CONFERENCE PROCEEDING
Projected impact of full implementation of tobacco control policies on future cancer incidence in East Asia
1
Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
Tob. Prev. Cessation 2026;12(Supplement 1):A111
ABSTRACT
BACKGROUND-AIM:
East Asia accounts for almost one-third of all cancer cases worldwide. Tobacco use continues to be one of the leading drivers of cancer in this region, particularly among men. This study evaluated how many cancer cases could be avoided over the next 25 years if East Asian countries were to maximize the implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC).
METHODS:
Using population-level data, we examined the association between changes in the national implementation of the WHO FCTC’s MPOWER measures (Monitor, Protect, Offer, Warn, Enforce, and Raise) and tobacco smoking prevalence through fixed-effects linear regression models, with and without Human Development Index (HDI) adjusted. Based on the model outputs, we generated two projections of smoking prevalence: (1) continuation of current trends and (2) full implementation of all MPOWER measures. Population Attributable Fractions (PAFs) for 13 cancer types linked to tobacco use were calculated using Levin’s formula. The number of preventable cancers (Potential Impact Fraction - PIF) was estimated as the difference of number of attributable cancers between the current and full implementation scenarios.
RESULTS:
Between 2025 and 2050, 163 million tobacco-related cancer cases are projected in East Asian countries, of which 44.5 million (PAF: 27.3%; 95% CI: 25.4–29.3) could be attributed to tobacco smoking. Of these, 41.8 million are expected among men (PAF: 41.2%) and 2.7 million among women (PAF: 4.2%). Before accounting for the HDI variations, full implementation of MPOWER measures was estimated to prevent 3.5 million (95% CI: 2.9–4.0) incident cancers (PIF: 2.1%), while, after accounting for the HDI variations, the estimated number of preventable cancers decreased to 2.2 million (PIF: 1.3%). The highest number of preventable cancers due to full implementation of MPOWER was observed in China (2.7 million, 95% CI: 2.3–3.1 million), followed by Japan (350000, 95% CI: 290000–260000) and Indonesia (137000, 95% CI: 109000–165000). By cancer sites, lung cancer (1.9 million), liver (309000), stomach (259000) and esophageal (238000) cancers were the leading preventable cancers.
CONCLUSIONS:
We found that comprehensive implementation of MPOWER policies could substantially reduce the future cancer burden in East Asian countries, even after adjusting for the variations in HDI. This study underscores the critical importance of strengthening tobacco control efforts across the region.
East Asia accounts for almost one-third of all cancer cases worldwide. Tobacco use continues to be one of the leading drivers of cancer in this region, particularly among men. This study evaluated how many cancer cases could be avoided over the next 25 years if East Asian countries were to maximize the implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC).
METHODS:
Using population-level data, we examined the association between changes in the national implementation of the WHO FCTC’s MPOWER measures (Monitor, Protect, Offer, Warn, Enforce, and Raise) and tobacco smoking prevalence through fixed-effects linear regression models, with and without Human Development Index (HDI) adjusted. Based on the model outputs, we generated two projections of smoking prevalence: (1) continuation of current trends and (2) full implementation of all MPOWER measures. Population Attributable Fractions (PAFs) for 13 cancer types linked to tobacco use were calculated using Levin’s formula. The number of preventable cancers (Potential Impact Fraction - PIF) was estimated as the difference of number of attributable cancers between the current and full implementation scenarios.
RESULTS:
Between 2025 and 2050, 163 million tobacco-related cancer cases are projected in East Asian countries, of which 44.5 million (PAF: 27.3%; 95% CI: 25.4–29.3) could be attributed to tobacco smoking. Of these, 41.8 million are expected among men (PAF: 41.2%) and 2.7 million among women (PAF: 4.2%). Before accounting for the HDI variations, full implementation of MPOWER measures was estimated to prevent 3.5 million (95% CI: 2.9–4.0) incident cancers (PIF: 2.1%), while, after accounting for the HDI variations, the estimated number of preventable cancers decreased to 2.2 million (PIF: 1.3%). The highest number of preventable cancers due to full implementation of MPOWER was observed in China (2.7 million, 95% CI: 2.3–3.1 million), followed by Japan (350000, 95% CI: 290000–260000) and Indonesia (137000, 95% CI: 109000–165000). By cancer sites, lung cancer (1.9 million), liver (309000), stomach (259000) and esophageal (238000) cancers were the leading preventable cancers.
CONCLUSIONS:
We found that comprehensive implementation of MPOWER policies could substantially reduce the future cancer burden in East Asian countries, even after adjusting for the variations in HDI. This study underscores the critical importance of strengthening tobacco control efforts across the region.
| eISSN: | 2459-3087 |
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