Cancer Causes & Control

, 20:395 | Cite as

Prevalence, trend, and sociodemographic association of five modifiable lifestyle risk factors for cancer in Alberta and Canada

  • Feng Xiao Li
  • Paula J. Robson
  • Yiqun Chen
  • Zhenguo Qiu
  • Geraldine Lo Siou
  • Heather E. Bryant
Original Paper



To examine the 12-year trend, in Alberta and Canada, of five modifiable lifestyle risk factors for cancer, and their associations with sociodemographic factors.


Six surveys collected data from Canadians aged ≥12 years. The prevalence, trends, and sociodemographic association of five lifestyle risk factors (smoking, inactivity, excessive drinking, overweight/obesity, and insufficient fruit/vegetable intake) were examined.


Smoking and inactivity decreased significantly: by 5.4% and 2.7% (Alberta men) and 4.9% and 12.1% (Alberta women); by 7.5% and 8.5% (Canada men) and 7.7% and 11.9% (Canada women). Excessive drinking increased significantly: by 3.6% (men) and 0.9% (women), Alberta; by 2.5% (men) and 0.9% (women), Canada. Overweight/obesity significantly increased by 6.0% (Alberta) and 4.1% (Canada) in women. Being female, single, highly educated, or having higher income decreased the likelihood of exposure to multiple lifestyle risk factors; being middle aged, widowed/separated/divorced, or in poor health condition increased the likelihood.


The downward trends for smoking and physical inactivity were in a direction that may help reduce cancer burden. The excessive drinking and overweight/obesity trends did not change in desired direction and deserve attention. The clustering of the lifestyle risk factors in specific social groups provides useful information for future intervention planning.


