Freddie Bray

Bio: Freddie Bray is an academic researcher from International Agency for Research on Cancer. The author has contributed to research in topics: Cancer & Population. The author has an hindex of 111, co-authored 402 publications receiving 262938 citations. Previous affiliations of Freddie Bray include University of Oslo.

Mustard oil consumption, cooking method, diet and gallbladder cancer risk in high- and low-risk regions of India.

Abstract: The current study aimed to investigate the role of cooking with mustard oil and other dietary factors in relation to gallbladder cancer (GBC) in high- and low-incidence regions of India. A case-control study was conducted including 1,170 histologically confirmed cases and 2,525 group-matched visitor controls from the largest cancer hospital in India. Dietary data were collected through a food frequency questionnaire. For oil consumption, we enquired about monthly consumption of 11 different types of cooking oil per family and the number of individuals usually sharing the meal to estimate per-individual consumption of oil. Information about method of cooking was also requested. Odds ratios (ORs) and 95% confidence intervals (CIs) quantifying the association of GBC risk consumption of different types of oil, method of cooking, and dietary food items, were estimated using logistic regression models, after adjusting for potential confounders. High consumption of mustard oil was associated with GBC risk in both high- and low-risk regions (OR = 1.33, 95% CI = 0.99-1.78; OR = 3.01, 95% CI = 1.66-5.45), respectively. An increased risk of GBC was observed with deep frying of fresh fish in mustard oil (OR = 1.57, 95% CI = 0.99-2.47, p-value = 0.052). A protective association was observed with consumption of leafy vegetables, fruits, onion and garlic. No association was observed between consumption of meat, spicy food, turmeric, pulses or with any other oil as a cooking medium. The effect of high consumption of mustard oil on GBC risk, if confirmed, has implications for the primary prevention of GBC, via a reduced consumption.

Modelling cervical cancer elimination

Abstract: In May, 2018, at the World Health Assembly, the Director-General of WHO made a global call for action towards the elimination of cervical cancer as a public health problem. The present focus of this initiative is to develop a global strategy and supporting approaches that can achieve this ambitious goal in every country within the 21st century. In their Article in The Lancet Public Health, Michaela Hall and colleagues take advantage of an extensively validated dynamic model of human papillomavirus (HPV) vaccination, natural history, and cervical screening to estimate the timeframe until cervical cancer elimination in Australia. Depending on the incidence threshold used to define public health elimination, cervical cancer will be eliminated by 2020 (based on a rare cancer threshold of fewer than six new cases per 100 000 women annually) or by 2028 (based on a lower threshold of four new cases per 100 000 women annually). The authors also predict that the mortality associated with cervical cancer could decrease below one death per 100 000 women by 2034. Beyond the specific merit of modelling cervical cancer elimination in Australia, the study by Hall and colleagues exemplifies a process that is likely to be replicated in most countries when they address elimination of cervical cancer. Worldwide, mathematical modelling has become a standard approach in the planning and evaluation of public health interventions. To be reliable, model based-projections must use valid data and realistic assumptions. From that perspective, the Australian modelling team had access to the best possible sets of data that were essential to make their projections. Furthermore, the routine monitoring of the prevalence of HPV, precancerous lesion detection rates, cervical cancer incidence, and the performance of HPV vaccination and screening programmes will enable adjustments of the predictions where necessary. At the global level, countries seeking to design, plan, and evaluate their own programmes for cervical cancer elimination can, in theory, rely on modelbased projections that are informed by local datasets. However, in most low-income and middle-income countries (LMIC), where elimination remains a more distant prospect than predicted in Australia by Hall and colleagues, access to modelling is not to be taken for granted. Most published models have been primarily developed by international or academic institutions and have been used to assess the effects of preventing cervical cancer in high-income countries. In some cases, these models have been adapted to predict the expected effects of preventing cervical cancer in LMIC. Evidently, access to open-source, validated, and well documented models to quantify the long-term medical, societal, and economic benefits of vaccination and screening in LMIC is essential. Technical guidance and transfer of modelling skills to LMIC must also be addressed. A more basic concern is the poor availability of data on cervical cancer incidence worldwide, particularly in LMIC. Although the feasibility of cervical cancer elimination, the definition of aspirational targets, and tailored incountry strategies might be driven by mathematical models, sensitivity analyses indicate that trends in the incidence of cervical cancer have a greater effect on future global estimates of elimination than other model parameters. At present, the likely future of the incidence of cervical cancer in most LMIC remains unknown. Taking the 47 constituent countries of sub-Saharan Africa as a regional example, only Uganda (Kampala) and Zimbabwe (Harare) have longstanding high-quality population-based cancer registries that are capable of providing such crucial information, and both report increasing trends in the incidence of cervical cancer. On a global scale, about a third of countries (68 countries) have high-quality national (or subnational) data on cancer incidence and about a quarter of countries (51 countries) can report all-cause mortality data to WHO; in both instances, most of these countries are classified as high-income. Given the global status of recorded health data in general, a compelling case for a shift away from the ongoing investments in global health estimations and towards building the capacity of countries to collect and analyse their own data was made in 2018 by Ties Boerma and colleagues. The growing burden of cancer worldwide reinforces the need for national implementation of tailored surveillance, with incidence—alongside risk factor and mortality data— as a core indicator of cancer surveillance programmes that are built around population-based cancer registries. These data systems permit governments to Published Online October 2, 2018 http://dx.doi.org/10.1016/ S2468-2667(18)30189-0

Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Abstract: This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions There will be an estimated 181 million new cancer cases (170 million excluding nonmelanoma skin cancer) and 96 million cancer deaths (95 million excluding nonmelanoma skin cancer) in 2018 In both sexes combined, lung cancer is the most commonly diagnosed cancer (116% of the total cases) and the leading cause of cancer death (184% of the total cancer deaths), closely followed by female breast cancer (116%), prostate cancer (71%), and colorectal cancer (61%) for incidence and colorectal cancer (92%), stomach cancer (82%), and liver cancer (82%) for mortality Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality) Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts CA: A Cancer Journal for Clinicians 2018;0:1-31 © 2018 American Cancer Society

Global cancer statistics

Abstract: The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally.

Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.

Abstract: This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.

Abstract: Estimates of the worldwide incidence and mortality from 27 major cancers and for all cancers combined for 2012 are now available in the GLOBOCAN series of the International Agency for Research on Cancer. We review the sources and methods used in compiling the national cancer incidence and mortality estimates, and briefly describe the key results by cancer site and in 20 large “areas” of the world. Overall, there were 14.1 million new cases and 8.2 million deaths in 2012. The most commonly diagnosed cancers were lung (1.82 million), breast (1.67 million), and colorectal (1.36 million); the most common causes of cancer death were lung cancer (1.6 million deaths), liver cancer (745,000 deaths), and stomach cancer (723,000 deaths).