Kabir Zubair, Connolly Gregory N, Clancy Luke, Jemal Ahmedin, Koh Howard K
Division of Public Health Practice, Harvard School of Public Health, 401 Park Drive, Landmark Center (3rd Floor, East), Boston, MA 02215, USA.
Cancer Causes Control. 2007 Oct;18(8):833-8. doi: 10.1007/s10552-007-9027-3. Epub 2007 Jun 22.
Approximately 88% of the lung cancer deaths in men and 71% in women occurring in the US are attributable to cigarette smoking, with almost 3,700 annual lung cancer deaths in Massachusetts. In the state, male lung cancer death rates are showing a per year annual decline following a peak in the early 1990s. Such recent declines could be mostly attributed to tobacco control efforts over the past 40 years.
This study predicts how many fewer lung cancer deaths have occurred in Massachusetts possibly attributable to tobacco control activities. The study employs the US National Cancer Institute's "Joinpoint" Regression Analysis Program (version 3.0) using statewide age-standardized (2000 US Standard Population) lung cancer death rates from 1931 to 2003 for each of the sexes. 95% confidence intervals (CI) were also calculated.
Modeled male lung cancer death rates stabilized from the calendar year 1977 onwards but showed significant decline from 1992 onwards, while females showed a deceleration in rising lung cancer rates from 1993 onwards. Therefore, based on their corresponding beta-coefficients (slope) and standard error for each of the two calendar years 19,665 (95% CI: 18,655; 20,765) fewer lung cancer deaths in males and 3,855 (95% CI: 3,630; 4,055) fewer lung cancer deaths in females were estimated to have occurred from 1977 to 1993 onwards, respectively, largely because of the anti-smoking interventions in the past.
Reductions in tobacco smoking are a major factor in the decrease in lung cancer mortality rates. Sustained progress in tobacco control is essential.
在美国，男性肺癌死亡病例中约88%、女性肺癌死亡病例中约71% 可归因于吸烟，马萨诸塞州每年有近3700例肺癌死亡病例。在该州，男性肺癌死亡率在20世纪90年代初达到峰值后呈逐年下降趋势。近期的这种下降主要归功于过去40年的控烟努力。
本研究预测了马萨诸塞州可能因控烟活动而减少的肺癌死亡病例数。该研究采用美国国家癌症研究所的“Joinpoint”回归分析程序（3.0版），使用1931年至2003年该州按性别划分的年龄标准化（2000年美国标准人口）肺癌死亡率。还计算了95%置信区间（CI）。
模拟的男性肺癌死亡率从1977年起趋于稳定，但从1992年起显著下降，而女性肺癌发病率从1993年起上升速度减缓。因此，根据1977年至1993年这两个历年各自对应的β系数（斜率）和标准误差，估计男性肺癌死亡病例减少了19,665例（95%CI：18,655；20,765），女性肺癌死亡病例减少了3,855例（95%CI：3,630；4,055），这主要是由于过去的反吸烟干预措施。
吸烟率的降低是肺癌死亡率下降的主要因素。持续推进控烟工作至关重要。
