AHS Cancer Study - July 2015

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Cancer Incidence Attributable to Modifiable Risk Factors in

Alberta, Canada in 2012

FINAL REPORT

Produced by the Department of Cancer Epidemiology and Prevention Research

for the Alberta Cancer Prevention Legacy Fund

Dr. Anne Grundy, Postdoctoral Fellow (Epidemiology)

Abbey Poirier, Epidemiology Research Associate

Farah Khandwala, Statistical Analyst

Dr. Christine Friedenreich, Scientific Leader

Dr. Darren Brenner, Research Scientist

July 10, 2015


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Table of Contents

EXECUTIVE SUMMARY ............................................................................................................................. 3

GENERAL INTRODUCTION ........................................................................................................................ 6

CHAPTER 1 Cancer Incidence Attributable to Active and Passive Tobacco Exposure in Alberta, Canada

in 2012 ............................................................................................................................ 16

1.1 Cancer Incidence Attributable to Active Tobacco Smoking in Alberta, Canada in 2012

.............................................................................................................................. 23

1.2 Cancer Incidence Attributable to Passive Tobacco Exposure in Alberta, Canada in

2012....................................................................................................................... 55

CHAPTER 2 Cancer Incidence Attributable to Overweight and Obesity in Alberta, Canada in 2012 ...... 62

CHAPTER 3 Cancer Incidence Attributable to Inadequate Physical in Alberta, Canada in 2012 ............ 92

CHAPTER 4 Cancer Incidence Attributable to Alcohol Consumption in Alberta, Canada in 2012 ........ 112

CHAPTER 5 Cancer Incidence Attributable to Insufficient Fruit and Vegetable Consumption in Alberta,

Canada in 2012 .............................................................................................................. 126

CHAPTER 6 Cancer Incidence Attributable to Red and Processed Meat Consumption in Alberta,

Canada in 2012 .............................................................................................................. 155

CHAPTER 7 Cancer Incidence Attributable to Insufficient Fibre Consumption in Alberta, Canada in

2012 .............................................................................................................................. 192

CHAPTER 8 Cancer Incidence Attributable to Excess Salt Intake in Alberta, Canada in 2012 .............. 214

CHAPTER 9 Cancer Incidence Attributable to Suboptimal Vitamin D Intake in Alberta, Canada in 2012

...................................................................................................................................... 225

CHAPTER 10 Cancer Incidence Attributable to Insufficient Dietary Calcium Intake in Alberta, Canada in

2012 .............................................................................................................................. 259

CHAPTER 11 Cancer Incidence Attributable to Oral Contraceptive Pills and Hormone Replacement

Therapy Use in Alberta, Canada in 2012......................................................................... 275

CHAPTER 12 Cancer Incidence Attributable to Infections in Alberta, Canada in 2012 ......................... 295

CHAPTER 13 Cancer Incidence Attributable to Ultraviolet Light Exposure in Alberta, Canada in 2012 309

CHAPTER 14 Cancer Incidence Attributable to PM2.5Air Pollution in Alberta, Canada in 2012 ............ 318

CHAPTER 15 Lung Cancer Incidence Attributable to Radon Exposure in Alberta, Canada in 2012 ....... 326

CHAPTER 16 Bladder Cancer Incidence Attributable to Disinfection By-Products in Drinking Water in

Alberta, Canada in 2012 ................................................................................................ 334

CHAPTER 17 Justification for Risk Factor Removal or Omission from ACPLF PAR-Alberta Project ........ 340

CHAPTER 18 Summary ....................... ........................... ........................... ........................... ............... 345

APPENDIX A Additional Tables for Cancer Incidence Attributable to Alcohol Consumption in Alberta,Canada in 2012 .............................................................................................................. 355

APPENDIX B Additional Tables for Cancer Incidence Attributable to Insufficient Fruit and Vegetable

Consumption in Alberta, Canada in 2012 ....................................................................... 364


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EXECUTIVE SUMMARY


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Executive Summary

Cancer Incidence Attributable to Modifiable Risk Factors in Alberta, Canada in 2012describes

the results of a project that the cancer burden attributable to 24 modifiable l ifestyle and environmental

risk factors in the province of Alberta. The cancer risk factors included in this project were identified

through the International Agency for Research on Cancer (IARC) Monograph Series, the World Cancer

Research Fund (WCRF) Report and the peer-reviewed epidemiologic literature. The selected exposures

can be classified into the categories of tobacco consumption and exposure, environmental factors (air,

water and soil contaminants), infectious agents, hormone therapies, dietary intake characteristics and

energy imbalance. The population attributable risk (PAR) was used to provide an estimate of the

proportion of the cancer burden in Alberta that can be attributed to these 24 risk factors and therefore

represent the proportion of cancer that could theoretically be prevented by removal of the exposure in

the province. This is the first time that a comprehensive estimation of cancer burden associated with

these modifiable lifestyle and environmental risk factors, has been estimated in Alberta.

Three main types of data were required to estimate the individual PARs associated with each

risk factor at each relevant cancer site: the magnitude of the risk association between individual risk

factors and cancer sites; the prevalence (%) of the risk factor among adults in Alberta; and age-sex-site-specific cancer incidence in Alberta in 2012. Risk estimates used to quantify the magnitude of the

association between risk factors and individual cancer sites were obtained from reports from

international collaborative groups (IARC, WCRF) and a review of the peer-reviewed epidemiologic

literature. Prevalence data for the risk factors of interest were obtained from Statistics Canada surveys,

publically available government databases, the published peer-reviewed literature and consultation with

relevant experts. Cancer incidence data for Alberta were obtained from the Alberta Cancer Registry for

the year 2012, the most recent year for which data were available. Risk estimate and prevalence data

were combined to provide estimates of the population attributable cancer risk for each risk factor and

these PAR estimates were combined with cancer incidence data to estimate the number of cases of each

cancer type that could be attributed to individual risk factors in 2012. PAR estimates for individual riskfactors were combined to estimate the overall proportion of cancer in Alberta in 2012 that could be

attributed to the full set of 24 modifiable risk factors.

Of the 24 modifiable risk factors included in this project, active tobacco consumption (15.7%),

physical inactivity (7.2%) and excess body weight (4.3%) were the leading causes of cancer in Alberta in

2012. Overall the 24 modifiable lifestyle and environmental risk factors examined here were together

responsible for 42.3% or 6,699 excess cases of incident cancer in 2012. Considering men and women

separately, 40.2% of cancers in men (3,278 cases) and 43.9% of cancers in women (3,372 cases) could be

attributed to the included risk factors. The cancer sites where the largest proportions of cancer

incidence could be explained by these 24 modifiable risk factors were cervix (100%), lung (85.1%), larynx(81.4%), endometrium (80.1%) and esophagus (79.9%). Active tobacco smoking was the most important

risk factor for each of lung, laryngeal and esophageal cancers, whereas the burden of endometrial

cancer was most attributable to physical inactivity and excess body weight. The burden of cervical

cancer was entirely attributed to Human Papillomavirus (HPV) infection, as HPV infection is seen in all

cervical cancer cases and is required for the development of cervical cancer. Physical inactivity and

excess body weight were also leading causes of breast and colorectal cancers, which were two of the

most common types of cancer diagnosed in Alberta in 2012.


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Among environmental exposures, natural UV exposure in relation to malignant melanoma and

residential radon in relation to lung cancer were the most important cancer risk factors in Alberta.

Specifically, the estimated proportion of malignant melanoma attributable to natural UV exposure

ranged from 13% (based on the proportion of Albertans reporting at least one sunburn over their

lifetime) to 82.1% (when comparing number of melanomas diagnosed on skin that is regularly

exposed/unexposed to sunlight), which corresponds to 0.5% - 3.1% of all cancers diagnosed in Alberta.

Residential radon exposure was responsible for 16.7% of lung cancers in Alberta, where these

proportions differed for ever and never smokers with an estimated 15.7% of lung cancers attributable to

radon exposure among ever smokers and 24.2% among never smokers. These estimates translated to

2.0% of all cancers diagnosed in Alberta when smoking status was not considered. While these

estimates suggest radon exposure is more important among never smokers, given that approximately

90% of lung cancers are diagnosed in ever smokers, the actual number of lung cancer cases attributable

to radon exposure among smokers is higher.

Overall, the findings of this project indicate that the risk factors responsible for the greatest

proportions of cancer in Alberta in 2012 (active tobacco consumption, physical inactivity, excess body

weight) represent important targets for cancer prevention. Second, the fact that all cases of cervical

cancer can be considered attributable to HPV infection highlights the importance of stopping the spread

of HPV infection. In particular, this emphasizes the potential cancer prevention benefits associated with

widespread uptake of the HPV vaccine. While the results of this project demonstrate the impact of

environmental risk factors on the overall cancer burden is smaller than for behavioural risk factors such

as smoking and physical inactivity, these risk factors are important in relation to individual cancer types.

Furthermore, the most important environmental risk factors (residential radon and UV exposure) may

be the most amenable to prevention activities. Finally, we estimate that approximately 40% of Albertas

cancer burden can be attributed to the 24 cancer risk factors included in this project. Given that these

are all potentially modifiable characteristics, changes in their prevalence towards levels associated with

minimal cancer risk have the potential to substantially influence the number of cancers diagnosed in

Alberta. As such, the findings of the project described in this report provide quantifiable estimates of the

impact of these cancer risk factors and will aid in setting priorities for cancer prevention.


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GENERAL INTRODUCTION


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GENERAL INTRODUCTION

Background and Rationale for the Population Attributable Risk Alberta Project

The population attributable risk (PAR) is a measure that can be used to estimate the proportions

and numbers of cases of cancer that can be attributed to an individual risk factor. This measure

corresponds to the theoretical proportion of cancers that could be prevented if an individual risk factor

was removed from the population. These PAR estimates can inform public health planning and cancer

prevention programs by identifying the risk factors that have the largest impact on cancer incidence.

To date, research that has attempted to estimate these PARs for modifiable risk factors for

cancer in Canada, and more specifically Alberta, has been limited. In 2009, the economic burden of

occupational cancers for Alberta was estimated, although no population based estimates for non-

occupational exposures were included in this effort [1]. In Canada there have been other risk factor-

specific efforts to estimate population attributable cancer risks. Specifically, in 2014 Dr. Brenner

estimated that 3.5% of new cancer cases in Canada could be attributed to overweight/obesity and 7.9%

to physical inactivity [2]. Cancer Care Ontario has estimated that in Ontario, 15% of incident cancers

could be attributed to smoking [3], 2 4% to alcohol consumption [4] and 4% to overweight and obesity

[5]. Finally, there have been a number of efforts to estimate the proportion of lung cancer mortality that

could be attributed to residential radon exposure both for Canada [6-8] and Ontario [9], where

estimates range from 8% - 16% for Canada [6-8] and 13.6% for Ontario [9]. However, despite these

existing studies, no work has been done that focuses specifically on modifiable lifestyle and

environmental cancer risk factors for cancer outside of the occupational context in Alberta.

