Table 2. Prevention program types.

The estimated PAF provides an indirect measure of the potential impact for a given prevention program. HPV, human papilloma virus; HCC, hepatocellular carcinoma.

EtiologyCarcinogenic risk factor (associated PAF)Overall PAF (%)Risk reduction programsKey multisectoral partnersEstimated cost-effectiveness
Infectious etiologiesHPV (cervical cancer 90–100%)*
Hepatitis B and C (HCC 77%)*
H. pylori (gastric cancer 75%)*
18VaccinationsHealth care workers
Pharmaceutical companies
Legislative bodies
Very cost-effective
Behavioral factorsTobacco (30%)†
Obesity (20%)†
Diet (5%)†
Alcohol (4%)†
66Tobacco cessation
Exercise programs
Public education and outreach
General population (health literacy)
Legislative bodies
Health care workers
Very cost-effective
Environmental factorsAir pollution
Aflatoxins
4Environmental regulationsLegislative bodies
Business sector
Potentially cost-effective
Clinical interventionsChemoprevention (such as tamoxifen, aspirin, celecoxib, or finasteride)
Surgical procedures (such as prophylactic mastectomy or prophylactic oophorectomy)
N/AInsurance coverage for correctly selected individuals at elevated riskHealth care workers
Pharmaceutical companies
General population
Cost-effective

*Percentage reflects PAF for a single cancer type (for example, 90 to 100% of cervical cancer can be avoided with universal vaccination). †Percentage reflects PAF for multiple cancer types (for example, reducing obesity can decrease incidence of up to 20% of cancers).