科学家早已知道一些癌症有可预防的原因；世界卫生组织旗下国际癌症研究机构领导的团队在2月3日发表于《自然·医学》的报告，给出了迄今最全面的估算。该研究覆盖30项风险因素，并估计2022年全球近2000万例新发癌症中有38%源于可预防因素；由于未纳入若干疑似致癌物，真实比例可能更高。

不同地区的暴露风险不同，但几乎在各地最突出的两项是烟草吸烟与感染。总体而言，全球每六例癌症中有一例由吸烟导致、每十例中有一例由感染导致；酒精在总排名中居第三位，导致男性全部癌症的4.6%与女性的1.6%，且在撒哈拉以南非洲以外几乎所有国家吸烟是男性癌症首要原因，并且在美洲、欧洲与大洋洲女性中居首，而在其他地区女性的首要原因是感染。

吸烟与至少15种癌症相关，戒烟后风险仍可能在数十年内偏高，因此多国正为现吸烟者与既往吸烟者引入常规CT筛查以更早发现肺癌。致癌感染方面，几乎所有宫颈癌由HPV慢性感染引起，肝癌主要源于乙肝与丙肝病毒，胃癌多由幽门螺杆菌感染造成；HPV与乙肝疫苗预计将在未来预防数百万例癌症，英国自2008年开始接种HPV疫苗后20多岁女性宫颈癌发病率下降了90%，而丙肝虽无疫苗但近十年来出现高效抗病毒治疗、幽门螺杆菌感染在过去一世纪因卫生与抗生素改善而大幅下降但在较贫穷国家仍广泛存在，且乳腺癌与胰腺癌等的发生多由尚未厘清的内部生物机制驱动、可预防性更低。

Scientists have long known that some cancers have preventable causes; a February 3 report in Nature Medicine led by the International Agency for Research on Cancer at the World Health Organisation provides the most comprehensive estimates to date. Covering 30 risk factors, it estimates that 38% of the nearly 20m new cancers worldwide in 2022 were due to preventable factors; because some suspected carcinogens were not included, the true share may be higher.

Risks vary by region, but two stand out almost everywhere: tobacco smoking and infections. Overall, one in six cancers worldwide is caused by smoking and one in ten by infection; alcohol ranks third, causing 4.6% of all cancers in men and 1.6% in women, and smoking is the leading cause for men in almost all countries outside sub-Saharan Africa and for women in America, Europe and Oceania, while infections lead for women elsewhere.

Smoking is linked to at least 15 cancer types and can leave elevated risk for decades after quitting, so many countries are introducing routine CT screening for current and former smokers to catch lung cancer earlier. For carcinogenic infections, nearly all cervical cancers are caused by chronic HPV infection, liver cancers mainly arise from Hepatitis B and C viruses, and stomach cancers are mostly caused by Helicobacter pylori; HPV and Hepatitis B vaccines are forecast to prevent millions of cancers, Britain has seen cervical-cancer rates among women in their 20s fall by 90% since HPV vaccination began in 2008, and while Hepatitis C lacks a vaccine effective antivirals have emerged in the past ten years and H. pylori infections have fallen sharply over the past century but remain widespread in poorer countries, while cancers such as breast and pancreas are still largely driven by internal biological mechanisms and are less amenable to prevention.

Source: More than a third of cancers arise from preventable risks

Subtitle: Smoking, infections and alcohol are the top causes

Dateline: 2月 05, 2026 06:24 上午