Outside of Canada, in 2010 Parkin et al.published a series of reports quantifying the burden of

cancer attributable to modifiable exposures in the United Kingdom [10-25]. These reports covered a

wide range of risk factors and overall estimated that exposure to less than optimum levels of the 14

risk factors included in the analysis was responsible for 42.7% of cancers in the United Kingdom in 2010,

with estimates of 45.3% for men and 40.1% for women [25]. To our knowledge, no similar systematic

assessment of the cancer burden in Alberta attributable to modifiable cancer risk factors has been

conducted.

Since information concerning the fraction of cancer attributable to individual risk factors is

important for both resource allocation and the implementation of population-based cancer prevention

strategies, additional research that quantifies the proportion of cancer attributable to individual cancer

risk factors in Alberta is needed. The Alberta Cancer Prevention Legacy Fund has a mandate to identify

cancer prevention priorities and implement preventive interventions across Alberta and PAR estimates

for modifiable cancer risk factors are needed to inform these activities. As such, the research described


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in this report details the results of the Population Attributable Risk Albertaproject, which was a

systematic effort to estimate the PAR associated with modifiable lifestyle and environmental cancer risk

factors in Alberta. Risk factors were selected for inclusion in this project on the basis of a literature

review of three main sources: 1) the International Agency for Research on Cancer (IARC) Monograph

Series; 2) the World Cancer Research Fund (WCRF) Report [26] and; 3) recent meta-analyses, large

prospective cohort studies and/or the current epidemiologic peer-reviewed literature. A complete list of

the risk factors included in the project described in the following chapters is found in Table I.1.

Evaluations of exposures occurring in an occupational setting were considered to be outside of the

scope of the project, as work quantifying the burden of cancer attributable to occupational exposures is

currently being conducted by the Occupational Cancer Research Centre at Cancer Care Ontario in

Toronto and their work will include Alberta-specific analyses (P. Demers, personal communication). The

data presented in the following chapters provides information on which modifiable risk factors make the

greatest contribution to Albertas cancer burden and quantifies the proportion of cancers in Alberta that

can be considered preventable.

Overview of Methods for the Population Attributable Risk Alberta Project

For all exposures included in the Population Attributable Risk Albertaproject, three sources of

data were required to calculate population attributable risk (PAR) estimates: 1) the prevalence of the

exposure among adults in Alberta; 2) the magnitude of the risk association between the exposure and

cancer site and; 3) cancer incidence data for those cancer sites in Alberta.

Risk Estimates

A detailed literature review of reports from international collaborative groups (e.g. IARC, WCRF),

along with a review of the current peer-reviewed literature in PubMed was conducted to extract risk

estimates for each exposure and cancer site of interest. When risk estimates were available from

multiple sources, they were prioritized according the process described in Figure I.1. This strategy

assumed that risk estimates reflect biological relationships independent of the population of study, such

that results from populations outside of Alberta or Canada would be applicable to the Alberta

population. In the end this process produced a single risk estimate for each exposure/cancer site pair,

stratified by gender, which was used in the estimation of PARs.

Exposure Prevalence Data

Prevalence data for the exposures of interest were collected at the provincial level, as well as by

Alberta Health Services (AHS) Zone. Prevalence data were obtained from a search of: 1) results from


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Statistics Canada surveys; 2) publically available government databases; 3) published peer-reviewed

literature; and 4) consultation with relevant experts. Data sources for estimation of exposure prevalence

were selected according to the hierarchy shown in Figure I.2.

Since the effect of exposure on cancer risk is assumed to be the product of previous exposure, a

biologically meaningful latency period was identified for all exposures from the peer-reviewed

epidemiologic literature. The average time between exposure and cancer diagnosis as assessed in high-

quality cohort studies was used to estimate an appropriate latency period. The quality of cohort studies

was evaluated based on the size of the cohort, methods of exposure assessment and follow-up time,

where large cohorts with detailed exposure and longer follow-up were considered to be of highest

quality. This latency information was then compared with the time period for which high-quality

exposure prevalence data were available. Where possible, prevalence estimates corresponding to the

midpoint of the range of potential latency periods identified from cohort studies were selected for

analysis. For example, if cohort studies identified potential latency periods as between nine and 13

years, exposure prevalence data incorporating an 11 year latency period were selected for analysis if

available. When high-quality prevalence data within the range of latency periods for a given exposure

could not be identified, the closest available estimates were used.

Cancer Incidence Data

Cancer incidence data for the year 2012 for Alberta were obtained from the Alberta Cancer

Registry and used for all exposures, as these are the most recent available data. Cases were classified

using the International Classification of Diseases for Oncology Third Edition (ICD-O-3) and the IARC rulesfor determining multiple primary sites.

Estimation of Population Attributable Risks

To estimate the PARs, Equation 1 was used with various modifications depending on the

exposure of interest. Exposure specific methods are described in more detail in each individual chapter.

1: = (

1)

1 + [( 1)]Pe= Prevalence of exposure

RR= relative risk


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The total number of attributable cancers at each site for each exposure were obtained by

multiplying the estimated PAR value by the total number of incident cancers at that site in 2012. Where

possible, PAR estimates and subsequent estimations of attributable cancers were stratified by age and

sex. Given the confidential nature of these data, any site-specific incident cancers with a total of less

than five cases were suppressed (displayed as


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13. Parkin D. 3. Cancers attributable to consumption of alcohol in the UK in 2010. British Journal of

Cancer. 2011;105:S14-S8.

14. Parkin DM. 5. Cancers attributable to dietary factors in the UK in 2010. Br J Cancer.

2011;105(s2):s24-S6.

15. Parkin DM, Boyd L. 6. Cancers attributable to dietary factors in the UK in 2010. Br J Cancer.

2011;105(S2):S27-S30.

16. Parkin DM. 7. Cancers attributable to dietary factors in the UK in 2010. Br J Cancer.

2011;105(S2):S31-S3.

17. Parkin DM, Boyd L. 8. Cancers attributable to overweight and obesity in the UK in 2010. Br J Cancer.

2011;105(S2):S34-S7.

18. Parkin DM. 9. Cancers attributable to inadequate physical exercise in the UK in 2010. Br J Cancer.

2011;105(S2):S38-S41.

19. Parkin DM. 10. Cancers attributable to exposure to hormones in the UK in 2010. Br J Cancer.

2011;105(S2):S42-S8.

20. Parkin DM. 11. Cancers attributable to infection in the UK in 2010. Br J Cancer. 2011;105(S2):S49-

S56.

21. Parkin DM, Darby SC. 12. Cancers in 2010 attributable to ionising radiation exposure in the UK. Br J

Cancer. 2011;105(S2):S57-S65.

22. Parkin DM, Mesher D, Sasieni P. 13. Cancers attributable to solar (ultraviolet) radiation exposure in

the UK in 2010. Br J Cancer. 2011;105(S2):S66-S9.

23. Parkin DM. 14. Cancers attributable to occupational exposures in the UK in 2010. Br J Cancer.2011;105(S2):S70-S2.

24. Parkin DM. 15. Cancers attributable to reproductive factors in the UK in 2010. Br J Cancer.

2011;105(S2):S73-S6.

25. Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental

factors in the UK in 2010. Br J Cancer. 2011;105 Suppl 2:S77-81.

26. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical

Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR, 2007.


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Table I.1.Exposure and Cancer Site Associations of Interest to be Included in this Project

Exposure Cancer types consistently associated with

exposure

Tobacco Consumption and ExposureActive exposure Lung

Oral cavity and pharynx

Oesophagus

Stomach

Liver

Pancreas

Colorectum

Larynx

Cervix

Ovarian (mucinous)

Urinary bladder

Kidney

Acute myeloid leukemiaPassive exposure Lung

Oral cavity and pharynx

Oesophagus

Larynx

Environmental factors (Air, Water, Soil Pollutants, Radiation)

Air pollution

PM 2.5 Lung

Radon Lung

UV Exposure Melanoma

Disinfection byproducts Bladder

Infectious agents

Human papillomavirus Cervix

Vagina

Penis

Anus

Vulva

Oropharynx

Helicobacter Pylori Stomach

Gastric mucosa-associated lymphoid tissue (MALT)

lymphoma.

Epstein Barr Virus non-Hodgkin lymphoma

Hodgkin lymphoma

Burkitt's lymphoma

Nasopharyngeal carcinoma

Hepatitis B Virus Liver

Hepatitis C Virus Liver


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Hormone therapies

Oral contraceptive use Breast

Endometrium

Ovary

Hormone Replacement Therapy Breast

Endometrium

Ovary

Dietary intake

Low vegetables intake Oral cavity and pharynx

(non-starchy) Oesophagus

Stomach

Larynx

Low fruit intake Oral cavity and pharynx

Oesophagus

Stomach

Larynx

Lung

High Alcohol Intake Mouth

Pharynx

Larynx

Liver

Colorectum

Breast (pre & post-menopause)

High red meat intake Colorectum

High process meat intake Colorectum

Low fibre intake Colorectum

Low vitamin D (Plasma 25-hydroxyvitamin D) Colorectum

Breast

High salt intake Stomach

Low dietary calcium intake Colorectum

Energy Imbalance

Overweight/Obesity Breast (post-menopausal)

(>25 kg/m2) Colorectum

Oesophagus (adenocarcinoma)

Kidney

Endometrium

Gall bladderPancreas

Physical inactivity Breast (post-menopausal)

Colorectum

Endometrium

Lung

Ovary

Prostate


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Figure I.1.The Process flow employed for selecting risk estimates used in this project.

Risk Estimates from International Collaborative Panels

Risk Estimates from High Quality* Meta-Analyses (2005

2014)

Risk Estimates from High Quality* Pooled Analyses of

Large Prospective Studies (2005 2014)

No Pooled or Meta-Analysis Results Available

quantitatively combine results from individual high quality** cohort and

*Quality determined using STrengthening the Reporting of OBservational

studies in Epidemiology (STROBE) guidelines for cohort and case-control

studies and Meta-analysis Of Observational Studies in Epidemiology (MOOSE)guidelines for meta-analysis


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1 Alberta Health Services2

CARcinogen Exposure (CAREX) a multi-institution research project dedicated to generating evidence

based carcinogen surveillance in Canada (www.carexcanada.ca)3

The Tomorrow Project is a large prospective cohort study currently being conducted in Alberta to study

health outcomes including cancer. The project, which began in 2000, is recruiting adults aged 35 69

who will be followed for up to 50 years.

Figure I.2. The hierarchy for selection of exposure prevalence estimates
http://www.carexcanada.ca/http://www.carexcanada.ca/http://www.carexcanada.ca/http://www.carexcanada.ca/


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CHAPTER 1 Cancer Incidence Attributable to Active and Passive

Tobacco Exposure in Alberta, Canada in 2012


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SUMMARY

The prevalence of current smokers in Alberta ranged from 12% - 31% in women and 14% - 40%

in men. The prevalence of former smokers ranged from 29% - 40% in women and 28% - 68% in men.

