. Int J Cancer 121, 27532760.
87. Vieira, AR, Abar, L, Vingeliene, S, et al. (2016) Fruits, vegetables and lung cancer risk: a systematic review and meta-analysis. Ann Oncol 27, 8196.
88. Aune, D, Chan, DS, Lau, R, et al. (2011) Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose–response meta-analysis of prospective studies. Br Med J 343, d6617.
89. Aune, D, Chan, D, Greenwood, D, et al. (2012) Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol 23, 13941402.
90. Chan, DS, Lau, R, Aune, D, et al. (2011) Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PLoS ONE 6, e20456.
91. Larsson, S & Wolk, A (2012) Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. Br J Cancer 106, 603607.
92. Alexander, DD, Mink, PJ, Cushing, CA, et al. (2010) A review and meta-analysis of prospective studies of red and processed meat intake and prostate cancer. Nutr J 9, 50.

Keywords

Type Description Title
WORD
Supplementary materials

Shield et al. supplementary material
Shield et al. supplementary material 1

 Word (5.7 MB)
5.7 MB
UNKNOWN
Supplementary materials

Shield et al. supplementary material
Shield et al. supplementary material 2

 Unknown (85 KB)
85 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed