The implementation of primary and secondary preventive strategies is based on the evidence generated by cancer epidemiology, where the identification of risk factors and the description of their prevalence are fundamental to derive estimates on the burden of cancer from different etiologies, typically expressed as the population attributable fraction, which corresponds to the proportion of a cancer that may be prevented by controlling a given risk factor. However, even when cancer finds its etiology in modifiable factors, its prevention through the control of those factors is not always feasible, or it remains suboptimal despite the possibility of reducing the burden. We reviewed selected associations between modifiable risk factors and cancer, including tobacco smoking, occupational exposures, infections, air pollution, alcohol, and diet and obesity, and illustrated examples of both successes and failures in cancer control, underlying how current understanding of the avoidable causes of cancer is incomplete.

中文翻译：

---

可改变的危险因素导致的癌症：预防路线图

一级和二级预防策略的实施基于癌症流行病学产生的证据，其中风险因素的识别及其患病率的描述对于得出不同病因的癌症负担的估计至关重要，通常表示为人群归因分数，对应于通过控制给定风险因素可以预防的癌症的比例。然而，即使癌症在可改变的因素中找到了病因，通过控制这些因素来预防癌症并不总是可行的，或者尽管有可能减轻负担，但它仍然不是最理想的。我们回顾了可改变的危险因素与癌症之间的选定关联，包括吸烟、职业暴露、感染、空气污染、酒精、饮食和肥胖，并举例说明了癌症控制方面成功和失败的例子，说明了目前对可避免原因的理解癌症的诊断是不完整的。