The scientific journal eClinicalMedicine published a study on the influence of various factors on cancer mortality

Russia shows high mortality rates due to alcohol, tobacco, excess weight and tumors caused by HPV (human papillomavirus, the main cause of cervical cancer). An international team of scientists came to this conclusion after studying data from 2020. The Russian Ministry of Health acknowledges the problem, but points to an improvement in the situation in these indicators.

The authoritative scientific journal eClinicalMedicine (published by The Lancet Group) published a study on the effect of smoking, alcohol consumption, HPV infection and excess weight on cancer mortality and the number of years of life lost. To do this, scientists took statistics from seven countries – Brazil, Russia, India, China, South Africa, Great Britain and the USA – in 2020. Russian scientists from the European University in St. Petersburg (EUSP) also participated in the study.

Epidemiologist, employee of EUSP and ITMO University Anton Barchuk explained that scientists focused on four key factors in the development of cancer. There are other risks, but these four are modifiable—that is, they can be influenced. The researchers calculated how many deaths could have been avoided if these factors had been eliminated. For Russia, scientists used data from Rosstat and registers of the Ministry of Health of the Russian Federation. Statistics showed: in 2020, in all seven countries, alcohol consumption caused 326.3 thousand deaths and 5.9 million years of life lost; smoking resulted in 1.3 million deaths and 20.8 million years of life lost; excess weight caused 208 thousand deaths and 3.1 million years of life lost; HPV infection – 190.4 thousand deaths and 4 million years of lost life. Together, these four factors accounted for 1.9 million cancer deaths and 30.4 million years of life lost.

Next, scientists looked at the situation by country. In 2020, the number of years of life lost from cancer caused by alcohol consumption was highest in China (548.2 thousand years per 100 thousand population) and Russia (427.8 thousand), and lowest in the United States (161 .5 thousand). Oncological diseases caused by smoking took the most years of life in China (1 million 882 thousand years per 100 thousand population) and Russia (1 million 671 thousand). Diseases caused by excess body weight affected Russia and the USA the most (660.7 thousand and 532.6 thousand, respectively). The highest toll from HPV was recorded in South Africa (763.5 thousand years per 100 thousand); India was in second place, and Russia was in third (308.8 thousand). The greatest number of years of life lost due to alcohol use in China and the US was associated with liver cancer, and in the UK it was with colorectal cancer. In Russia, head and neck tumors, as well as breast cancer in women, contribute to this indicator. In all countries except India, the largest number of years of life lost due to smoking was due to lung cancer. Researchers emphasize that smoking is the cause of the largest number of deaths from tumors in all countries. In China and Russia, the mortality rate associated with this factor turned out to be the highest – and there, according to WHO, about half of the male population smokes. However, the chief freelance specialist in therapy and general medical practice of the Ministry of Health of the Russian Federation, Oksana Drapkina, points to data from a large epidemiological study ESSE-RF 3. According to it, the prevalence of smoking in 2020–2022 was only 17% of the Russian population – 27.7% in men and 7.6% in women. Ms. Drapkina insists that the effectiveness of Russian measures to combat the spread of tobacco smoking “is recognized internationally, and therefore in 2021 the Russian Federation, represented by the Russian Ministry of Health, received a WHO award for its outstanding contribution to the fight against tobacco consumption.”

Ms. Drapkina also emphasizes: in 2012, the proportion of people who do not consume alcohol in the age group 35–74 years old was 18.4%, and in 2021–2022 the same figure, according to ESSE-RF 3 data, was 33.9%. The study’s authors acknowledge some success in the field of sobriety, but believe that efforts to control alcohol have “reached a dead end” and that by 2025 alcohol consumption in Russia will increase. Oksana Drapkina believes that the authors of the Lancet publication approached a number of issues “selectively and, in some cases, pretentiously.”

Anton Barchuk notes: scientists were surprised by the increase in the prevalence of obesity in Russia. This figure is already comparable to the situation in the United States and exceeds other European countries, scientists say: “We are seeing an increase in the number of tumors associated with excess body weight. These are some tumors of the esophagus, stomach, intestines, liver tumors, kidney tumors, breast cancer and some gynecological tumors.” “The undisputed leader in the prevalence of obesity among the countries analyzed is the United States. Therefore, the greatest damage from this risk factor due to its contribution to cancer raises questions about the research methodology – including an even larger number of the population,” comments Oksana Drapkina. Let us note: this summer, at a meeting of the Government Council on issues of trusteeship in the social sphere, Ms. Drapkina herself pointed out that in 30 regions of Russia there is a trend towards an increase in the level of obesity. She cited data: in 1993, 8.3% of men and 23.2% of women suffered from obesity in Russia, in 2017 – 28.1% of men and 32.1% of women, in 2021 – 30.1% of men and 36.7% women.

The study shows how important primary prevention is, says Anton Barchuk: “If we are talking about body mass index, then this should be information campaigns and an attempt to change the diet. As for HPV, the simplest thing is to launch a full-scale vaccination campaign for adolescents.” However, the chief oncologist of the Ministry of Health of the Russian Federation, Andrei Karpin, points out that the incidence is a demographic indicator and the increase in the incidence of cancer is not “evil.” “On the contrary, this speaks about the quality of work of the oncology service, the improvement of diagnostic procedures and their accessibility,” says Mr. Karpin. “And if we turn to international statistics, then the “rough” cancer incidence rates in the UK or Germany are even higher than in Russia : 674.6 per 100 thousand people and 750.2 per 100 thousand people, respectively.”

Natalia Kostarnova