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As noted above, epidemiologists have attributed as many as 30% of all cancer deaths to tobacco use, primarily cigarette smoking. In 2005, for example, approximately 163,000 deaths due to lung cancer were expected to occur in the United States (90,000 men and 73,000 women), making up about 31% of all deaths from cancer in men and 27% in women.3 Although the most direct correlation is between cigarette smoking and lung cancer, tobacco use has also been implicated in cancers of the mouth, pharynx, larynx, esophagus, urinary bladder, pancreas, kidney, and, more recently, stomach and liver49 and perhaps colorectal cancer.52 Smoking of pipes or cigars has been implicated in the occurrence of cancers of the mouth, pharynx, larynx, and esophagus, but this form of tobacco use is generally considered much less dangerous because the smoke is usually not inhaled. A number of studies have also suggested a correlation between ''passive

Table 3-5. Estimated Percentage of Total Cancer Deaths Attributable to Established Causes of Cancer

Risk Factor Percentage

Tobacco 30

Adult diet and obesity 30

Sedentary lifestyle 5

Occupational factors 5

Family history of cancer 5

Viruses and other biologic agents 5

Perinatal factors and growth 5

Reproductive factors 3

Alcohol 3

Socioeconomic status 3

Environmental pollution 2

Ionizing and ultraviolet radiation 2

Prescription drugs and medical procedures 1

Salt, other food additives, and contaminants 1

^Estimates according to Harvard Center for Cancer Prevention. (From America's War on Carcinogens50)

Table 3-6. Established Human Carcinogenic Agents and Circumstances

Type of Exposure*

Table 3-6. Established Human Carcinogenic Agents and Circumstances

Type of Exposure*

Agent or Circumstance




Site of Cancer


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