Approximately 78 % and 73% of lung cancer in men and women, respectively could be attributed to

current or former active tobacco smoking. Population attributable risk (PAR) estimates for the other

active tobacco-related cancer sites ranged from approximately 4% for ovarian cancer to 74% for

laryngeal cancer. Approximately 2% of incident lung cancers in never smoking men and women could be

attributed to passive tobacco exposure at home, in a vehicle or in a public place. Overall, approximately

37% of tobacco-related cancers in Alberta in 2012 were attributable to active tobacco smoking. This

equates to 16% of all incident cancers in Alberta in 2012 (Table 1.1).

METHODS OVERVIEW

Active and passive (second-hand smoke) tobacco exposures were analyzed independently using

separate data sources to calculate PARs of cancer in Alberta. These PAR estimates represent the

proportion of cancer at each individual cancer site that can be attributed to either active or passive

tobacco exposure. Three sources of data were required to calculate these PAR estimates: the prevalence

of active or passive tobacco smoking in Alberta, the magnitude of the relative risk (RR) between active

or passive tobacco smoking and the cancer sites of interest and cancer incidence data for those cancer

sites in Alberta. Data from the Canadian Community Health Survey (CCHS) were obtained for active and

passive tobacco exposure prevalence estimates. The cycle of the CCHS used corresponded to the

midpoint of the latency period suggested by cohort studies for each cancer site of interest (Table 1.2).As Alberta Health Services zone data were not available for Cycle 1.1 (2000/2001) of the CCHS, PAR

calculations by zone for cancer sites using exposure data from Cycle 1.1 were performed using CCHS

Cycle 2.1 (2003), as this was the earliest date for which such data were available. The relative risks for

the associations between active and passive tobacco exposure and the cancer sites of interest are

shown in Table 1.3.

Active Tobacco Exposure

In the CCHS, current smokers are defined as those who smoked cigarettes daily or occasionally

at the time of the interview, while former smokers are those who did not smoke at the time of the

interview and had smoked more than 100 cigarettes in their lifetime. For the current analyses, active

smoking included both current and former smokers. Analyses for current and former smokers

separately were also completed. Never smokers were defined as those who did not smoke at the time of

the interview and had smoked less than 100 cigarettes in their lifetime. The proportions of Albertans


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who were current or former smokers in 2000/2001 are shown in Table 1.1.1 and Figure 1.1.1.

Prevalence by Alberta health Services (AHS) Zone for the year 2003 are shown in Table 1.1.2 and Table

1.1.2.

PARs associated with active tobacco consumption were estimated according to equation 1.1:

1.1: = ( ) + 1 + ( ) +

where represents the prevalence of current smokers and represents the prevalence offormer smokers. Excess relative risks (ERRs) for both current and former smokers were calculated as the

RR 1. PARs were estimated using Equation 1.1 and then combined with cancer incidence data from the

year 2012 from the Alberta Cancer Registry for all included cancer sites to estimate the number of

excess attributable cancer cases. PAR estimates as well as the number of cancer cases attributable to

active tobacco smoking for each specific cancer site are shown in Table 1.1.3. PARs for active smoking

for each AHS zone are presented in Tables 1.1.4 1.1.8. PARs for current and former smoking exposure

separately are presented in Tables 1.1.9 and 1.1.10 respectively. Table 1.1.11 shows estimates of PAR

for Alberta similar to Table 1.1.3 including 95% confidence intervals to demonstrate the precision of our

estimates. For lung cancer specifically, the PARs and number of attributable cases are shown in Table

1.1.12, with results by AHS zone in Tables 1.1.13 1.1.17 and results for current and former smoking

separately in Table 1.1.18. The total number of cancer cases at each site attributable to active tobacco

smoking and other causes are shown in Figure 1.1.3.

Passive Tobacco Exposure

Data on the prevalence of passive smoking in never smokers were used for the current

analyses. Passive smokers (any exposure) were defined as those who were regularly exposed to tobacco

smoke in their home, a vehicle, or a public place. Prevalence and PAR estimates are also presented

separately for those exposed at home. The proportions of Albertans exposed to second-hand smoke are

shown in Table 1.2.1 (Figure 1.2.1) and by AHS zone in Table 1.2.2 (Figure 1.2.2).

PARs associated with passive tobacco exposure were estimated using Equation 1. To estimate

the cases of lung cancer attributable to passive tobacco exposure, an approximation of 10% of incident

lung cancer cases in the year 2012 from the Alberta Cancer Registry was used to represent the

proportion of lung cancer occurring in never smokers. This value was then multiplied by the PAR to

estimate the number of incident lung cancer cases attributable to passive tobacco exposure in Alberta in


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2012. Estimates of PAR for Alberta as well as the number of lung cancer cases attributable to passive

tobacco exposure are shown in Table 1.2.3 and Table 1.2.4 by AHS Zone.


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Table 1.1 Summary of cases and proportions of cancer in Alberta in 2012 attributable to active and passive tobacco exposurea

a. Data on prevalence of tobacco exposure from the Canadian Community Health Survey. Current smokers are defined as those who smoked cigarettes daily

occasionally at the time of the interview. Former smokers are those who did not smoke at the time of the interview and had smoked more than 100 cigarette

in their lifetime. Passive smokers were defined as those who were regularly exposed to tobacco smoke in their home, a vehicle, or a public place.

b. Cancer incidence data for the year 2012 from the Alberta Cancer Registry.

c. Number of observed cancer cases in Alberta in 2012 at individual cancer sites.

d. Number of cancer cases at individual cancer sites that can be attributed to active/passive tobacco exposure.

e. Proportion of cancers at individual cancer sites attributable to active/passive tobacco exposure. Calculated as excess attributable cases/observed cases.

f. All associated cancers includes all cancers known to be associated with active or passive tobacco exposure (as listed in the current table).

g. All cancers includes all incident cancer cases in Alberta for all ages in 2012.

Exposure Cancer Siteb

Total Men Women

Observed

Casesc

Excess

Attributable

Casesd

%

Attributablee

Observed

Cases

Excess

Attributable

Cases

%

Attributable

Observed

Cases

Excess

Attributable

Cases

%

Attributa

Active

Tobacco

Smoking

Lung 1952 1475 75.6 953 739 77.5 999 733 73.4

Colorectum 1951 223 11.4 1105 141 12.7 846 85 10.1

Kidney 482 95 19.7 326 69 21.1 156 28 18

Pancreas 379 73 19.3 171 36 20.9 208 37 17.7

Oral Cavity and Pharynx 373 159 42.6 273 123 45 100 39 38.7

Bladder 354 147 41.6 280 125 44.7 74 28 37.8

Stomach 255 53 20.9 158 36 23 97 18 18.9

Liver 217 57 26.4 148 42 28.6 69 17 24.1

Ovary 189 7 3.6 189 7 3.6

Esophagus 183 83 45.4 151 73 48.1 32 14 42.8

Myeloid Leukemia 176 22 12.3 99 14 13.8 77 8 10.8

Cervix 132 34 25.9 132 34 25.9

Larynx 76 56 74.3 64 49 76.5 12 8 70.8

All Associated Cancers 6719 2485 37.0 3728 1446 38.8 2991 1056 35.3

All Cancers 15836 2485 15.7 8155 1446 17.7 7681 1056 13.7

PassiveTobacco

Exposure

Lung 139 3 2.4 69 2 2.3 70 2 2.4All Associated Cancers

f 139 3 2.4 69 2 2.3 70 2 2.4

All Cancersg 15836 3 - 8155 2 - 7681 2 -


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Table 1.2 Predetermined latency periods by cancer site and cycle of prevalence data used for active and

passive tobacco exposure

Exposure Cancer site Corresponding CCHS cycle (year)

Active tobaccoexposure Lung 1.1 (2000/2001)Oral Cavity and pharynx 1.1 (2000/2001)

Larynx 3.1 (2005)

Esophagus 1.1 (2000/2001)

Stomach 3.1 (2005)

Liver 1.1 (2000/2001)

Pancreas 1.1 (2000/2001)

Colorectum 1.1 (2000/2001)

Ovary 1.1 (2000/2001)

Cervix 4.1 (2007)

Kidney 1.1 (2000/2001)

Myeloid Leukemia 1.1 (2000/2001)

Bladder 1.1 (2000/2001)

Passive tobacco

exposure

Lung 2.1 (2003)

CCHS, Canadian Community Health Survey


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Table 1.3 Relative risks of cancers for current and former active tobacco smokers compared to never smokers

Cancer sitePeriod/place of

exposureMen Women All Source

Active tobacco

Lung Current 9.9 7.6 9.0 Gandini et al., 2008

Former - - 3.8

Oral Cavity and

pharynx

Current - - 3.6 Gandini et al., 2008

Former - - 1.2

LarynxCurrent - - 7.0 Gandini et al., 2008

Former - - 4.6

EsophagusCurrent 2.52 2.3 2.5 Gandini et al., 2008

Former - - 2.0

StomachCurrent 1.7 1.4 1.6 Gandini et al., 2008

Former - - 1.3

LiverCurrent 1.8 1.5 1.6 Gandini et al., 2008

Former - - 1.5

PancreasCurrent 1.6 1.7 1.7 Gandini et al., 2008

Former - - 1.2

ColorectumCurrent 1.4 1.1 1.2 Tsoi et al., 2009

Former 1.2 1.2 1.2

OvaryCurrent - 1.1 - Hamajima et al., 2002

Former - 1.1 -

CervixCurrent - 2.2 - Gandini et al., 2008

Former - 1.3 -

KidneyCurrent 1.6 1.4 1.5 Gandini et al., 2008

Former - - 1.2

Myeloid

Leukemia

Current - - 1.1 Gandini et al., 2008

Former - - 1.3

BladderCurrent 2.8 2.7 2.8 Gandini et al., 2008

Former - - 1.7

Passive tobacco

LungEver exposed - - 1.34

Kim et al., 2014Exposed at home - - 1.19


23/365

23

1.1 Cancer Incidence Attributable to Active Tobacco Smoking in Alberta,

Canada in 2012


24/365

24

Table 1.1.1 Prevalence of current smokers and former smokers in Alberta, Canadian Community Health Survey,

2000-2001

Age (years)Prevalence (95% CI)

Current Smokers Former Smokers

Men

20-34 39.5 (36.1,42.9) 28.3 (25.5,31.2)

35-44 34.4 (30.8,37.9) 38.3 (35.0,41.7)

45-64 28.9 (25.9,31.9) 49.1 (45.5,52.6)

65 13.5 (10.5,16.5) 68.5 (64.2,72.7)

Women

20-34 31.0 (27.7,34.2) 28.5 (25.7,31.4)

