Prevalence of cancer-related risk factors and associated cancer burden: A targeted literature review.

Abdul-Rahman Jazieh Cincinnati Cancer Advisors, Cincinnati, OH info_outline Abdul-Rahman Jazieh, Ashley Kim, Ze Cong, Whitney Jones

Authors Abdul-Rahman Jazieh Cincinnati Cancer Advisors, Cincinnati, OH info_outline Abdul-Rahman Jazieh, Ashley Kim, Ze Cong, Whitney Jones Organizations Cincinnati Cancer Advisors, Cincinnati, OH, GRAIL, LLC, a subsidiary of Illumina, Inc., currently held separate from Illumina, Inc., under the terms of the Interim Measures Order of the European Commission dated 29 October 2021, Menlo Park, CA Abstract Disclosures Research Funding Pharmaceutical/Biotech Company GRAIL, LLC, a subsidiary of Illumina, Inc., currently held separate from Illumina, Inc., under the terms of the Interim Measures Order of the European Commission dated 29 October 2021 Background: Cancer risk is impacted by a variety of factors besides age, which may lead to an elevated risk of cancer compared to the general population and have disparate impact on individuals. A targeted literature review was conducted to estimate the prevalence of, and the magnitude of risk of any cancer among, individuals with key risk factors, including chronic inflammation, immunodeficiency, genetics, recurrence, or behavioral. Methods: Data were abstracted using a structured search (2000-2022) in Embase, MEDLINE, and gray literature. The most recent/high quality publications involving adults with the specified risk factors were included (Table). For each risk factor, the prevalence and the standardized incidence ratio (SIR), which measures the heightened risk of cancer relative to the general population/individuals without the condition, were abstracted. Results: Overall, 35 studies were reviewed. Risk factors with the highest SIR of cancer included genetic predisposition (SIR=5.30-9.48 for Lynch syndrome or BRCA mutation), HIV (SIR=3.62), cirrhosis (SIR=2.00), and immunodeficiency disorders (SIR=1.99), with prevalence estimates of <3.0% in the general population (Table). The most prevalent risk factors were tobacco use (42.8%; SIR=1.24), family history of cancer (35.6%; SIR=1.23), and obesity (34.8%; SIR=1.09). The prevalence tended to be higher for individuals aged 65+ (Table). Almost all studies reported an elevated risk of more than one type of cancer. Conclusions: Among individuals with known risk factors, an elevated risk of cancer was observed. Risk factors that confer the highest risk of cancer are mostly genetic and immune-related with low prevalence, while other risk factors with a moderately elevated risk of cancer are more prevalent. These estimates could be useful when determining which individuals need to be screened earlier and/or with comprehensive cancer screening options. Prevalence and cancer burden among individuals with risk factors. Risk factor Prevalence, % Standardized incidence ratio Aged 18+ Aged 65+ Chronic inflammation, autoimmune Diabetes; IBD; Asthma; RA 14.5; 1.2; 7.7; 0.7 29.4; 1.7; 7.0; 2.0 1.06 (T1D)/1.13 (T2D); 1.19; 1.19; 1.10 Chronic inflammation, non-autoimmune Fatty liver disease; Cirrhosis; Hep B; Hep C 23.4; 0.3 † ; 0.4; 1.0 NR 1.27; 2.00; 1.47; 1.49 Immunodeficiency PID/SID; HIV; Transplant 2.5 † ; 0.4; NR NR; 0.2; NR 1.99; 3.62; 1.86 Behavioral Tobacco use; Obesity; Alcohol use 42.8; 34.8; 23.5 47.5; 27.0; NR 1.24; 1.09; 1.64 Family hx of cancer; Genetic predisposition; Personal hx of cancer 35.6; <3.0 † ; 5.0 NR; NR; 14.9 1.23; 5.30 (Lynch)/9.54 (BRCA1)/7.48 (BRCA2); 1.11 Chronic pancreatitis 0.1 † NR 1.20 † Age not specified hx, history; IBD, inflammatory bowel disease; NR, not reported; PID/SID, primary or secondary immunodeficiency disorder; RA, rheumatoid arthritis, T1D, type 1 diabetes; T2D, type 2 diabetes.