Statistical modeling and projections of lung cancer mortality in 4 industrialized countries
Statistical modeling and projections of lung cancer mortality in 4 industrialized countries
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DOI：
10.1002/ijc.21078
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发表时间：
2005-11-10
影响因子：
6.4
通讯作者：
Lopez, AD
中科院分区：
文献类型：
--
作者：
Shibuya, K;Inoue, M;Lopez, AD
这项工作的目的是模拟肺癌死亡率作为过去暴露于烟草的函数，并预测年龄性别特异性肺癌死亡率。采用最大似然法对美国、英国、加拿大和澳大利亚的3因素年龄-时期-队列（APC）模型进行了估计，在该模型中，时期变量被平均焦油含量和成人人均烟草消费量的乘积所取代。根据吸烟流行率和烟草总消费量的历史数据估计了特定年龄和性别的烟草消费量。肺癌死亡率来自生命登记记录。未来烟草消费量，焦油含量和队列参数的预测自回归移动平均（ARIMA）估计。最佳暴露变量被认为是产品的平均焦油含量和成人香烟消费量的人均，落后2530年的男性和女性在所有4个国家。平均焦油含量与人均烟草消费量乘积的系数因年龄和性别而异。在所有模型中，不同性别的时期变量系数存在统计学显着差异。在所有国家，男性年龄标准化肺癌死亡率在1980年代达到高峰，此后下降。预计女性死亡率将在本世纪的头十年达到高峰。年龄，烟草暴露和队列的乘法模型符合1950年和1999年之间的观测数据相当不错，时间序列模型产生合理的相关变量的过去趋势。尽管在过去几十年中，烟草消费量和销售的香烟的平均焦油含量显着减少，但对肺癌死亡率的影响受到暴露和确诊疾病之间的时间差的影响。因此，女性肺癌的负担刚刚达到或即将达到高峰，但男性肺癌的负担在1至20年内一直在下降。由于性别之间暴露模式的差异，未来北美肺癌死亡率的性别差异可能大于澳大利亚和英国。(c)2005 Wiley-Liss，Inc.
The purpose of this work was to model lung cancer mortality as a function of past exposure to tobacco and to forecast age-sex-specific lung cancer mortality rates. A 3-factor age-period-cohort (APC) model, in which the period variable is replaced by the product of average tar content and adult tobacco consumption per capita, was estimated for the US, UK, Canada and Australia by the maximum likelihood method. Age- and sex-specific tobacco consumption was estimated from historical data on smoking prevalence and total tobacco consumption. Lung cancer mortality was derived from vital registration records. Future tobacco consumption, tar content and the cohort parameter were projected by autoregressive moving average (ARIMA) estimation. The optimal exposure variable was found to be the product of average tar content and adult cigarette consumption per capita, lagged for 2530 years for both males and females in all 4 countries. The coefficient of the product of average tar content and tobacco consumption per capita differs by age and sex. In all models, there was a statistically significant difference in the coefficient of the period variable by sex. In all countries, male age-standardized lung cancer mortality rates peaked in the 1980s and declined thereafter. Female mortality rates are projected to peak in the first decade of this century. The multiplicative models of age, tobacco exposure and cohort fit the observed data between 1950 and 1999 reasonably well, and time-series models yield plausible past trends of relevant variables. Despite a significant reduction in tobacco consumption and average tar content of cigarettes sold over the past few decades, the effect on lung cancer mortality is affected by the time lag between exposure and established disease. As a result, the burden of lung cancer among females is only just reaching, or soon will reach, its peak but has been declining for I to 2 decades in men. Future sex differences in lung cancer mortality are likely to be greater in North America than Australia and the UK due to differences in exposure patterns between the sexes. (c) 2005 Wiley-Liss, Inc.