35-44 29.7 (26.4,33.1) 35.1 (31.9,38.3)

45-64 26.0 (23.2,28.8) 40.1 (36.9,43.3)

65 12.4 (9.9,14.9) 38.7 (35.1,42.3)

Total

20-34 35.4 (33.0,37.7) 28.4 (26.4,30.5)

35-44 32.1 (29.6,34.6) 36.7 (34.3,39.1)

45-64 27.5 (25.4,29.5) 44.6 (42.3,47.0)

65 12.9 (10.9,14.9) 52.2 (49.4,55.0)

CI, confidence intervals


25/365

25

Table 1.1.2 Prevalence of current and former smokers in Alberta by health region (zone), Canadian Community Health Survey, 2003

Age (years)

Prevalence (95% CI)

South Zone Calgary Zone Central Zone Edmonton Zone North Zone

Current Former Current Former Current Former Current Former Current Forme

Men

20-34 27.7

(18.6,36.9)

34.1

(25.3,42.9)

32.9

(26.4,39.5)

35.0

(28.2,41.9)

36.6

(28.9,44.4)

31.6

(23.9,39.4)

28.6

(20.9,36.3)

34.4

(26.2,42.5)

41.2

(34.2,48.3)

32.1

(25.8,38

35-44 40.8

(27.0,54.5)

42.7

(29.0,56.1)

23.1

(15.7,30.5)

45.0

(37.1,53.0)

28.6

(20.6,36.6)

45.9

(36.7,55.1)

28.0

(19.3,36.6)

40.2

(31.2,49.2)

39.3

(31.2,47.3)

38.9

(31.2,46

45-64 26.2(18.4,34.1)

49.1(40.0,58.3)

20.2(13.8,26.6)

55.7(48.2,63.2)

30.2(23.7,36.6)

49.0(41.5,56.4)

28.9(22.8,34.9)

49.7(42.3,57.0)

26.9(22.2,31.7)

50.1(43.9,56

65 13.0

(6.9,19.1)

69.0

(59.8,78.2)

13.3

(6.9,19.7)

65.3

(56.4,74.3)

9.5

(5.0,14.0)

76.8

(70.7,83.0)

10.0

(4.4,15.6)

73.8

(65.4,82.1)

12.6

(7.0,18.3)

74.3

(66.8,81

Women

20-34 21.9

(15.4,28.5)

40.1

(30.9,49.2)

23.3

(17.6,29.1)

34.7

(28.7,40.7)

30.5

(24.3,36.7)

28.4

(22.2,34.7)

30.7

(24.4,37.0)

26.5

(20.8,32.1)

28.5

(23.3,33.8)

35.4

(29.3,41

35-44 34.5

(22.2,46.8)

37.6

(23.9,51.4)

21.2

(15.0,27.5)

39.8

(31.7,47.8)

31.1

(21.3,40.8)

35.3

(25.8,44.8)

26.1

(16.8,35.3)

39.1

(28.6,49.5)

32.4

(24.6,40.1)

39.6

(31.4,47

45-64 19.1

(12.9,25.3)

33.8

(25.8,41.9)

16.4

(11.4,21.3)

45.4

(38.6,52.1)

28.3

(22.9,33.7)

44.8

(39.2,50.4)

19.1

(13.8,24.4)

38.3

(31.4,45.2)

24.5

(19.8,29.3)

51.8

(45.8,57

65 8.6

(4.4,12.8)

30.7

(23.3,38.0)

10.3

(5.6,15.0)

46.6

(38.3,54.8)

12.8

(8.0,17.5)

32.7

(26.8,38.7)

13.8

(6.8,20.8)

40.4

(32.7,48.1)

12.0

(7.1,16.9)

39.9

(31.8,48

Total

20-34 25.1

(19.3,30.9)

36.8

(30.4,43.1)

28.2

(24.0,32.4)

34.9

(30.3,39.4)

33.6

(28.9,38.3)

30.0

(25.1,35.0)

29.6

(24.1,35.1)

30.4

(25.4,35.4)

35.1

(30.7,39.5)

33.7

(29.3,38

35-44 37.4

(28.5,46.3)

40.0

(30.4,49.7)

22.2

(17.1,27.3)

42.5

(36.8,48.2)

29.8

(23.5,36.0)

40.8

(34.2,47.5)

27.0

(20.6,33.5)

39.6

(32.8,46.5)

35.9

(30.4,41.3)

39.3

(33.7,44

45-64 22.7

(17.6,27.8)

41.5

(35.4,47.6)

18.3

(14.1,22.5)

50.6

(45.5,55.7)

29.3

(24.8,33.7)

46.9

(42.2,51.6)

24.0

(20.0,28.0)

44.0

(38.9,49.1)

25.8

(22.4,29.2)

50.9

(46.6,55

65 10.6

(6.7,14.4)

47.9

(41.8,54.1)

11.6

(7.6,15.6)

54.9

(48.8,61.0)

11.3

(8.0,14.6)

53.3

(48.3,58.3)

12.1

(7.5,16.7)

55.1

(49.0,61.3)

12.3

(8.7,16.0)

57.1

(51.2,63

CI, confidence interval


26/365

able 1.1.3 Cancer cases and proportions attributable to active smoking in Alberta (2012)

AC, excess attributable risk; Obs. Cases, observed cases; PAR, population attributable risk (%)

otes:

Cases represent the total number of cases of each cancer type in 2012

PAR represents the proportion (%) of cancer cases attributable to active smoking

Excess attributable cases represent the number of cases attributable to active smoking in 2012

Results by zone are included in Tables 1.1.4-1.1.8

Age at

Exposure

Lung Oral cavity and pharynx Esophagus Stomach Liver

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EA

Men

20-34 30-44 13 79.8 10 30-44 24 51.6 12 30-44 < 5 46.9 < 5 25-39 5 23.9 1 30-44 < 5 26.5 <

35-44 45-54 51 79.3 40 45-54 62 48.8 30 45-54 21 47.7 10 40-49 < 5 24.2 < 5 45-54 20 27.6 6

45-64 55-74 558 78.7 439 55-74 153 45.4 69 55-74 89 48.4 43 50-69 74 23.9 18 55-74 92 28.7 2

65 75 331 75.2 249 75 34 32.0 11 75 37 47.6 18 70 77 22 17 75 34 29.1 10

Total Total 953 739 Total 273 123 Total < 152 < 76 Total < 161 < 41 Total < 151 < 4

Women

20-34 30-44 8 76.6 6 30-44 12 45.9 6 30-44 < 5 43.1 < 5 25-39 5 19.7 1 30-44 < 5 23.9 <

35-44 45-54 76 77.1 59 45-54 14 45.2 6 45-54 < 5 44.7 < 5 40-49 13 21.9 3 45-54 6 25.3 2

45-64 55-74 574 76.3 438 55-74 42 42.5 18 55-74 20 44.5 9 50-69 29 21 6 55-74 43 25.5 11

65 75 341 67.6 231 75 32 28.0 9 75 7 36.9 3 70 50 16.8 8 75 18 20.6 4

Total Total 999 733 Total 100 39 Total 32 14 Total 97 18 Total < 72 < 2

otal

20-34 30-44 21 78.4 16 30-44 36 49 18 30-44 5 45.2 < 5 25-39 10 21.9 2 30-44 < 5 25.2 1

35-44 45-54 127 78.3 99 45-54 76 47.1 36 45-54 < 26 46.2 < 15 40-49 < 18 23.1 < 8 45-54 26 26.4 8

45-64 55-74 1132 77.6 878 55-74 195 44.0 86 55-74 109 46.6 51 50-69 103 22.5 24 55-74 135 27.1 37

65 75 672 71.5 481 75 66 29.8 20 75 44 42.2 19 70 127 19.3 25 75 52 24.7 14

Total Total 1952 1475 Total 373 159 Total < 184 < 90 Total < 258 < 59 Total < 218 57


27/365

able 1.1.3 Continued


Age at

Exposure

Pancreas Colorectum Larynx Bladder Kidney

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR E

Men

20-34 30-44 < 5 24.7 < 5 30-44 37 11.5 4 25-39 - - - 30-44 - - - 30-44 28 21.6

35-44 45-54 19 23.6 4 45-54 125 12.1 15 40-49 6 76.4 5 45-54 16 46.9 8 45-54 56 21.5

45-64 55-74 83 22.5 19 55-74 605 12.8 77 50-69 37 76.9 28 55-74 147 46.4 68 55-74 188 21.4

65 75 65 17.9 12 75 338 13.1 44 70 21 75.8 16 75 117 42.3 49 75 54 19.4

Total Total < 172 < 40 Total 1105 141 Total 64 49 Total 280 125 Total 326

Women

20-34 30-44 < 5 21.2 < 5 30-44 35 10.2 4 25-39 - - - 30-44 - - - 30-44 14 18.9

35-44 45-54 26 21.3 6 45-54 108 10.9 12 40-49 - - - 45-54 < 5 43.8 < 5 45-54 28 19.5

45-64 55-74 96 20.3 19 55-74 377 11 42 50-69 5 73.7 4 55-74 32 42.8 14 55-74 81 19.1

65 75 85 13.5 11 75 326 8.6 28 70 7 68.7 5 75 39 33.2 13 75 33 13.9

Total Total < 212 < 41 Total 846 85 Total 12 8 Total < 76 < 32 Total 156

otal

20-34 30-44 5 23 1 30-44 72 10.9 8 25-39 - - - 30-44 - - - 30-44 42 20.3

35-44 45-54 45 22.5 10 45-54 233 11.5 27 40-49 6 75.4 5 45-54 < 21 45.4 < 13 45-54 84 20.6

45-64 55-74 179 21.4 38 55-74 982 11.9 117 50-69 42 75.4 32 55-74 179 44.7 80 55-74 269 20.3

65 75 150 15.6 23 75 664 10.7 71 70 28 72.4 20 75 156 37.7 59 75 87 16.5

Total Total 379 72 Total 1951 223 Total 76 56 Total < 356 < 157 Total 482


28/365



Age at

Exposure

Myeloid Leukemia Cervix Ovary

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

Age at

Outcome

Obs.

