Risk Factor-Associated Cancers

Although cancer represents many heterogeneous diseases, some cancer types share common risk factors.1 For example, conclusive evidence links cancer at multiple sites with tobacco use, alcohol use, human papillomavirus (HPV) infection, obesity, and physical inactivity.2–6 Because risk factor information is not routinely collected by cancer registries, estimates for risk factor-associated cancers often are based only on cancer type. Using these standard definitions for risk factor-associated cancers can help facilitate comparisons of cancer burden across states and communities. Keeping in mind that individual cancer cases may occur among persons who were or were not exposed to a risk factor, population-based risk factor-associated cancer rates can help identify communities with disproportionately high cancer rates, which reflect, in part, the population’s exposure to cancer risk factors. These exposures can be reduced through clinical preventive services and community-based approaches, the impact of which can be monitored with cancer surveillance data.

Definitions of Risk Factor Groupings

Alcohol-associated cancers include oral cavity and pharynx; esophagus; colon and rectum; liver; larynx; and female breast.2

HPV-associated cancers include microscopically confirmed carcinoma of the cervix and squamous cell carcinomas of the vagina, vulva, penis, anus (including rectal squamous cell carcinoma), and oropharynx.3

Obesity-associated cancers include adenocarcinoma of the esophagus; cancers of the breast (in postmenopausal women), colon and rectum, endometrium (corpus uterus), gallbladder, gastric cardia, kidney (renal cell), liver, ovary, pancreas, and thyroid; meningioma, and multiple myeloma.4

Physical inactivity-associated cancers include breast cancer in post-menopausal women, endometrium (corpus uterus) cancer, and colon cancer.5

Tobacco-associated cancers include oral cavity and pharynx; esophagus; stomach; colon and rectum; liver; pancreas; larynx; lung, bronchus, and trachea; cervix; kidney and renal pelvis; urinary bladder; and acute myeloid leukemia.6

The ICD-O-3 site and histology codes used to define these five variables are available in Definitions of Risk Factor-Associated Cancers.


  1. Henley SJ, Singh SD, King J, Wilson RJ, O’Neil ME, Ryerson AB. Invasive cancer incidence and survival—United States, 2013. MMWR 2017;66:69–75. DOI: 10.15585/mmwr.mm6603a1.external icon
  2. International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 100E: Personal Habits and Indoor Combustions: Consumption of Alcoholic Beverages. Lyon, France: International Agency for Research on Cancer; 2012.
  3. International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 90: Human Papillomaviruses.external icon Lyon, France: International Agency for Research on Cancer; 2007.
  4. Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K. Body fatness and cancer—viewpoint of the IARC Working Group.external icon New England Journal of Medicine 2016;375:794-798. DOI: 10.1056/NEJMsr1606602.external icon
  5. World Cancer Research Fund / American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: A Global Perspective. pdf icon[PDF-5MB]external icon Continuous Update Project Expert Report 2018.
  6. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.