Stewart Sherri L, Cardinez Cheryll J, Richardson Lisa C, Norman Leslie, Kaufmann Rachel, Pechacek Terry F, Thompson Trevor D, Weir Hannah K, Sabatino Susan A
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, USA.
MMWR Surveill Summ. 2008 Sep 5;57(8):1-33.
PROBLEM/CONDITION: Tobacco use is the leading preventable cause of disease and premature death in the United States. The 2004 Surgeon General report found convincing evidence for a direct causal relationship between tobacco use and the following cancers: lung and bronchial, laryngeal, oral cavity and pharyngeal, esophageal, stomach, pancreatic, kidney and renal pelvis, urinary bladder, and cervical cancers and acute myelogenous leukemia (AML). This report provides state-level cancer incidence data and recent trends for cancers associated with tobacco use. Because information on tobacco use was not available in the databases of the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) program, cases of cancer included in this report might or might not be in persons who used tobacco; however, the cancer types included in this report are those defined by the U.S. Surgeon General as having a direct causal relationship with tobacco use (i.e., referred to as tobacco-related cancer in this report). These data are important for initiation, monitoring, and evaluation of targeted tobacco prevention and control measures.
1999--2004.
Data were obtained from cancer registries affiliated with CDC's NPCR and the National Cancer Institute's SEER program; combined, these data cover approximately 92% of the U.S. population. Combined data from the NPCR and SEER programs provide the best source of information on population-based cancer incidence for the nation and are the only source of information for 41 states (including the District of Columbia) with cancer surveillance programs that are funded solely by NPCR. This report provides age-adjusted cancer incidence rates by demographic and geographic characteristics, percentage distributions for tumor characteristics, and trends in cancer incidence by sex.
Approximately 2.4 million cases of tobacco-related cancer were diagnosed during 1999--2004. Age-adjusted incidence rates ranged from 4.0 per 100,000 persons (for AML) to 69.4 (for lung and bronchial cancer). High rates occurred among men, black and non-Hispanic populations, and older adults. Higher incidence rates of lung and laryngeal cancer occurred in the South compared with other regions, particularly the West, consistent with high smoking patterns in the South.
The high rates of tobacco-related cancer observed among men, blacks, non-Hispanics, and older adults reflect overall demographic patterns of cancer incidence in the United States and reflect patterns of tobacco use.
The findings in this report emphasize the need for ongoing surveillance and reporting to monitor cancer incidence trends, identify populations at greatest risk for developing cancer related to tobacco use, and evaluate the effectiveness of targeted tobacco control programs and policies.
问题/状况：在美国，烟草使用是可预防的主要疾病和过早死亡原因。2004年美国卫生局局长报告发现了令人信服的证据，表明烟草使用与以下癌症之间存在直接因果关系：肺癌和支气管癌、喉癌、口腔和咽癌、食管癌、胃癌、胰腺癌、肾癌和肾盂癌、膀胱癌、宫颈癌以及急性髓细胞白血病（AML）。本报告提供了与烟草使用相关癌症的州级癌症发病率数据及近期趋势。由于国家癌症登记计划（NPCR）和监测、流行病学及最终结果（SEER）计划的数据库中没有烟草使用信息，本报告中包含的癌症病例可能是也可能不是使用烟草的人；然而，本报告中包含的癌症类型是美国卫生局局长定义为与烟草使用有直接因果关系的类型（即本报告中称为烟草相关癌症）。这些数据对于启动、监测和评估有针对性的烟草预防和控制措施很重要。
1999 - 2004年。
数据来自疾病预防控制中心的NPCR附属癌症登记处和美国国立癌症研究所的SEER计划；这些数据合起来覆盖了约92%的美国人口。NPCR和SEER计划的合并数据是全国基于人群癌症发病率的最佳信息来源，也是41个州（包括哥伦比亚特区）癌症监测计划唯一的信息来源，这些州的癌症监测计划仅由NPCR资助。本报告按人口统计学和地理特征提供年龄调整后的癌症发病率、肿瘤特征的百分比分布以及按性别划分的癌症发病率趋势。
1999 - 2004年期间，约有240万例烟草相关癌症被诊断出来。年龄调整后的发病率范围从每10万人4.0例（AML）到69.4例（肺癌和支气管癌）。男性、黑人和非西班牙裔人群以及老年人的发病率较高。与其他地区，特别是西部相比，南部的肺癌和喉癌发病率更高，这与南部的高吸烟率一致。
在男性、黑人、非西班牙裔和老年人中观察到的高烟草相关癌症发病率反映了美国癌症发病率的总体人口统计学模式，并反映了烟草使用模式。
本报告中的研究结果强调需要持续监测和报告，以监测癌症发病率趋势、确定患烟草相关癌症风险最高的人群，并评估有针对性的烟草控制计划和政策的有效性。