CasesPAR EAC

en

20-34 30-44 10 10.1 1

35-44 45-54 15 11.8 2

45-64 55-74 47 13.7 6

65 75 27 16.5 4

Total Total 99 14

omen

20-34 30-44 9 9.5 1 25-39 49 25.3 12 30-44 15 3.4 1

35-44 45-54 13 10.8 1 40-49 30 28.3 8 45-54 41 3.7 2

45-64 55-74 27 11.6 3 50-69 38 27.7 11 55-74 85 3.8 3

65 75 28 10.4 3 70 15 18.3 3 75 48 3 1

Total Total 77 8 Total 132 34 Total 189 7

otal

20-34 30-44 19 9.8 2 25-39 49 25.3 12 30-44 15 3.4 1

35-44 45-54 28 11.3 3 40-49 30 28.3 8 45-54 41 3.7 2

45-64 55-74 74 12.7 9 50-69 38 27.7 11 55-74 85 3.8 3

65 75 55 13.2 7 70 15 18.3 3 75 48 3 1

Total Total 176 22 Total 132 34 Total 189 7


29/365

able 1.1.4 Other cancer (not including lung cancer) cases observed in the South Zonehealth region (2012) and proportions attributable to active smoking

bs. Cases, observed cases; PAR, population attributable risk (%)

ote: Estimates for lung cancer in the South Zone are shown in Table 1.13

Age at

Exposure

Oral cavity and pharynx Esophagus Stomach Liver Pancreas Colorectum

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 30-44 < 5 43.6 30-44 - - 25-39 - - 30-44 - - 30-44 - - 30-44 5 10.5

35-44 45-54 7 53 45-54 - - 40-49 - - 45-54 - - 45-54 < 5 26.6 45-54 11 13.7

45-64 55-74 6 43.2 55-74 12 47.3 50-69 7 24.2 55-74 7 27.9 55-74 11 21.4 55-74 56 12.3

65 75 6 31.4 75 < 5 47.5 70 12 21.5 75 < 5 29.1 75 7 17.7 75 27 13.1

Total Total < 24 Total < 17 Total 19 Total < 12 Total < 23 Total 99

Women

20-34 30-44 < 5 38.8 30-44 - - 25-39 - - 30-44 - - 30-44 - - 30-44 < 5 10.4

35-44 45-54 < 5 48.8 45-54 - - 40-49 - - 45-54 < 5 27.4 45-54 5 23.6 45-54 13 12

45-64 55-74 < 5 35.6 55-74 < 5 38.8 50-69 < 5 21.3 55-74 < 5 21.4 55-74 8 16.3 55-74 45 9

65 75 2 21.6 75 - 30.8 70 9 14.2 75 - 16.6 75 8 10.4 75 20 6.8

Total Total < 5 Total < 5 Total < 14 Total < 5 Total 21 Total < 83

otal

20-34 30-44 < 5 41.6 30-44 - - 25-39 - - 30-44 - - 30-44 - - 30-44 < 10 10.4

35-44 45-54 < 12 50.8 45-54 - - 40-49 - - 45-54 < 5 28.8 45-54 < 10 25 45-54 24 12.8

45-64 55-74 < 11 39.7 55-74 < 17 43.4 50-69 < 12 22.8 55-74 < 12 24.8 55-74 19 18.9 55-74 101 10.7

65 75 8 26.4 75 < 5 39.5 70 21 17.7 75 < 5 22.7 75 15 13.8 75 47 9.7

Total Total 24 Total 15 Total < 33 Total 14 Total < 44 Total < 182


30/365



Age at

Exposure

Larynx Bladder Kidney Myeloid Leukemia Cervix Ovary

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 25-39 - - 30-44 - - 30-44 < 5 18.7 30-44 < 5 10.5

35-44 40-49 - - 45-54 < 5 50.7 45-54 5 24.2 45-54 < 5 13.2

45-64 50-69 < 5 77.3 55-74 13 45 55-74 23 20.6 55-74 < 5 13.5

65 70 - - 75 10 42.1 75 < 5 19.4 75 < 5 16.5

Total Total < 5 Total < 28 Total 31 Total 7

Women

20-34 25-39 - - 30-44 - - 30-44 < 5 17.6 30-44 - - 25-39 6 24.3 30-44 - -

35-44 40-49 - - 45-54 - - 45-54 < 5 21.5 45-54 - - 40-49 < 5 33.4 45-54 < 5 4.1

45-64 50-69 - - 55-74 5 36.8 55-74 7 15.5 55-74 < 5 9.8 50-69 < 5 30.6 55-74 7 3.1

65 70 - - 75 < 5 27.2 75 < 5 10.8 75 < 5 8.3 70 0 17.5 75 8 2.3

Total Total - Total < 10 Total 12 Total 5 Total 11 Total < 20

otal

20-34 25-39 - - 30-44 - - 30-44 < 5 18.2 30-44 < 5 10.9 25-39 6 24.3 30-44 - -

35-44 40-49 - - 45-54 < 5 48.7 45-54 < 10 22.7 45-54 < 5 12.4 40-49 < 5 33.4 45-54 < 5 4.1

45-64 50-69 < 5 75.6 55-74 18 41.2 55-74 30 18.2 55-74 < 10 11.7 50-69 < 5 30.6 55-74 7 3.1

65 70 - - 75 < 15 34.7 75 5 14.9 75 < 10 12.2 70 0 17.5 75 8 2.3

Total Total < 5 Total 33 Total 43 Total 12 Total 11 Total < 20


31/365

able 1.1.5 Other cancer (not including lung cancer) cases observed in the Calgary Zonehealth region (2012) and proportions attributable to active smoking


ote: Estimates for lung cancer in the Calgary Zone are shown in Table 1.1.14

Age at

xposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

en

20-34 30-44 10 47.6 30-44 - - 25-39 < 5 23.4 30-44 < 5 26.2 30-44 < 5 22.7 30-44 10 11.4

35-44 45-54 19 40.3 45-54 < 5 44.8 40-49 - - 45-54 5 25.9 45-54 5 19.5 45-54 39 11.3

45-64 55-74 73 38.2 55-74 26 46.7 50-69 24 22 55-74 39 27.9 55-74 32 19.5 55-74 190 12.3

65 75 8 31.5 75 12 46.6 70 24 20.8 75 10 28.3 75 27 17.4 75 110 12.6Total Total 110 Total < 43 Total < 53 Total < 59 Total < 69 Total 349

omen

20-34 30-44 < 5 39.8 30-44 < 5 41.4 25-39 < 5 18.4 30-44 < 5 23.1 30-44 - - 30-44 17 9.8

35-44 45-54 7 38.1 45-54 < 5 42.1 40-49 < 5 20.9 45-54 < 5 23.9 45-54 7 18 45-54 46 10.2

45-64 55-74 15 33.5 55-74 8 41.6 50-69 10 19.9 55-74 17 23.9 55-74 37 16.4 55-74 116 10.3

65 75 10 25.8 75 < 5 38.8 70 14 17.4 75 9 22.2 75 24 13.5 75 99 9.5

Total Total < 37 Total < 23 Total < 29 Total < 36 Total 68 Total 278

tal

20-34 30-44 < 15 44.1 30-44 < 5 43.9 25-39 4 21 30-44 2 24.8 30-44 < 5 20.6 30-44 27 10.7

35-44 45-54 26 39.3 45-54 7 43.5 40-49 < 5 21 45-54 < 10 25 45-54 12 18.8 45-54 85 10.845-64 55-74 88 36 55-74 34 44.3 50-69 34 21 55-74 56 25.9 55-74 69 18 55-74 306 11.3

65 75 18 28.4 75 < 17 42.5 70 38 19 75 19 25 75 51 15.3 75 209 10.9

Total Total < 147 Total 57 Total < 81 Total < 87 Total < 137 Total 627


32/365



Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 25-39 - - 30-44 - - 30-44 13 20.5 30-44 < 5 11.0

35-44 40-49 < 5 73.4 45-54 7 42.3 45-54 17 18.9 45-54 < 5 12.5

45-64 50-69 13 75.1 55-74 42 43.1 55-74 70 19.6 55-74 18 14.4

65 70 8 74.7 75 44 41.4 75 23 18.9 75 5 15.8

Total Total < 26 Total 93 Total 123 Total 31

Women

20-34 25-39 - - 30-44 - - 30-44 < 5 17.2 30-44 < 5 10.3 25-39 13 20.5 30-44 6 3.4

35-44 40-49 - - 45-54 < 5 39.8 45-54 11 17.3 45-54 9 11.2 40-49 13 23.1 45-54 13 3.5

45-64 50-69 < 5 72.7 55-74 13 38.2 55-74 26 16.6 55-74 9 12.1 50-69 17 22.8 55-74 35 3.6

65 70 < 5 69.6 75 11 34.1 75 12 14.5 75 12 11.9 70 4 20.8 75 15 3.3

Total Total 5 Total < 29 Total < 54 Total < 35 Total 47 Total 69

otal

20-34 25-39 0 73.2 30-44 - - 30-44 < 18 19.0 30-44 7 10.7 25-39 13 20.5 30-44 6 3.4

35-44 40-49 < 5 73.4 45-54 < 12 41.1 45-54 28 18.1 45-54 < 14 11.9 40-49 13 23.1 45-54 13 3.5

45-64 50-69 < 18 74.0 55-74 55 40.8 55-74 96 18.1 55-74 27 13.3 50-69 17 22.8 55-74 35 3.6

65 70 < 13 72.1 75 55 37.5 75 35 16.5 75 17 13.7 70 4 20.8 75 15 3.3



33/365

able 1.1.6 Other cancer (not including lung cancer) cases observed in the Central Zonehealth region (2012) and proportions attributable to active smoking


ote: Estimates for lung cancer in the Central Zone are shown in Table 1.1.15

Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 30-44 < 5 49.9 30-44 < 5 46.7 25-39 < 5 23.2 30-44 - 26.5 30-44 - - 30-44 5 11.5

35-44 45-54 10 45.0 45-54 < 5 47.4 40-49 - - 45-54 < 5 27.8 45-54 < 5 22.0 45-54 20 12.3

45-64 55-74 16 46.4 55-74 12 48.9 50-69 9 25.0 55-74 9 29.0 55-74 7 23.1 55-74 87 12.9

65 75 < 5 27.7 75 5 48.3 70 11 21.6 75 < 5 30.0 75 11 17.0 75 51 13.6Total Total 29 Total 19 Total < 25 Total 14 Total < 23 Total 163

Women

20-34 30-44 < 5 45.5 30-44 - - 25-39 - - 30-44 < 5 23.7 30-44 - - 30-44 - -

35-44 45-54 < 5 46.3 45-54 - - 40-49 < 5 25.8 45-54 - - 45-54 < 5 22.0 45-54 5 11.2

45-64 55-74 < 5 44.7 55-74 5 47.0 50-69 < 5 24.0 55-74 5 27.4 55-74 11 21.8 55-74 54 12.1

65 75 < 5 27.9 75 < 5 34.6 70 < 5 17.2 75 < 5 18.8 75 14 12.9 75 56 7.8

Total Total 10 Total < 10 Total 9 Total 7 Total < 30 Total 115

otal

20-34 30-44 < 5 47.8 30-44 < 5 44.8 25-39 < 5 22.3 30-44 < 5 25.1 30-44 - - 30-44 5 10.8

35-44 45-54 < 15 45.6 45-54 < 5 46.4 40-49 < 5 25.9 45-54 < 5 26.8 45-54 6 22.0 45-54 25 11.7

