PURPOSE Vietnam is undergoing rapid socio-economic transition with an increasing cancer burden. The contribution of modifiable risk factors to cancers in Vietnam has not been studied. Therefore, we sought to evaluate the attributable causes of cancer in Vietnam. METHODS We reviewed the data on burden of cancer in Vietnam from 2 cancer registries in Hanoi and Ho Chi Minh City between 1995 and 2012. Next, we calculated the fractions of cancers occurring in 2018 attributable to established modifiable risk factors whose impact could be quantified. Data on exposure prevalence were obtained for the period from 2000 to 2010 from national sources wherever possible. RESULTS Cancer incidence in Vietnam has decreased slightly in both sexes. Cancer related to infectious agents decreased sharply, whereas cancer related to nutrition and metabolism has increased. In 2018, established carcinogens included in the analysis explained 47.0% of cancer burden in Vietnam. Chronic infections accounted for 29.1% of cancers (34.7% in men and 22.1% in women), tobacco smoking for 13.5% (23.9% in men and 0.8% in women), and alcohol drinking for 10.3%. Passive smoking was responsible for 8.8% of cancers in women. Other risk factors, including overweight or obesity, nulliparity, and low vegetable and fruit intake, accounted for < 1% of all cancers each. CONCLUSION Cancer incidence is slowly decreasing in Vietnam, and the causes of more than half of cancers remain unexplained. This result underlines the need for further epidemiologic and fundamental research. Our findings confirm the notion that controlling oncogenic infections and decreasing tobacco smoking are the most effective approaches to reduce the burden of cancer in Vietnam, but other risk factors, including alcohol drinking and diet, should not be neglected.

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Background: Rapid economic growth, industrialization, and widespread adoption of a Western lifestyle in Vietnam have been accompanied by an emerging epidemic of noncommunicable diseases (NCDs), including cancer. We investigated current status, identified challenges and evaluated opportunities for the development of a comprehensive program in cancer epidemiology research in Vietnam. Methods: We systematically searched OvidMedline, PubMed, and the Cochrane Library for studies published in English on cancer epidemiology in Vietnam prior to November 2017. Data from Vietnam cancer registries were used for descriptive analyses. Technical reports in Vietnamese were also included in our review. Results: Cancer registry data show that by end of 2013, the total number of new cancer cases was 146,457. The most common cancers, in descending order, among men were lung, gastric, colorectal, liver and esophageal cancers while breast, lung, colorectal, gastric and thyroid cancers were the most common cancers among women. Data from six (6) cancer registries during 2004-2013 show that the incidence of several cancers has increased during the past decade, including colorectal cancer (both genders), lung cancer (men), and breast and thyroid cancers (women). Mortality data are limited due to the unavailability of death registries and/or modes of death ascertainment (i.e., causes of death). There is a scarcity of high-quality research on the risk factors (e.g., lifestyle such as smoking, alcohol consumption, physical activity, and BMI, environmental or genetic factors) for cancer in Vietnam. The majority of prior research consists of hospital-based studies (either case-control or cross-sectional designs) with small sample sizes. Since there is no population-based epidemiologic study on cancer in Vietnam, it is difficult to assess temporal trends and risk factors for cancers. Additional challenges include a lack of studies on infectious agents related to cancers and a paucity of molecular or genetic data in cancer, except for a few publications on HBV, HCV, H. Pylori, or EBV or susceptibility genes, such as BRCA1, BRCA2 for breast cancer or GSTA1, GSTP1, GSTT1 and GSTM1 for gastric cancer. Conclusions: Currently, there is no population-based epidemiologic research program for cancer in Vietnam due to the lack of a population-based cancer registry, a dearth of well-trained investigators, and the absence of proper research support infrastructure. This, along with the lack of comprehensive etiologic research in Vietnam, prevents the evaluation of the temporal trends of cancer and risk factors for cancer. The cancer registry has provided important data on cancer incidence; however, there are no data on cancer mortality. Data on molecular and genetic epidemiology of cancer are also limited. These challenges shows the need to develop a comprehensive program in cancer control in Vietnam. Citation Format: Thuan V. Tran, Chi T. Du Tran, Huong T. Tran, Mai V. Nguyen, Mo T. Tran, Quang H. Tran, Thuy Thi-Van Tuong, Martha J. Shrubsole, Qiuyin Cai, Wei Zheng, Xiao-Ou Shu, Linh C. Le, Paolo Boffetta, Hung N. Luu. Cancer epidemiology research in Vietnam: Current status, challenges and opportunities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1216.

operated completely (R0-89%), 4 e microscopically incompletely (positive bronchial resection margin, R1-11%), pN+ was diagnosed in 12 patients (32%). No postoperative mortality and major complications were noted. During follow-up (from 6 to 72 months) one local recurrence was developed (3%); three-and five-year survival rates were 88% and 55%. Conclusion: Preoperative treatment including chemotherapy and PDT led to less extensive resections (lobectomy instead of pneumonectomy) reducing surgical risks.