Prevalence Trend Lifestyle risk factors Sociodemographic factors Cancer 


  1. 1.
    Statistics Canada (2007) Mortality, summary list of causes, 2004. Available at
  2. 2.
    Colditz GA, Samplin-Salgado M, Ryan CT et al (2002) Harvard report on cancer prevention, volume 5: fulfilling the potential for cancer prevention: policy approaches. Cancer Causes Control 13:199–212. doi:10.1023/A:1015040702565 PubMedCrossRefGoogle Scholar
  3. 3.
    Colditz GA, DeJong D, Hunter D, Trichopoulos D, Willett W (1996) Harvard report on cancer prevention, volume 1: causes of human cancer. Cancer Causes Control 7:1–59. doi:10.1007/BF00051890 CrossRefGoogle Scholar
  4. 4.
    Stein CJ, Colditz GA (2004) Modifiable risk factors for cancer. Br J Cancer 90:299–303. doi:10.1038/sj.bjc.6601509 PubMedCrossRefGoogle Scholar
  5. 5.
    Tubiana M (1999) Cancer prevention. Acta Oncol 38:689–694. doi:10.1080/028418699432833 PubMedCrossRefGoogle Scholar
  6. 6.
    CDC (2002) Annual smoking-attributable mortality, years of potential life lost, and economic costs: United States, 1995–1999. MMWR Morb Mortal Wkly Rep 51:300–303Google Scholar
  7. 7.
    Doll R, Peto R (1981) The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 66:1191–1308PubMedGoogle Scholar
  8. 8.
    Jemal A, Tiwari RC, Murray T et al (2004) Cancer statistics, 2004. CA Cancer J Clin 54:8–29PubMedCrossRefGoogle Scholar
  9. 9.
    WHO International Agency for Research on Cancer (2003) World cancer report. In: Stewart BW, Kleihues P (eds) Lyon. IARC Press, FranceGoogle Scholar
  10. 10.
    World Cancer Research Fund/American Institute for Cancer Research (1997) Food, nutrition and the prevention of cancer: a global perspective. American Institute for Cancer Research, Washington, DCGoogle Scholar
  11. 11.
    Baan R, Straif K, Grosse Y et al (2007) Carcinogenicity of alcoholic beverages. Lancet Oncol 8:292–293. doi:10.1016/S1470-2045(07)70099-2 PubMedCrossRefGoogle Scholar
  12. 12.
    Seitz HK, Stickel F (2007) Molecular mechanisms of alcohol-mediated carcinogenesis. Nat Rev Cancer 7:599–612. doi:10.1038/nrc2191 PubMedCrossRefGoogle Scholar
  13. 13.
    Public Health Agency of Canada (2004) Progress report on cancer control in Canada: cancer prevention. Available at
  14. 14.
    Canadian Cancer Society and BC Cancer Agency (2005) Risk factor interventions: an overview of their effectiveness. Canadian Cancer Society and BC Cancer Agency, British ColumbiaGoogle Scholar
  15. 15.
    World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition and the prevention of cancer: a global perspective (second expert report). American Institute for Cancer Research, Washington, DCGoogle Scholar
  16. 16.
    Stephens M, Siroonian J (1998) Smoking prevalence, quit attempts and successes. Health Rep 9:31–37PubMedGoogle Scholar
  17. 17.
    Statistics Canada (1999) Personal health practices: smoking, drinking, physical activity and weight. Health Rep 11:83–90Google Scholar
  18. 18.
    Starky S (2005) The obesity epidemic in Canada. Available at
  19. 19.
    Shields M (2005) The journey to quitting smoking. Health Rep 16:19–36PubMedGoogle Scholar
  20. 20.
    Statistics Canada (2005) Population health surveys: National Population Health Survey (NPHS); Canadian Community Health Survey (CCHS). Available at
  21. 21.
    Sobell LC, Sobell MB, Leo GI, Agrawal S, Johnson-Young L, Cunningham JA (2002) Promoting self-change with alcohol abusers: a community-level mail intervention based on natural recovery studies. Alcohol Clin Exp Res 26:936–948PubMedGoogle Scholar
  22. 22.
    Sulaiman ND, Florey C, Taylor DJ, Ogston SA (1988) Alcohol consumption in Dundee primigravidas and its effects on outcome of pregnancy. BMJ 296:1500–1503PubMedCrossRefGoogle Scholar
  23. 23.
    Statistics Canada (2005) Canadian Community Health Survey (CCHS 3.1): Derived Variable (DV) Specifications. Statistics Canada Health Statistics Division, Ottawa, OntGoogle Scholar
  24. 24.
    Ainsworth BE, Haskell WL, Whitt MC et al (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32:S498–S516. doi:10.1097/00005768-200009001-00009 PubMedCrossRefGoogle Scholar
  25. 25.
    Tu D, Shao J (1995) The jackknife and bootstrap—springer series in statistics. Springer-Verlag, New York, LLCGoogle Scholar
  26. 26.
    O’Connell AA (2006) Logistic regression models for ordinal response variables—series: quantitative applications in the social sciences. SAGE Publications, London, p 27Google Scholar