45-64 55-74 < 21 45.6 55-74 17 48.0 50-69 < 14 24.5 55-74 14 28.3 55-74 18 22.5 55-74 141 12.5

65 75 < 10 27.9 75 < 10 41.8 70 < 16 19.4 75 5 24.5 75 25 14.9 75 107 10.6

Total Total 39 Total 26 Total < 35 Total 21 Total 49 Total 278


34/365



Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 25-39 - - 30-44 - - 30-44 < 5 21.2 30-44 < 5 10.6

35-44 40-49 < 5 78.2 45-54 < 5 45.6 45-54 10 20.9 45-54 < 5 13.0

45-64 50-69 < 5 77.7 55-74 18 47.0 55-74 21 21.8 55-74 < 5 13.8

65 70 < 5 75.6 75 16 41.9 75 11 19.4 75 < 5 17.8

Total Total 7 Total < 39 Total < 47 Total 10

Women

20-34 25-39 - - 30-44 - - 30-44 < 5 18.7 30-44 < 5 9.4 25-39 6 27.6 30-44 - -

35-44 40-49 - - 45-54 < 5 44.6 45-54 < 5 20.0 45-54 < 5 11.0 40-49 < 5 32.5 45-54 5 3.8

45-64 50-69 - - 55-74 < 5 45.2 55-74 13 20.6 55-74 7 12.8 50-69 7 33.0 55-74 10 4.2

65 70 < 5 69.3 75 6 31.6 75 5 12.9 75 < 5 9.1 70 < 5 18.8 75 9 2.7

Total Total < 5 Total 11 Total 24 Total 15 Total 17 Total 24

otal

20-34 25-39 - - 30-44 - - 30-44 6 20.0 30-44 5 10.0 25-39 6 27.6 30-44 - -

35-44 40-49 < 5 78.3 45-54 < 5 45.1 45-54 < 15 20.4 45-54 < 5 12.0 40-49 < 5 32.5 45-54 5 3.8

45-64 50-69 < 5 77.2 55-74 < 23 46.1 55-74 34 21.2 55-74 < 12 13.3 50-69 7 33.0 55-74 10 4.2

65 70 < 5 72.6 75 22 36.9 75 16 16.1 75 6 13.4 70 < 5 18.8 75 9 2.7

Total Total < 12 Total 46 Total < 71 Total 25 Total 17 Total 24


35/365

able 1.1.7 Other cancer (not including lung cancer) cases observed in the Edmonton Zonehealth region (2012) and proportions attributable to active smoking


ote: Estimates for lung cancer in the Edmonton Zone are shown in Table 1.1.16

Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 30-44 9 44.3 30-44 < 5 43.9 25-39 < 5 24.5 30-44 < 5 24.7 30-44 - - 30-44 10 10.6

35-44 45-54 22 44.2 45-54 13 45.5 40-49 < 5 25.8 45-54 9 26.1 45-54 8 21.2 45-54 35 11.4

45-64 55-74 43 45.4 55-74 32 48.6 50-69 27 24.9 55-74 28 28.8 55-74 21 22.6 55-74 206 12.8

65 75 12 28.0 75 13 47.6 70 22 23.0 75 8 29.5 75 15 16.9 75 109 13.3Total Total 86 Total < 63 Total 53 Total < 50 Total 44 Total 360

Women

20-34 30-44 < 5 45.6 30-44 - - 25-39 < 5 18.5 30-44 - - 30-44 < 5 20.8 30-44 12 9.8

35-44 45-54 4 42.6 45-54 - - 40-49 7 20.1 45-54 - - 45-54 9 20.2 45-54 33 10.9

45-64 55-74 22 35.9 55-74 5 40.5 50-69 9 19.9 55-74 16 22.8 55-74 31 16.8 55-74 114 9.7

65 75 14 29.9 75 < 5 38.4 70 17 16.5 75 6 21.6 75 31 14.5 75 125 9.1

Total Total < 45 Total < 10 Total < 38 Total 22 Total < 76 Total 284

otal

20-34 30-44 < 14 44.9 30-44 < 5 43.1 25-39 5 21.6 30-44 < 5 23.9 30-44 < 5 20.8 30-44 22 10.2

35-44 45-54 26 43.3 45-54 13 44.8 40-49 < 12 23.1 45-54 9 25.7 45-54 17 20.7 45-54 68 11.1

45-64 55-74 65 41.0 55-74 37 44.8 50-69 36 22.4 55-74 44 25.9 55-74 52 19.8 55-74 320 11.3

65 75 26 29.1 75 < 18 42.8 70 39 19.5 75 14 25.2 75 46 15.5 75 234 11.0

Total Total < 131 Total 68 Total < 92 Total < 72 Total < 120 Total 644


36/365



Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 25-39 - - 30-44 - - 30-44 6 19.0 30-44 < 5 10.6

35-44 40-49 < 5 77.7 45-54 < 5 44.0 45-54 16 19.7 45-54 6 11.8

45-64 50-69 12 77.7 55-74 56 46.5 55-74 52 21.5 55-74 15 13.8

65 70 8 76.5 75 37 41.5 75 13 19.1 75 13 17.2

Total Total < 25 Total < 98 Total 87 Total < 39

Women

20-34 25-39 - - 30-44 - - 30-44 < 5 18.4 30-44 < 5 9.0 25-39 14 27.3 30-44 5 3.3

35-44 40-49 - - 45-54 - - 45-54 6 18.9 45-54 < 5 11.4 40-49 8 26.8 45-54 12 3.8

45-64 50-69 < 5 72.1 55-74 10 38.0 55-74 24 16.3 55-74 7 10.8 50-69 6 27.4 55-74 25 3.3

65 70 < 5 68.4 75 15 34.9 75 9 14.7 75 8 10.8 70 8 18.5 75 14 3.1


otal

20-34 25-39 - - 30-44 - - 30-44 < 11 18.7 30-44 < 5 9.8 25-39 14 27.3 30-44 5 3.3

35-44 40-49 < 5 75.2 45-54 < 5 43.3 45-54 22 19.3 45-54 < 11 11.6 40-49 8 26.8 45-54 12 3.8

45-64 50-69 < 17 75.2 55-74 66 42.6 55-74 76 19.0 55-74 22 12.3 50-69 6 27.4 55-74 25 3.3

65 70 < 13 72.6 75 52 37.9 75 22 16.7 75 21 13.8 70 8 18.5 75 14 3.1



37/365

able 1.1.8 Other cancer (not including lung cancer) cases observed in the North Zone health region (2012) and proportions attributable to active smoking


ote: Estimates for lung cancer in the North Zone are shown in Table 1.1.17

Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 30-44 < 5 52.8 30-44 - - 25-39 - - 30-44 - - 30-44 < 5 25.7 30-44 7 12.3

35-44 45-54 < 5 51.9 45-54 < 5 49.8 40-49 - - 45-54 5 29.1 45-54 < 5 25.7 45-54 20 12.9

45-64 55-74 15 43.9 55-74 7 47.9 50-69 7 25.9 55-74 9 28.4 55-74 12 21.8 55-74 66 12.6

65 75 6 31.4 75 5 48.8 70 8 23.6 75 8 30.3 75 5 18.2 75 41 13.7Total Total 28 Total < 17 Total 15 Total 22 Total 19 Total 134

Women

20-34 30-44 < 5 44.3 30-44 - - 25-39 - - 30-44 - - 30-44 - - 30-44 < 5 10.8

35-44 45-54 - - 45-54 < 5 47.2 40-49 < 5 25.2 45-54 < 5 27.3 45-54 < 5 23 45-54 11 12.0

45-64 55-74 < 5 42.0 55-74 < 5 47.4 50-69 5 24.2 55-74 < 5 28.1 55-74 9 20.9 55-74 48 12.5

65 75 < 5 27.5 75 - - 70 6 18.0 75 < 5 20.8 75 8 13.5 75 26 8.7

Total Total 8 Total < 5 Total < 16 Total 7 Total < 22 Total < 90

otal

20-34 30-44 8 49.1 30-44 - - 25-39 - 24.7 30-44 - 26.6 30-44 < 5 23.5 30-44 < 12 11.6

35-44 45-54 < 5 49.8 45-54 < 5 48.5 40-49 < 5 25.9 45-54 < 10 28.2 45-54 < 5 24.4 45-54 31 12.5

45-64 55-74 < 20 43.0 55-74 < 12 47.7 50-69 12 25.1 55-74 < 14 28.3 55-74 21 21.4 55-74 114 12.5

65 75 < 11 29.5 75 5 43.6 70 14 20.9 75 < 13 25.9 75 13 15.9 75 67 11.3

Total Total 36 Total 17 Total < 31 Total 29 Total < 41 Total < 224


38/365



Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 25-39 - - 30-44 - - 30-44 < 5 22.7 30-44 < 5 11.0

35-44 40-49 < 5 78.3 45-54 < 5 49.4 45-54 8 23.2 45-54 < 5 12.3

45-64 50-69 6 78.6 55-74 18 45.6 55-74 22 21.0 55-74 9 13.8

65 70 < 5 77.5 75 10 43.1 75 5 20.1 75 < 5 17.5

Total Total 10 Total < 33 Total < 40 Total 15

Women

20-34 25-39 - - 30-44 - - 30-44 < 5 19.1 30-44 < 5 10.8 25-39 10 34.2 30-44 < 5 3.7

35-44 40-49 - - 45-54 - - 45-54 6 21.1 45-54 - - 40-49 6 37.9 45-54 8 4.1

45-64 50-69 < 5 77.1 55-74 - - 55-74 11 20.4 55-74 < 5 13.9 50-69 < 5 33.9 55-74 8 4.4

65 70 < 5 70.5 75 < 5 33.3 75 < 5 14.0 75 < 5 10.6 70 < 5 24.9 75 < 5 3.0

Total Total < 5 Total < 5 Total 24 Total 5 Total 21 Total 22

otal

20-34 25-39 - - 30-44 - - 30-44 < 10 21.1 30-44 < 5 10.9 25-39 10 34.2 30-44 < 5 3.7

35-44 40-49 < 5 77.9 45-54 < 5 47.9 45-54 14 22.2 45-54 < 5 12.2 40-49 6 37.9 45-54 8 4.1

45-64 50-69 < 11 77.9 55-74 18 45.1 55-74 33 20.7 55-74 < 14 13.8 50-69 < 5 33.9 55-74 8 4.4

65 70 < 5 74.5 75 < 15 38.6 75 < 10 17.1 75 6 14.2 70 < 5 24.9 75 < 5 3.0



39/365

able 1.1.9 Other cancer (not including lung cancer) cases observed in Alberta (2012) and proportions attributable to current smoking


otes:


PAR represents the proportion (%) of cancer cases attributable to current smoking

Results based on current smoking only

Estimates for lung cancer are shown in Table 1.1.18

Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 30-44 24 50.4 30-44 < 5 37.2 25-39 5 17.7 30-44 < 5 18.1 30-44 < 5 21.7 30-44 37 7.3

