Contents

Foreword ix 3 Biological processes in cancer 147

Preface x development
Introduction xii 3.1 Sporadic cancer 148
Tumorigenesis in the absence of an established
or avoidable cause
1 The global cancer burden 15
1.1 The burden and prevention of premature 16 3.2 Genomics 154
Susceptibility and somatic patterns
deaths from noncommunicable diseases,
including cancer: a global perspective 3.3 Gene–environment interactions 164
1.2 Global trends in cancer incidence 23 The preventive implications are still not clear
and mortality 3.4 DNA repair and genetic instability 170
1.3 Transitions in human development 34 Endogenous and exogenous sources of damage
and the global cancer burden and hereditary syndromes

Known causes of human cancer by organ site 45 3.5 Inflammation 181

Playing a pivotal role in cancer pathogenesis

2 Causes of cancer, including 49 3.6 Reproductive and hormonal factors 189

hazardous circumstances Important contributors to several cancer sites

2.1 Tobacco products 50 3.7 Metabolic change and metabolomics 200

Massive and still growing causes of cancer Emerging approaches and new insights
worldwide 3.8 Epigenetics 206
2.2 Infectious agents 61 Potential in diagnostics, therapy, and prevention
Missed opportunities for prevention 3.9 Immune function 215
2.3 Alcohol consumption 68 From the tumour microenvironment to therapeutic
A leading risk factor for cancer targeting
2.4 Sunlight and ultraviolet radiation 77 3.10 The microbiome 221
Affecting skin cancer incidence in many countries Its influence on tumorigenesis and therapy
2.5 Ionizing radiation and radiofrequency 84 3.11 Identifying carcinogens from 10 key 229
electromagnetic fields characteristics
Further clarification of particular risks A new approach based on mechanisms
2.6 Diet and nutrition 92 The IARC Handbooks of Cancer Prevention 236
Understanding which factors are critical
2.7 Physical activity, sedentary behaviour, 101 4 Inequalities that affect cancer 237
and obesity prevention
Established and emerging modifiable risk factors 4.1 Inequalities between and within countries 238
2.8 Dietary carcinogens 109 Impact on cancer prevention
A continuing concern in various contexts
4.2 Socioeconomic factors and cancer 246
2.9 Contamination of air, water, soil, and food 115 prevention in Africa
The challenge is to characterize specific risks Cervical cancer as an example
2.10 Occupation 127 4.3 Cancer in urban and rural communities 252
The need for continuing vigilance in China
2.11 Pharmaceutical drugs 137 Patterns reflect social dynamics
A current focus on hormones 4.4 Socioeconomic factors and cancer 258
World Cancer Research Fund International/ 144 prevention in India
American Institute for Cancer Research Diverse interventions are needed
4.5 Variations in implementation of cancer 266 5.16 Kidney cancer 447
screening in European countries Multiple risk factors, but currently limited
Striving for best practice preventive strategies
4.6 Disparities in cancer prevention services 276 5.17 Brain cancer 454
in the USA Increasing attention on the immune response
A long-standing, persistent cause of inequity 5.18 Thyroid cancer 461
4.7 Cancer in Indigenous populations 288 The challenge of overdiagnosis
Focusing on inequalities that are sometimes 5.19 Non-Hodgkin lymphoma 468
invisible Complex etiology, including the role of immune
Towards the World Code Against Cancer 295 function
5.20 Leukaemias 477
5 Preventing particular tumour types 297 Understanding pathogenesis through similarities
A guide to the epidemiology data in Section 5: 298 and differences
Preventing particular tumour types WHO Report on Cancer: Setting priorities, 485
5.1 Lung cancer 299 investing wisely and providing care for all
Continues to be the leading cause of cancer death
5.2 Head and neck cancers 310 6 The basis for, and outcomes 487
New etiological insights from, prevention strategies
5.3 Oesophageal cancer 323 Tobacco cessation: the WHO perspective 488
A tale of two malignancies 6.1 Changing behaviour 499
5.4 Stomach cancer 333 The need for sustainable implementation
Still one of the main cancer types worldwide 6.2 Improving diet and nutrition, physical 506
5.5 Colorectal cancer 344 activity, and body weight
Decreasing disparities and promoting prevention From evidence to practice
are policy priorities 6.3 Vaccination 513
5.6 Liver cancer 355 The prospect of eliminating some cancer types
An infectious disease for many communities 6.4 Preventive therapy 522
5.7 Pancreatic cancer 367 Certain interventions clearly established
Many risk factors too poorly characterized 6.5 Managing people with high and moderate 530
to enable prevention genetic risk
5.8 Skin cancer 374 Genomic tools to promote effective cancer risk
A focus on primary prevention reduction
5.9 Breast cancer 382 6.6 Screening 540
Multiple, often complex, risk factors From biology to public health
5.10 Cervical cancer 394 6.7 Circulating DNA and other biomarkers for 550
Successes in some communities to be extended early diagnosis
worldwide Great potential, but challenges recognized
5.11 Endometrial cancer 403 6.8 Governmental action to control carcinogen 557
Prevention through control of obesity exposure
5.12 Ovarian cancer 411 Multiple options covering diverse scenarios
Complicated etiology and very few preventive 6.9 Prevention strategies common to 565
options noncommunicable diseases
5.13 Prostate cancer 421 A focus on tobacco, alcohol, obesity, and physical
Challenges for prevention, detection, and inactivity
treatment
Contributors 573
5.14 Testicular cancer 430
New inroads into early diagnosis Disclosures of interests 582
5.15 Bladder cancer 439 Sources 584
A genotoxic causal agent recognized Subject index 595