Cancer and work. A holistic preventive view of a complex disease

Introduction: Cancer and its prevention is currently a public health priority in all countries. In occupational cancer, the World Health Organisation estimates that each year at least 200,000 people worldwide die of cancer related to their workplace. Cancer is considered a multifactorial disease that may not be due to a single cause but to a sequence of exposures over a lifetime. Methodology: A search was conducted in July 2022 in PubMed/Medline databases, using as keywords and MeSH terms: health promotion and cancer, Workplace and cancer, Environment and cancer; exposome and Cancer. Forty-three original articles, systematic reviews and review articles related to cancer and occupational and environmental exposure were selected. Studies with non-relevant information were excluded, with the authors commenting on 11 of these articles with relevant information from an occupational point of view. Results: The etiology of cancer requires studies that include genetic alterations, occupational and environmental exposures as well as the assessment of socio-economic aspects in affected individuals to provide an evidence base for prevention. Some environmental exposures associated with occupational exposures increase the risk of cancer: indoor and outdoor air pollution, pesticides, some endocrine disruptors, carcinogenic metals and metalloids, and radiation among others. Conclusions: Lifestyle factors, increased screening and ageing cannot fully explain the current increasing global incidence of cancer. The joint assessment of environmental, occupational and occupational exposures facilitates the preventive view within the concept of occupational exposome, although it requires costly procedures not available to all.