35-44 45-54 62 46.9 45-54 21 34.0 40-49 < 5 17.8 45-54 20 16.2 45-54 19 19.4 45-54 125 6.4

45-64 55-74 153 42.6 55-74 89 30.2 50-69 74 13.4 55-74 92 13.9 55-74 83 16.8 55-74 605 5.5

65 75 34 25.8 75 37 16.8 70 77 7.4 75 34 7.0 75 65 8.6 75 338 2.6

Total Total 273 Total < 152 Total < 161 Total < 151 Total < 172 Total 1105

Women

20-34 30-44 12 44.3 30-44 < 5 31.7 25-39 5 12.9 30-44 < 5 14.8 30-44 < 5 17.8 30-44 35 5.8

35-44 45-54 14 43.3 45-54 < 5 30.8 40-49 13 14.0 45-54 6 14.3 45-54 26 17.2 45-54 108 5.6

45-64 55-74 42 40.1 55-74 20 28.1 50-69 29 12.0 55-74 43 12.7 55-74 96 15.4 55-74 377 4.9

65 75 32 24.2 75 7 15.7 70 50 7.0 75 18 6.5 75 85 8.0 75 326 2.4

Total Total 100 Total 32 Total 97 Total < 72 Total < 212 Total 846

otal

20-34 30-44 36 47.6 30-44 5 34.7 25-39 10 15.4 30-44 < 5 16.5 30-44 5 19.9 30-44 72 6.6

35-44 45-54 76 45.2 45-54 < 26 32.5 40-49 < 18 16.0 45-54 26 15.2 45-54 45 18.3 45-54 233 6.0

45-64 55-74 195 41.4 55-74 109 29.2 50-69 103 12.7 55-74 135 13.3 55-74 179 16.1 55-74 982 5.2

65 75 66 24.9 75 44 16.2 70 127 7.1 75 52 6.7 75 150 8.3 75 664 2.5



40/365



Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 25-39 - - 30-44 - - 30-44 28 17.0 30-44 10 3.4

35-44 40-49 6 66.9 45-54 16 37.8 45-54 56 15.2 45-54 15 3.0

45-64 50-69 37 59.1 55-74 147 33.8 55-74 188 13.1 55-74 47 2.5

65 70 21 42.6 75 117 19.3 75 54 6.6 75 27 1.2

Total Total 64 Total 280 Total 326 Total 99

Women

20-34 25-39 - - 30-44 - - 30-44 14 13.9 30-44 9 2.7 25-39 49 20.8 30-44 15 1.8

35-44 40-49 - - 45-54 < 5 34.5 45-54 28 13.4 45-54 13 2.6 40-49 30 23.8 45-54 41 1.8

45-64 50-69 5 56.0 55-74 32 31.5 55-74 81 11.9 55-74 27 2.3 50-69 38 21.4 55-74 85 1.5

65 70 7 41.2 75 39 18 75 33 6.1 75 28 1.1 70 15 9.6 75 48 0.7

Total Total 12 Total < 76 Total 156 Total 77 Total 132 Total 189

otal

20-34 25-39 - - 30-44 - - 30-44 42 15.5 30-44 19 3.1 25-39 49 20.8 30-44 15 1.8

35-44 40-49 6 64 45-54 < 21 36.2 45-54 84 14.3 45-54 28 2.8 40-49 30 23.8 45-54 41 1.8

45-64 50-69 42 57.7 55-74 179 32.7 55-74 269 12.5 55-74 74 2.4 50-69 38 21.4 55-74 85 1.5

65 70 28 41.8 75 156 18.6 75 87 6.3 75 55 1.1 70 15 9.6 75 48 0.7



41/365

able 1.1.10 Other cancer (not including lung cancer) cases observed in Alberta (2012) and proportions attributable to former smoking


otes:


PAR represents the proportion (%) of cancer cases attributable to former smoking

Results based on former smoking only

Estimates for lung cancer are shown in Table 1.1.18

Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 30-44 24 4.8 30-44 < 5 22.6 25-39 5 9.0 30-44 < 5 12.2 30-44 < 5 4.8 30-44 37 4.8

35-44 45-54 62 6.4 45-54 21 28.3 40-49 < 5 9.3 45-54 20 15.8 45-54 19 6.4 45-54 125 6.4

45-64 55-74 153 8.1 55-74 89 33.6 50-69 74 13.8 55-74 92 19.4 55-74 83 8.1 55-74 605 8.1

65 75 34 11 75 37 41.4 70 77 16.9 75 34 25.1 75 65 11 75 338 11.0Total Total 273 Total < 152 Total < 161 Total < 151 Total < 172 Total 1105

Women

20-34 30-44 12 4.9 30-44 < 5 22.7 25-39 5 8.9 30-44 < 5 12.3 30-44 < 5 4.9 30-44 35 4.9

35-44 45-54 14 5.9 45-54 < 5 26.6 40-49 13 10.5 45-54 6 14.7 45-54 26 5.9 45-54 108 5.9

45-64 55-74 42 6.7 55-74 20 29.2 50-69 29 11.4 55-74 43 16.4 55-74 96 6.7 55-74 377 6.7

65 75 32 6.5 75 7 28.5 70 50 11.3 75 18 15.9 75 85 6.5 75 326 6.5

Total Total 100 Total 32 Total 97 Total < 72 Total < 212 Total 846

otal

20-34 30-44 36 4.9 30-44 5 22.6 25-39 10 8.9 30-44 < 5 12.2 30-44 5 4.9 30-44 72 4.9

35-44 45-54 76 6.2 45-54 < 26 27.4 40-49 < 18 9.9 45-54 26 15.2 45-54 45 6.2 45-54 233 6.2

45-64 55-74 195 7.4 55-74 109 31.5 50-69 103 12.6 55-74 135 17.9 55-74 179 7.4 55-74 982 7.4

65 75 66 8.6 75 44 35.0 70 127 14 75 52 20.4 75 150 8.6 75 664 8.6



42/365



Age at

Exposure


Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Age at

Outcome

Obs.

CasesPAR

Men

20-34 25-39 - - 30-44 - - 30-44 28 6.6 30-44 10 7.1

35-44 40-49 6 54.7 45-54 16 21.6 45-54 56 8.7 45-54 15 9.4

45-64 50-69 37 65.3 55-74 147 26.1 55-74 188 10.9 55-74 47 11.7

65 70 21 70.5 75 117 33 75 54 14.6 75 27 15.6

Total Total 64 Total 280 Total 326 Total 99

Women

20-34 25-39 - - 30-44 - - 30-44 14 6.7 30-44 9 7.1 25-39 49 7.1 30-44 15 1.7

35-44 40-49 - - 45-54 < 5 20.2 45-54 28 8.1 45-54 13 8.7 40-49 30 7.6 45-54 41 2.1

45-64 50-69 5 60.3 55-74 32 22.4 55-74 81 9.1 55-74 27 9.8 50-69 38 9.9 55-74 85 2.3

65 70 7 60.0 75 39 21.8 75 33 8.8 75 28 9.5 70 15 10.5 75 48 2.3


otal

20-34 25-39 - - 30-44 - - 30-44 42 6.6 30-44 19 7.1 25-39 49 7.1 30-44 15 1.7

35-44 40-49 6 56.4 45-54 < 21 20.9 45-54 84 8.4 45-54 28 9.0 40-49 30 7.6 45-54 41 2.1

45-64 50-69 42 63.0 55-74 179 24.3 55-74 269 10.0 55-74 74 10.7 50-69 38 9.9 55-74 85 2.3

65 70 28 65.6 75 156 27.3 75 87 11.5 75 55 12.4 70 15 10.5 75 48 2.3



43/365

43

Table 1.1.11 Cancer cases observed in Alberta (2012) and proportions attributable to active smoking

CI, confidence interval; PAR, population attributable risk

Age at

Exposure

Age at

OutcomeCancer Site

Total

Obs.

Cases

Total PAR

(95% CI)

Men

Obs.

Cases

Men PAR

(95% CI)

Women

Obs.

Cases

Women PAR

(95% CI)

20-34 30-44 Lung 21 78.4 (73.3,82.8) 13 79.8 (74.8,84.1) 8 76.6 (71.2,81

30-44 Oral cavity and pharynx 36 49.0 (37.5,59.4) 24 51.6 (39.7,61.9) 12 45.9 (34.5,56

30-44 Esophagus 5 45.2 (38.5,51.5) < 5 46.9 (40.1,53.7) < 5 43.1 (36.7,49

25-39 Stomach 10 21.9 (16.1,27.7) 5 23.9 (17.3,30.3) 5 19.7 (14.5,25

30-44 Liver < 5 25.2 (15.1,35.1) < 5 26.5 (16.1,36.4) < 5 23.9 (14.1,34

30-44 Pancreas 5 23.0 (18.0,27.9) < 5 24.7 (19.4,29.8) < 5 21.2 (16.3,25

30-44 Colorectum 72 10.9 (7.7,14.1) 37 11.5 (8.1,15.0) 35 10.2 (7.3,13.

25-39 Larynx - 74.1 (62.4,84.2) - 76.1 (64.4,86.0) - 71.7 (60.3,82

25-39 Cervix 49 25.3 (9.3,44.4) 49 25.3 (9.3,44.4

30-44 Ovary 15 3.4 (1.0,5.9) 15 3.4 (1.0,5.9

30-44 Bladder - 45.4 (37.6,52.9) - 47.4 (39.4,55.2) - 43.0 (35.3,50

30-44 Kidney 42 20.3 (15.2,25.5) 28 21.6 (16.3,27.1) 14 18.9 (14.0,23

30-44 Myeloid leukemia 19 9.8 (0,59.1) 10 10.1 (0,59.5) 9 9.5 (0,57.7)

35-44 45-54 Lung 127 78.3 (73.4,82.6) 51 79.3 (74.4,83.5) 76 77.1 (71.7,81


45-54 Esophagus 25 46.2 (39.9,52.2) 21 47.7 (41.5,53.8) 4 44.7 (38.4,50

40-49 Stomach < 18 23.1 (17.1,29.2) < 5 24.2 (17.8,30.8) 13 21.9 (16.0,27

45-54 Liver 26 26.4 (15.2,37.9) 20 27.6 (16.0,39.0) 6 25.3 (14.3,36

45-54 Pancreas 45 22.5 (17.4,27.6) 19 23.6 (18.3,28.9) 26 21.3 (16.3,26

45-54 Colorectum 233 11.5 (8.3,14.6) 125 12.1 (8.7,15.4) 108 10.9 (7.9,14.0

40-49 Larynx 6 75.4 (64.5,85.0) 6 76.4 (64.6,85.9) - -

40-49 Cervix 30 28.3 (10.1,48.6) 30 28.3 (10.1,48

45-54 Ovary 41 3.7 (1.1,6.5) 41 3.7 (1.1,6.5

45-54 Bladder < 21 45.4 (37.9,52.6) 16 46.9 (39.2,54.2) < 5 43.8 (36.3,50

45-54 Kidney 84 20.6 (15.5,25.5) 56 21.5 (16.3,26.7) 28 19.5 (14.7,2445-54 Myeloid leukemia 28 11.3 (0,63.5) 15 11.8 (0,64.7) 13 10.8 (0,63.2

45-64 55-74 Lung 1132 77.6 (72.6,81.9) 558 78.7 (73.8,83.0) 574 76.3 (71.0,80


55-74 Esophagus 109 46.6 (40.7,52.2) 89 48.4 (42.4,54.2) 20 44.5 (38.4,50

50-69 Stomach 103 22.5 (16.7,28.3) 74 23.9 (17.7,30.0) 29 21.0 (15.4,26

55-74 Liver 135 27.1 (14.2,39.8) 92 28.7 (15.2,41.8) 43 25.5 (13.4,37

55-74 Pancreas 179 21.4 (16.0,26.8) 83 22.5 (16.7,28.1) 96 20.3 (15.1,25

55-74 Colorectum 982 11.9 (8.7,15.1) 605 12.8 (9.4,16.2) 377 11.0 (8.1,14.