  27. 27.
    Chaloupka FJ, Hu T, Warner KE, Jacobs R, Yurekli A (2007) Tobacco control in developing countries: the taxation of tobacco products. In: Jha P, Chaloupka TJ (eds) The World Bank. Available at
  28. 28.
    Division of Population Health & Information ACB (2007) Snapshot of tobacco facts: a resource to guide tobacco control planning in Alberta. Alberta Cancer Board. Available at
  29. 29.
    Alberta Cancer Board/Alberta Cancer Foundation (2007) Briefing note—RE: evidence supporting tobacco control policies, Alberta Cancer Board/Alberta Cancer Foundation. Available at
  30. 30.
    Health Canada (2005) Healthy living: Federal Tobacco Control Strategy. Available at
  31. 31.
    Chen Y, Mao Y (2006) Obesity and leisure time physical activity among Canadians. Prev Med 42:261–265. doi:10.1016/j.ypmed.2006.01.006 PubMedCrossRefGoogle Scholar
  32. 32.
    Saris WHM, Blair SN, van Baak MA et al (2003) How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obes Rev 4:101–114. doi:10.1046/j.1467-789X.2003.00101.x PubMedCrossRefGoogle Scholar
  33. 33.
    Engstrom L-M (2004) Social change and physical activity. Scand J Nutr 48:108–113. doi:10.1080/16513860410017674 CrossRefGoogle Scholar
  34. 34.
    Donaldson M (2004) Nutrition and cancer: a review of the evidence for an anti-cancer diet. Nutr J 3:19. doi:10.1186/1475-2891-3-19 PubMedCrossRefGoogle Scholar
  35. 35.
    Brown LM, Swanson CA, Gridley G et al (1995) Adenocarcinoma of the esophagus: role of obesity and diet. J Natl Cancer Inst 87:104–109. doi:10.1093/jnci/87.2.104 PubMedCrossRefGoogle Scholar
  36. 36.
    Vaughan TL, Davis S, Kristal A, Thomas DB (1995) Obesity, alcohol, and tobacco as risk factors for cancers of the esophagus and gastric cardia: adenocarcinoma versus squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev 4:85–92PubMedGoogle Scholar
  37. 37.
    Ji BT, Chow WH, Yang G et al (1997) Body mass index and the risk of cancers of the gastric cardia and distal stomach in Shanghai, China. Cancer Epidemiol Biomarkers Prev 6:481–485PubMedGoogle Scholar
  38. 38.
    Chow WH, Blot WJ, Vaughan TL et al (1998) Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst 90:150–155. doi:10.1093/jnci/90.2.150 PubMedCrossRefGoogle Scholar
  39. 39.
    Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591. doi:10.1038/nrc1408 PubMedCrossRefGoogle Scholar
  40. 40.
    Murphy TK, Calle EE, Rodriguez C, Kahn HS, Thun MJ (2000) Body mass index and colon cancer mortality in a large prospective study. Am J Epidemiol 152:847–854. doi:10.1093/aje/152.9.847 PubMedCrossRefGoogle Scholar
  41. 41.
    Calle E, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348:1625–1638. doi:10.1056/NEJMoa021423 PubMedCrossRefGoogle Scholar
  42. 42.
    Thorogood M, Mann J, McPherson K (1993) Alcohol intake and the U-shaped curve: do non-drinkers have a higher prevalence of cardiovascular-related disease? J Public Health Med 15:61–68PubMedGoogle Scholar
  43. 43.
    Williams GD, DeBakey SF (1992) Changes in levels of alcohol consumption: United States, 1983–1988. Br J Addict 87:643–648. doi:10.1111/j.1360-0443.1992.tb01966.x PubMedCrossRefGoogle Scholar
  44. 44.
    Rohan TE, Jain M, Howe GR, Miller AB (2000) Alcohol consumption and risk of breast cancer: a cohort study. Cancer Causes Control 11:239–247. doi:10.1023/A:1008933824645 PubMedCrossRefGoogle Scholar
  45. 45.
    Doll R (1997) One for the heart. BMJ 315:1664–1668PubMedGoogle Scholar
  46. 46.
    Thun MJ, Peto R, Lopez AD et al (1997) Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med 337:1705–1714. doi:10.1056/NEJM199712113372401 PubMedCrossRefGoogle Scholar
  47. 47.
    Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367:1747–1757. doi:10.1016/S0140-6736(06)68770-9 PubMedCrossRefGoogle Scholar
  48. 48.
    WHO (2003) The world health report: shaping the future. World Health Organization, Geneva, SwitzerlandGoogle Scholar
  49. 49.
    Backlund E, Sorlie PD, Johnson NJ (1999) A comparison of the relationships of education and income with mortality: the National Longitudinal Mortality Study. Soc Sci Med 49:1373–1384. doi:10.1016/S0277-9536(99)00209-9 PubMedCrossRefGoogle Scholar
  50. 50.
    Giskes K, Kunst AE, Benach J et al (2005) Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. J Epidemiol Community Health 59:395–401. doi:10.1136/jech.2004.025684 PubMedCrossRefGoogle Scholar
