The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019.
The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019.
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DOI：
10.1016/s0140-6736(22)01438-6
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发表时间：
2022-08-20
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了解可归因于潜在可改变的风险因素的癌症负担的大小对于制定有效的预防和缓解策略至关重要。我们分析了2019年全球疾病、伤害和风险因素负担研究(GBD)的结果，为全球癌症控制规划工作提供信息。使用GBD 2019比较风险评估框架来估计可归因于行为、环境和职业以及代谢风险因素的癌症负担。根据世界癌症研究基金会的标准，总共纳入了82对风险-结果对。2019年估计的癌症死亡人数和伤残调整寿命年(DALY)以及这些措施在2010年至2019年之间的变化。在全球范围内，2019年，这项分析中包括的风险因素导致445万人(95%不确定区间4·01-4.94)死亡和1.05亿(95.0-116)个DALY，占所有癌症死亡人数的44.4%(41.3%-48.4%)，占所有DALY的42.0%(39.1%-45.6%)。男性中有288万人(2·60-3·18)死于癌症风险(占所有男性癌症死亡人数的50·6%[47·8-54·1])，女性有158万人(占所有女性癌症死亡人数的36·3%[32·5-41·3])。在全球最详细的风险归因性癌症死亡和2019年男女DALY的最详细水平上，主要风险因素是吸烟，其次是饮酒和高BMI。风险归因性癌症负担因世界区域和社会人口指数(SDI)而异，吸烟、不安全性行为和饮酒是2019年低SDI地区风险归因性癌症DALY的三个主要风险因素，而SDI高地区的DALY反映了全球前三大风险因素排名。从2010年到2019年，全球风险可归因性癌症死亡增加了20.4%(12.6-28.4)，DALY增加了16.8%(8.8-25.0)，其中代谢风险增加的百分比最大(34.7%[27.9-42.8]和33.3%[25.8-42.0])。2019年导致全球癌症负担的主要风险因素是行为，而代谢风险因素在2010年至2019年期间增幅最大。减少对这些可改变的危险因素的暴露将降低全球癌症死亡率和DALY率，政策应该根据当地的癌症危险因素负担进行适当的调整。比尔和梅琳达·盖茨基金会。
Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Bill & Melinda Gates Foundation.