Role of smoking in global and regional cancer epidemiology: current patterns and data needs
Role of smoking in global and regional cancer epidemiology: current patterns and data needs
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DOI：
10.1002/ijc.21100
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发表时间：
2005-10-10
影响因子：
6.4
通讯作者：
Thun, MJ
中科院分区：
文献类型：
--
作者：
Ezzati, M;Henley, SJ;Thun, MJ
尽管吸烟被广泛认为是癌症的主要原因，但关于吸烟如何与影响背景癌症死亡模式的其他风险因素一起造成全球和地区癌症负担的信息很少。我们使用了美国癌症协会癌症预防研究II(CPS-II)以及世卫组织和国际癌症研究机构癌症死亡率数据库的数据，按年龄和性别估计了世界14个流行病学亚区由吸烟引起的8组特定部位癌症的死亡人数。我们使用肺癌死亡率作为累积吸烟风险的间接标志。针对重要的协变量对CPS-II风险进行了调整。2000年，估计全世界有142万(95%可信区间1.27-1.57)万人死于癌症，占全球癌症死亡总数的21%是由吸烟引起的。其中，男性死亡118万人，女性死亡24万人；625,000人(95%可信区间485,000-749,000)因吸烟导致的癌症死亡发生在发展中国家，794,000人(95%可信区间749,000-840,000)发生在工业化地区。肺癌占吸烟导致的癌症死亡的60%，其次是上呼吸道癌症(20%)。根据现有的数据，2000年世界上每5例癌症死亡中就有1例以上是由吸烟引起的，这可能使其成为癌症死亡的最大可预防原因。吸烟作为不同部位特定癌症的原因，在不同地区的作用存在显著差异。这种变异性说明了将吸烟研究和监测与其他危险因素相结合，以更有效地预防癌症的重要性。(C)2005年Wiley-Liss，Inc.
Although smoking is widely recognized as a major cause of cancer, there is little information on how it contributes to the global and regional burden of cancers in combination with other risk factors that affect background cancer mortality patterns. We used data from the American Cancer Society's Cancer Prevention Study II (CPS-II) and the WHO and IARC cancer mortality databases to estimate deaths from 8 clusters of site-specific cancers caused by smoking, for 14 epidemiologic subregions of the world, by age and sex. We used lung cancer mortality as an indirect marker for accumulated smoking hazard. CPS-II hazards were adjusted for important covariates. In the year 2000, an estimated 1.42 (95% CI 1.27-1.57) million cancer deaths in the world, 21% of total global cancer deaths, were caused by smoking. Of these, 1.18 million deaths were among men and 0.24 million among women; 625,000 (95% CI 485,000-749,000) smoking-caused cancer deaths occurred in the developing world and 794,000 (95% CI 749,000-840,000) in industrialized regions. Lung cancer accounted for 60% of smoking-attributable cancer mortality, followed by cancers of the upper aerodigestive tract (20%). Based on available data, more than one in every 5 cancer deaths in the world in the year 2000 were caused by smoking, making it possibly the single largest preventable cause of cancer mortality. There was significant variability across regions in the role of smoking as a cause of the different site-specific cancers. This variability illustrates the importance of coupling research and surveillance of smoking with that for other risk factors for more effective cancer prevention. (C) 2005 Wiley-Liss, Inc.