Abstract: Objective To explore the main risk factors for cancer, cardiovascular and cerebrovascular diseases, diabetes and chronic respiratory disease (referred to as the four major chronic diseases), and to evaluate the disease burden associated with the exposure to risk factors. Methods  The data of this study were collected from the 2019 Global Burden of Disease Study (GBD) database. By analyzing the number of deaths and disability⁃adjusted life years (DALYs) of four major chronic diseases among Chinese residents in 2019, the proportion of these four major chronic diseases attributable to the exposure to related risk factors was determined. Results The primary risk factor for disease burden was the tobacco exposure, which accounted for 31.4% of DALYs. High systolic blood pressure was the main risk factor for cardiovascular and cerebrovascular diseases, which accounted for 55.6% of DALYs. The common risk factors of four major chronic diseases were tobacco exposure, air pollution and high body mass index (BMI); among them, tobacco exposure had the highest proportion of attributable risk in the disease burden of cancer and chronic respiratory disease. Diet related risk factors, alcohol consumption, and physical inactivity were associated with cancer, cardiovascular and cerebrovascular diseases, and diabetes. The results of the attribution analysis of major cancers showed that lung cancer had the highest proportion of attributable risk due to tobacco exposure, followed by esophageal cancer, gastric cancer, liver cancer, and colorectal cancer. Conclusions Tobacco exposure, air pollution and high BMI are common risk factors for the four major chronic diseases in Chinese residents. This result provides important evidence for high⁃risk population screening.

Key words: Cancer, Cardiovascular and cerebrovascular diseases, Diabetes, Chronic respiratory disease, Disease burden, Risk factors, Attributable risk