Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study.
Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study.
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DOI：
10.1016/s0140-6736(08)61345-8
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发表时间：
2008-10-25
期刊：
影响因子：
168.9
通讯作者：
Ezzati, Majid
中科院分区：
文献类型：
--
作者：
Lin, Hsien-Ho;Murray, Megan;Cohen, Ted;Colijn, Caroline;Ezzati, Majid
慢性阻塞性肺病（COPD）、肺癌和肺结核是中国三大死亡原因，吸烟和使用固体燃料的流行率也很高。我们的目的是预测危险因素趋势对慢性阻塞性肺病、肺癌和结核病的影响。我们使用代表性数据源来估计吸烟和家庭固体燃料使用的过去趋势，并构建一系列未来情景。我们通过流行病学研究的荟萃分析和中国的大型研究获得了危险因素对疾病的病因学影响。我们模拟了未来慢性阻塞性肺病和肺癌的死亡率和结核病发病率，考虑到随着时间的推移，危险因素对慢性阻塞性肺病和肺癌的危险影响的累积，以及结核病感染风险对疾病患病率的依赖性。我们量化了结果对方法和数据选择的敏感性。如果2003年至2033年间吸烟和固体燃料的使用保持在目前的水平，预计中国将有6500万人死于慢性阻塞性肺病，1800万人死于肺癌； 82% 的慢性阻塞性肺病死亡和 75% 的肺癌死亡可归因于吸烟和使用固体燃料的综合影响。到 2033 年完全逐步停止吸烟和固体燃料的使用可以避免 2600 万人死于慢性阻塞性肺病和 6·300 万人死于肺癌；中等规模的干预措施将使死亡人数减少 6-31%（慢性阻塞性肺病）和 8-26%（肺癌）。如果维持 80% DOTS 覆盖率，到 2033 年完全停止吸烟和固体燃料使用，预计 2033 年结核病年发病率将减少 14-52%；如果维持 50% 覆盖率，则减少 27-62%；如果维持 20% 覆盖率，则减少 33-71%。减少吸烟和固体燃料的使用可以大大降低慢性阻塞性肺病和肺癌负担的预测，并有助于中国有效控制结核病。国际防痨和肺病联盟。
Chronic obstructive pulmonary disease (COPD), lung cancer, and tuberculosis are three leading causes of death in China, where prevalences of smoking and solid-fuel use are also high. We aimed to predict the effects of risk-factor trends on COPD, lung cancer, and tuberculosis. We used representative data sources to estimate past trends in smoking and household solid-fuel use and to construct a range of future scenarios. We obtained the aetiological effects of risk factors on diseases from meta-analyses of epidemiological studies and from large studies in China. We modelled future COPD and lung cancer mortality and tuberculosis incidence, taking into account the accumulation of hazardous effects of risk factors on COPD and lung cancer over time, and dependency of the risk of tuberculosis infection on the prevalence of disease. We quantified the sensitivity of our results to methods and data choices. If smoking and solid-fuel use remain at current levels between 2003 and 2033, 65 million deaths from COPD and 18 million deaths from lung cancer are predicted in China; 82% of COPD deaths and 75% of lung cancer deaths will be attributable to the combined effects of smoking and solid-fuel use. Complete gradual cessation of smoking and solid-fuel use by 2033 could avoid 26 million deaths from COPD and 6·3 million deaths from lung cancer; interventions of intermediate magnitude would reduce deaths by 6–31% (COPD) and 8–26% (lung cancer). Complete cessation of smoking and solid-fuel use by 2033 would reduce the projected annual tuberculosis incidence in 2033 by 14–52% if 80% DOTS coverage is sustained, 27–62% if 50% coverage is sustained, or 33–71% if 20% coverage is sustained. Reducing smoking and solid-fuel use can substantially lower predictions of COPD and lung cancer burden and would contribute to effective tuberculosis control in China. International Union Against Tuberculosis and Lung Disease.