Projected preventable cancers through full implementation of tobacco control policies in East and South-East Asian countries, 2025-2050: a modeling study.

BACKGROUND: To estimate the number of tobacco-related cancer cases that could be prevented if countries in East and South-East Asia achieved the highest level of implementation of the WHO MPOWER policy package (Monitor, Protect, Offer, Warn, Enforce, and Raise). METHODS: Based on data from Global Health Observatory and Global Cancer Observatory. We applied fixed-effects linear regression models to examine the association between changes in the national implementation of the MPOWER policies and tobacco smoking prevalence. Population Attributable Fractions (PAFs) for 13 tobacco-related cancers were calculated using Levin's formula under the scenarios of (i) continuation of the current trend, (ii) full implementation of MPOWER. The number of preventable cases (Potential Impact Fraction-PIF) was estimated using the difference in PAFs between the two scenarios. FINDINGS: Between 2025 and 2050, 159 million tobacco-related cancer cases were projected in East and South-East Asian countries, of which 44.2 million (PAF: 27.7%; 95% CI: 25.5-29.9) attributed to current tobacco smoking, including 41.6 million among men (PAF: 42.1%, 95% CI: 39.3-44.8) and 2.6 million among women (PAF: 4.3%, 95% CI: 3.0-5.7). Full implementation of MPOWER was estimated to prevent 3.5 million (95% CI: 2.9-4.0) cancers (PIF: 2.2%, 95% CI: 1.8-2.5). After adjusting for Human Development Index (HDI) variations, preventable cancers decreased to 2.2 million (PIF: 1.4%, 95% CI: 1.2-1.6). INTERPRETATION: Comprehensive implementation of MPOWER policies could substantially reduce the future cancer burden in East and South-East Asian countries. FUNDING: None.