Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
Jpn J Clin Oncol. 2011 Apr;41(4):483-9. doi: 10.1093/jjco/hyq247. Epub 2011 Jan 24.
Male smoking prevalence is still high in Japan, and quantitative information for tobacco control is scarce. The aim of the present study was to project cancer mortality among Japanese males under different future scenarios of smoking prevalence.
The target population comprised Japanese males aged 40-79 years in 2007, whose smoking prevalence was 35%. On the basis of the pooled data from three large-scale cohort studies in Japan, the effects of age, years of smoking and years after smoking cessation on the time to all-cancer or lung cancer death were estimated by an accelerated failure time model. The parameter estimates were used to project the annual number of deaths from all cancers and lung cancer by running simulations for different future scenarios of smoking prevalence. Each scenario was evaluated by the cumulative number of avoided deaths when compared with the status quo and by the percent change (from the baseline year) in age-standardized rate of mortality.
Reducing the smoking prevalence from 35% in 2007 to 0% in 2017 was estimated to avoid 333 900 all-cancer deaths and 171 100 lung cancer deaths in 20 years. Even when we shortened the projection period to 10 years, these numbers of avoided deaths would be 81 100 and 38 800, respectively. The age-standardized rate of all-cancer mortality was estimated to decrease by 9.6% in 10 years and 18.1% in 20 years.
Reducing the prevalence of smoking among males would be effective in reducing the cancer burden even within 10 years in countries with a high male smoking prevalence.
日本男性的吸烟率仍然很高，且缺乏有关烟草控制的定量信息。本研究旨在根据不同的吸烟流行率未来情景预测日本男性的癌症死亡率。
目标人群为 2007 年年龄在 40-79 岁、吸烟率为 35%的日本男性。基于日本三项大型队列研究的汇总数据，采用加速失效时间模型估计年龄、吸烟年数和戒烟后年数对所有癌症或肺癌死亡时间的影响。利用参数估计值，通过对不同吸烟流行率未来情景进行模拟，预测所有癌症和肺癌的年死亡人数。通过与现状相比累计避免死亡人数和死亡率标准化年龄比的百分比变化来评估每种情景。
预计到 2017 年，将 2007 年的吸烟率从 35%降低到 0%，可在 20 年内避免 333 900 例所有癌症死亡和 171 100 例肺癌死亡。即使将预测期缩短至 10 年，这两种情况下避免的死亡人数分别为 81 100 人和 38 800 人。预计在 10 年内和 20 年内，所有癌症死亡率的标准化年龄比分别降低 9.6%和 18.1%。
在男性吸烟率较高的国家，即使在 10 年内降低男性的吸烟率也将有效降低癌症负担。