50-69 Larynx 42 75.4 (66.2,83.8) 37 76.9 (67.7,84.9) 5 73.7 (63.9,82

50-69 Cervix 38 27.7 (11.6,47.2) 38 27.7 (11.6,47

55-74 Ovary 85 3.8 (1.1,6.6) 85 3.8 (1.1,6.6

55-74 Bladder 179 44.7 (37.6,51.4) 147 46.4 (38.9,53.3) 32 42.8 (35.5,49

55-74 Kidney 269 20.3 (15.3,25.2) 188 21.4 (16.2,26.5) 81 19.1 (14.5,23

55-74 Myeloid leukemia 74 12.7 (0,68.8) 47 13.7 (0,70.9) 27 11.6 (0,66.9


44/365

44

Table 1.1.11 Continued

CI, confidence interval; PAR, population attributable risk

Notes:

This table duplicates Table 1.1.3, with the addition of 95% confidence intervals


PAR represents the proportion (%) of cancer cases attributable to active smoking

Age at

Exposure

Age at

OutcomeCancer Site

Total

Cases

Total PAR

(95% CI)

Men

Obs.

Cases

Men PAR

(95% CI)

Women

Obs.

Cases

Women PAR

(95% CI)

65 75 Lung 672 71.5 (64.8,77.3) 331 75.2 (68.5,80.8) 341 67.6 (60.4,73.9)

75 Oral cavity and pharynx 66 29.8 (13.6,45.6) 34 32.0 (10.9,50.2) 32 28.0 (14.1,41.8)

75 Esophagus 44 42.2 (36.4,47.8) 37 47.6 (41.3,53.5) 7 36.9 (31.0,42.6) 75 Stomach 127 19.3 (13.7,24.7) 77 22.0 (15.6,28.4) 50 16.8 (11.7,22.0)

75 Liver 52 24.7 (9.2,39.3) 34 29.1 (10.1,45.8) 18 20.6 (8.3,33.5)

75 Pancreas 150 15.6 (9.6,21.3) 65 17.9 (10.8,24.9) 85 13.5 (8.8,18.6)

75 Colorectum 664 10.7 (7.7,13.7) 338 13.1 (9.5,16.7) 326 8.6 (6.2,11.2)

75 Larynx 28 72.4 (63.8,80.0) 21 75.8 (68.0,82.7) 7 68.7 (59.2,77.7)

75 Cervix 15 18.3 (9.5,30.4)

75 Ovary 48 3.0 (0.7,5.4)

75 Bladder 156 37.7 (30.5,44.6) 117 42.3 (34.6,49.4) 39 33.2 (26.6,40.0)

75 Kidney 87 16.5 (11.7,21.1) 54 19.4 (13.7,25.0) 33 13.9 (9.9,17.9)

75 Myeloid leukemia 55 13.2 (0,71.6) 27 16.5 (0,76.9) 28 10.4 (0,64.7)


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Table 1.1.12 Proportions and cases of lung cancer attributable to current or former active smoking

in Alberta (2012)

CI, confidence interval; EAC, Excess attributable cases; PAR, population attributable risk

Notes:

Cases represent the total number of cases of lung cancer in 2012

PAR represents the proportion (%) of lung cancer cases attributable to active smoking

Excess attributable cases represent the number of lung cancer cases attributable to

active smoking in 2012

Results by zone are included in Tables 1.1.13-1.1.17

Age at Exposure Age at Outcome Observed Cases PAR (95% CI) EAC (95% CI)

Men

20-34 30-44 13 79.8 (74.8,84.1) 10 (5,16)

35-44 45-54 51 79.3 (74.4,83.5) 40 (29,52)

45-64 55-74 558 78.7 (73.8,83.0) 439 (395,483)

65 75 331 75.2 (68.5,80.8) 249 (216,282)

Total Total 953 739

Women

20-34 30-44 8 76.6 (71.2,81.3) 6 (2,11)

35-44 45-54 76 77.1 (71.7,81.6) 59 (46,73)

45-64 55-74 574 76.3 (71.0,80.9) 438 (392,483)

65 75 341 67.6 (60.4,73.9) 231 (198,264)

Total Total 999 733

Total

20-34 30-44 21 78.4 (73.3,82.8) 16 (10,24)

35-44 45-54 127 78.3 (73.4,82.6) 99 (82,118)

45-64 55-74 1132 77.6 (72.6,81.9) 878 (804,951)

65 75 672 71.5 (64.8,77.3) 481 (425,535)

Total Total 1952 1475


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Table 1.1.13 Proportions and cases of lung cancer attributable to active smoking in the

South Zonehealth region, Alberta in 2012



Men

20-34 30-44 - - -

35-44 45-54 8 81.7 (75.2,86.6) 7 (2,11)

45-64 55-74 56 77.7 (71.3,82.9) 44 (32,56)

65 75 35 75.0 (67.0,81.1) 26 (18,35)

Total Total 99 76

Women

20-34 30-44 - - -

35-44 45-54 5 79.2 (71.7,84.7) 4 (1,8)

45-64 55-74 46 71.3 (63.4,77.6) 33 (23,43)

65 75 37 60.9 (50.3,69.8) 23 (15,31)

Total Total 88 59

Total

20-34 30-44 - - -

35-44 45-54 13 80.5 (74.7,85.0) 10 (5,16)

45-64 55-74 102 74.9 (68.7,80.3) 76 (61,93)

65 75 72 68.8 (60.8,75.7) 50 (38,63)

Total Total 187 136


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Table 1.1.14 Proportions and cases of lung cancer attributable to active smoking in the Calgary

Zone health region, Alberta in 2012



Men

20-34 30-44 < 5 78.3 (72.8,83.0) < 5

35-44 45-54 12 75.7 (68.7,81.3) 9 (4,15)

45-64 55-74 150 76.2 (69.6,81.7) 114 (94,135)

65 75 108 74.5 (66.5,80.7) 80 (63,98)

Total Total < 275 < 208

Women

20-34 30-44 < 5 74.0 (67.2,79.5) < 5

35-44 45-54 25 73.8 (66.7,79.8) 18 (11,26)

45-64 55-74 162 72.2 (64.9,78.4) 117 (97,138)

65 75 96 68.2 (59.1,75.7) 66 (50,81)


Total

20-34 30-44 6 76.4 (71.0,81.2) 5 (1,9)

35-44 45-54 37 74.9 (68.6,80.3) 28 (19,37)

45-64 55-74 312 74.4 (67.8,79.8) 232 (200,264)

65 75 204 71.3 (63.5,77.8) 146 (121,170)

Total Total 559 410


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Table 1.1.15 Proportions and cases of lung cancer attributable to active smoking in the Central

Zonehealth region, Alberta in 2012



Men

20-34 30-44 5 79.2 (73.1,84.1) < 5

35-44 45-54 6 78.2 (71.9,83.2) 5 (2,9)

45-64 55-74 83 79.2 (73.5,83.7) 66 (51,81)

65 75 32 74.7 (66.7,80.8) 24 (16,33)

Total Total 126 < 99

Women

20-34 30-44 < 5 76.4 (70.2,81.7) < 5

35-44 45-54 11 77.7 (70.9,83.2) 9 (4,14)

45-64 55-74 95 77.9 (72.3,82.6) 74 (59,90)

65 75 45 66.1 (57.3,73.5) 30 (21,40)


Total

20-34 30-44 < 10 77.9 (72.3,82.7) < 10

35-44 45-54 17 77.9 (72.0,82.7) 13 (7,20)

45-64 55-74 178 78.6 (73.4,83.1) 140 (118,163)

65 75 77 70.7 (63.2,77.1) 54 (42,68)



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Table 1.1.16 Proportions and cases of lung cancer attributable to active smoking in the

Edmonton Zonehealth region, Alberta in 2012



Men

20-34 30-44 < 5 76.5 (69.9,81.9) < 5

35-44 45-54 18 77.1 (70.4,82.5) 14 (8,21)

45-64 55-74 187 78.8 (73.2,83.4) 147 (125,171)

65 75 120 74.4 (66.0,80.8) 89 (71,108)


Women

20-34 30-44 < 5 76.2 (70.0,81.5) < 5

35-44 45-54 27 76.1 (68.7,81.8) 21 (13,29)

45-64 55-74 189 72.3 (65.2,78.3) 137 (114,161)

65 75 134 69.2 (59.6,76.7) 93 (74,112)


Total

20-34 30-44 5 76.3 (70.4,81.4) 4 (1,8)

35-44 45-54 45 76.6 (70.6,81.7) 34 (24,45)

45-64 55-74 376 76.0 (70.3,80.9) 286 (250,322)

65 75 254 71.7 (63.6,78.0) 182 (153,211)

Total Total 680 506


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Table 1.1.17 Proportions and cases of lung cancer attributable to active smoking in the North

Zonehealth region, Alberta in 2012



Men

20-34 30-44 < 5 80.7 (75.5,85.1) < 5

35-44 45-54 7 80.9 (75.5,85.3) 6 (2,10)

45-64 55-74 82 78.1 (72.7,82.7) 64 (50,79)

65 75 36 75.7 (68.1,81.6) 27 (18,37)


Women

20-34 30-44 < 5 76.6 (70.7,81.5) < 5

35-44 45-54 8 78.8 (72.9,83.6) 6 (2,11)

45-64 55-74 82 77.4 (71.6,82.3) 63 (50,78)

65 75 29 67.7 (58.7,74.7) 20 (13,27)


Total

20-34 30-44 < 5 79.0 (73.9,83.4) < 5

35-44 45-54 15 79.9 (74.8,84.2) 12 (6,18)

45-64 55-74 164 77.8 (72.4,82.3) 128 (10

AHS Cancer Study - July 2015

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