Monitoring the Role of Modifiable Factors in Cancer Burden with Population-Based Surveys

Key Contextual Factors

• Utilizes health registry infrastructure (cancer registry) for obtaining incident cancers, repeated national large-scale health surveys (background characteristics, lifestyle factors) and population demographic registration for the construction of follow-up cohort for cancer risk assessment.
• Implemented as part of infrastructure of the National Institute of Health and Welfare with close collaboration of Cancer Society Finland and Finnish Cancer Registry.
• Challenges include difficulties in reaching lower socioeconomic groups for the surveys and communicating recommendations related to reduction of the cancer risk factors in a positive manner.

Key Components/Steps

• The key component of setting up the monitoring system is the ability to utilize health registry infrastructure in Finland: cancer registry for obtaining incident cancers, repeated national large-scale health surveys for background characteristics and lifestyle factors, and population demographic registration for the construction of follow-up cohort for the cancer risk assessment.
• Utilizing several national registry data infrastructure requires knowledge of laws on data security etc.
• The implementation of the results will take place as part of primary prevention activities of the Cancer Society Finland.

Main Impacts / Added Value

• Benefits for the individuals: Up-to-date information on joint and interactive effects of lifestyle habits on cancer-specific risk. 
• Benefits for the society: Information on the current and future role of risk factors in cancer burden. The project will provide up-to-date information on the attributable fractions of modifiable lifestyle factors in cancer risk and mortality.
• We have assessed contribution of major lifestyle factors in cancer risk and will proceed with the evaluation of major lifestyle factor effects on preventable fractions of cancers in the Finnish population.

Lessons Learned

• Pooling health surveys from several decades is essential for reliable estimation of the role of modifiable factors in cancers due to their long incubation period.
• Long and comprehensive follow-up is vital, because many cancers are rare.
• The project has demonstrated not only the importance, but also the incompleteness of national data infrastructure. More comprehensive information is needed on the prevalence of lifestyle factors, even them being difficultly measured.

Download PDF