  51. 51.
    Laaksonen M, Rahkonen O, Karvonen S, Lahelma E (2005) Socioeconomic status and smoking: analysing inequalities with multiple indicators. Eur J Public Health 15:262–269. doi:10.1093/eurpub/cki115 PubMedCrossRefGoogle Scholar
  52. 52.
    CDC (2007) Cigarette smoking among adults–United States, 2006. MMWR Morb Mortal Wkly Rep 56:1157–1161Google Scholar
  53. 53.
    Regidor E, Gutierrez-Fisac JL, Ronda E, Calle ME, Martinez D, Dominguez V (2008) Impact of cumulative area-based adverse socioeconomic environment on body mass index and overweight. J Epidemiol Community Health 62:231–238. doi:10.1136/jech.2006.059360 PubMedCrossRefGoogle Scholar
  54. 54.
    Robert SA, Reither EN (2004) A multilevel analysis of race, community disadvantage, and body mass index among adults in the US. Soc Sci Med 59:2421–2434. doi:10.1016/j.socscimed.2004.03.034 PubMedCrossRefGoogle Scholar
  55. 55.
    van Lenthe FJ, Mackenbach JP (2002) Neighbourhood deprivation and overweight: the GLOBE study. Int J Obes Relat Metab Disrod 26:234–240. doi:10.1038/sj.ijo.0801841 CrossRefGoogle Scholar
  56. 56.
    Hammond EC, Garfinkel L (1961) Smoking habits of men and women. J Natl Cancer Inst 27:442Google Scholar
  57. 57.
    Harris JE (1983) Cigarette smoking among successive birth cohorts of men and women in the United States during 1900–80. J Natl Cancer Inst 71:473–479PubMedGoogle Scholar
  58. 58.
    Tolstrup J, Jensen MK, Tjonneland A, Overvad K, Mukamal KJ, Gronbaek M (2006) Prospective study of alcohol drinking patterns and coronary heart disease in women and men. BMJ 332:1244–1248. doi:10.1136/bmj.38831.503113.7C PubMedCrossRefGoogle Scholar
  59. 59.
    Martin S (2002) Surprise! Women eat healthier than men. CMAJ 167:913PubMedGoogle Scholar
  60. 60.
    Rust P, Elmadfa I (2005) Attitudes of Austrian adults to the consumption of fruits and vegetables. Forum Nutr 57:91–99. doi:10.1159/000083772 PubMedCrossRefGoogle Scholar
  61. 61.
    Schuit AJ, van Loon AJ, Tijhuis M, Ockθ MC (2002) Clustering of lifestyle risk factors in a general adult population. Prev Med 35:219–224. doi:10.1006/pmed.2002.1064 PubMedCrossRefGoogle Scholar
  62. 62.
    Poortinga W (2007) The prevalence and clustering of four major lifestyle risk factors in an English adult population. Prev Med 44:124–128. doi:10.1016/j.ypmed.2006.10.006 PubMedCrossRefGoogle Scholar
  63. 63.
    Galán I, Tobías A, Díez-Gañán L, Gandarillas A, Zorrilla B (2005) Clustering of behavioural risk factors and their association with subjective health. Gac Sanit 19:370–378. doi:10.1157/13080136 PubMedGoogle Scholar
  64. 64.
    CDC (2007) Fruit and vegetable consumption among adults—United States, 2005. MMWR Weekly 56:213–217Google Scholar
  65. 65.
    Goss J, Grubbs L (2005) Comparative analysis of body mass index, consumption of fruits and vegetables, smoking, and physical activity among Florida residents. J Community Health Nurs 22:37–46. doi:10.1207/s15327655jchn2201_4 PubMedCrossRefGoogle Scholar
  66. 66.
    Ward H, Tarasuk V, Mendelson R (2007) Socioeconomic patterns of obesity in Canada: modeling the role of health behaviour. Appl Physiol Nutr Metab 32:206–216. doi:10.1139/H06-104 PubMedCrossRefGoogle Scholar
  67. 67.
    Chen J, Ng E, Wilkins R (1996) The health of Canada’s immigrants in 1994–95. Health Rep 7:33–45PubMedGoogle Scholar
  68. 68.
    Georgiades K, Boyle MH, Duku E, Racine Y (2006) Tobacco use among immigrant and nonimmigrant adolescents: individual and family level influences. J Adolesc Health 38:443. doi:10.1016/j.jadohealth.2005.02.007 PubMedCrossRefGoogle Scholar
  69. 69.
    Tremblay MS, Pérez CE, Ardern CI, Bryan SN, Katzmarzyk PT (2005) Obesity, overweight and ethnicity. Health Rep 16:23–34PubMedGoogle Scholar
  70. 70.
    Katzmarzyk PT (2002) The Canadian obesity epidemic: an historical perspective. Obes Res 10:666–674. doi:10.1038/oby.2002.90 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Feng Xiao Li
    • 1
  • Paula J. Robson
    • 1
  • Yiqun Chen
    • 1
  • Zhenguo Qiu
    • 1
  • Geraldine Lo Siou
    • 2
  • Heather E. Bryant
    • 3
  1. 1.Division of Population Health and InformationAlberta Cancer BoardEdmontonCanada
  2. 2.Division of Population Health and InformationAlberta Cancer BoardCalgaryCanada
  3. 3.Canadian Partnership Against CancerTorontoCanada

Personalised recommendations