Over one-third of cancer cases and two-fifths of cancer deaths in southern China are preventable: Insights from the latest representative population-based cancer registry data and risk factor survey.

Assessing the impact of modifiable risk factors on cancer is crucial for prioritizing effective prevention interventions. This study aimed to quantify the cancer burden attributable to modifiable risk factors in Guangdong in 2019, thereby informing targeted prevention strategies tailored to the region. The population attributable fraction (PAF) was estimated by Levin's method, based on the 2010 prevalence of 15 risk factors and the latest representative relative risks. PAFs for specific age groups, sexes, risk factors, and cancer types were then combined to obtain overall PAF. Attributable cancer cases were calculated using cancer burden data in 2019 and PAF estimate. 34.4% of incident cancer and 44.5% of cancer deaths in Guangdong were attributable to 15 potentially modifiable risk factors, with higher PAF among males (44.3% for incidence and 52.0% for mortality) than females (22.9% for incidence cancer and 29.9% for mortality). Ten of the twenty-two cancers exhibited an attributable fraction exceeding 50%, with five cancers exceeding 70%, including cancers of cervix uteri, nasopharynx, oral cavity and pharynx, liver and larynx. Behavioral factors contributed the most to incident cancer burden, followed by infectious, dietary, and metabolic factors. Nearly one-third of incident cancer and two-fifths of cancer deaths in Guangdong were preventable through addressing modifiable risk factors. The findings emphasize the critical need for targeted prevention strategies, particularly focusing on smoking, alcohol consumption, and infection control, to significantly reduce cancer burden. This study underscores the importance of integrating risk factor mitigation into public health policies to advance cancer prevention efforts in the region.