Leistikow Bruce N, Tsodikov Alexander
Department of Public Health Sciences, University of California, Davis, CA 95616, USA.
Prev Med. 2005 Aug;41(2):380-5. doi: 10.1016/j.ypmed.2004.12.011.
Estimates that smoking contributes 38-72% of the United States (US) Black male cancer death rate leave a wide range of uncertainty. This paper uses additional and regional data, and refined methods, to reassess that range.
This study uses lung cancer rates as an exposure index, linear regression, age adjusted US 1950-2001 and US regional 1969-2001 death rates (rates), and the formula: smoking-attributable fraction (SAF)=(1-((rate in the unexposed) / (rate in the exposed))). Estimated lung cancer rates in the unexposed range between rates predicted for a population with no smoking-attributable lung cancers to rates seen in "nonsmokers."
Lung cancer death rates predicted 99.9% and 99.8% of the variances in non-lung non-stomach cancer death rates from 1950-1980 and 1950-1988, respectively (each P<0.0001). That suggests 2001 all-sites cancer death SAFs of 63% (sensitivity range 60-66%) nationally and from 43% in the Northeast to 67% in the South.
Smoking may cause most premature cancer deaths and temporal and regional cancer death rate disparities in Black men.
据估计，吸烟导致美国黑人男性癌症死亡率的比例在38%至72%之间，这一范围存在很大的不确定性。本文使用了额外的区域数据和改进的方法，对这一范围进行重新评估。
本研究以肺癌发病率作为暴露指数，采用线性回归、1950 - 2001年美国年龄调整死亡率以及1969 - 2001年美国区域死亡率（发病率），并使用公式：吸烟归因分数（SAF）=（1 - （（未暴露人群的发病率）/（暴露人群的发病率）））。未暴露人群的估计肺癌发病率范围为从无吸烟归因肺癌人群预测的发病率到“非吸烟者”中观察到的发病率。
肺癌死亡率分别预测了1950 - 1980年和1950 - 1988年非肺癌非胃癌死亡率方差的99.9%和99.8%（P均<0.0001）。这表明2001年全国所有部位癌症死亡的吸烟归因分数为63%（敏感范围为60 - 66%），从东北部的43%到南部的67%。
吸烟可能导致黑人男性中大多数过早的癌症死亡以及癌症死亡率的时间和区域差异。
