Martiniuk Alexandra, Lee Crystal M Y, Woodward Mark, Huxley Rachel
The George Institute For International Health, Sydney, Australia.
Asian Pac J Cancer Prev. 2010;11(1):67-72.
Eighty percent of all smokers live in low and middle-income countries of the Asia Pacific region but actual estimates of the burden of disease due to smoking in the region have yet to be quantified.
The burden of lung cancer due to smoking for all countries in the WHO Western Pacific and South East Asian regions was calculated from the population attributable fractions (PAFs). Nationally representative sex-specific prevalences of smoking were obtained from the World Health Organization, MEDLINE and/or national government documents and hazard ratios (HR) for lung cancer due to smoking in Asian and non-Asian populations were obtained from published data. The HR and prevalence were then used to calculate PAFs for lung cancer deaths due to smoking, by gender and by country.
The national prevalence of smoking in the Asia Pacific region ranged from 18-65% in men and from 0-50% in women. The fraction of lung cancer deaths attributable to smoking ranged from 0-40% in Asian women and from 21-49% in Asian men. In ANZ, PAFs were as high as 80% for women and 68% for men. Future estimates of the burden of smoking-related lung cancer in Asia were obtained by assuming a continuation of current smoking habits in these populations. By extrapolating the higher HR from the ANZ region to Asia, resulted in an increase in the PAFs to 4-90% in women and from 62-85% in men.
The current burden of lung-cancer due to smoking in the Asia-Pacific region is substantial accounting for up to 50% of deaths from the disease in men and up to 40% in women depending on the country. If current smoking habits in Asia remain unchanged then the number of people dying from smoking-related lung cancer over the next couple of decades is expected to double. It is known that the majority of lung cancer is due to smoking. This is the first paper to systematically compare current burdens of lung cancer deaths due to smoking in countries in the Western Pacific and South East Asia and by gender. Findings from this paper demonstrate the number of lung cancer deaths that could be prevented if the prevalence of smoking was eliminated.
80%的吸烟者生活在亚太地区的低收入和中等收入国家，但该地区因吸烟导致的疾病负担实际估计数尚未量化。
根据人群归因分数（PAF）计算世界卫生组织西太平洋和东南亚区域所有国家因吸烟导致的肺癌负担。从世界卫生组织、医学在线数据库和/或国家政府文件中获取具有全国代表性的按性别划分的吸烟流行率，并从已发表的数据中获取亚洲和非亚洲人群因吸烟导致肺癌的风险比（HR）。然后，利用风险比和流行率，按性别和国家计算因吸烟导致肺癌死亡的人群归因分数。
亚太地区男性吸烟的全国流行率在18%至65%之间，女性在0%至50%之间。亚洲女性因吸烟导致的肺癌死亡比例在0%至40%之间，亚洲男性在21%至49%之间。在澳大利亚和新西兰，女性的人群归因分数高达80%，男性为68%。通过假设这些人群继续保持目前的吸烟习惯，对亚洲未来与吸烟相关的肺癌负担进行了估计。将澳大利亚和新西兰地区较高的风险比推算到亚洲，导致女性的人群归因分数增加到4%至90%，男性从62%至85%。
亚太地区目前因吸烟导致的肺癌负担相当大，根据国家不同，在男性中占该疾病死亡人数的比例高达50%，在女性中高达40%。如果亚洲目前的吸烟习惯保持不变，那么在未来几十年里，因吸烟相关肺癌死亡的人数预计将翻倍。众所周知，大多数肺癌是由吸烟引起的。这是第一篇系统比较西太平洋和东南亚国家因吸烟导致的肺癌死亡的当前负担并按性别进行比较的论文。本文的研究结果表明，如果消除吸烟流行率，可预防的肺癌死亡人数。
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