Institute of Public Health, University Hospital Heidelberg, Germany.
Prev Med. 2013 Nov;57(5):634-40. doi: 10.1016/j.ypmed.2013.08.022. Epub 2013 Sep 5.
Reliable mortality data are sparse for developing countries. Furthermore, risk factor prevalence information is hardly available and thus not taken into consideration when estimating mortality.
The authors used a validated, statistical model combined with representative smoking prevalence from WHO STEPS surveys to estimate lung cancer mortality for six Sub-Saharan African countries (Benin, Malawi, Mozambique, Niger, Sierra Leone, Swaziland). Results were compared to a reference database (GLOBOCAN). Using different smoking prevalence scenarios, future lung cancer deaths were estimated.
The prevalence of current moderate smoking among males ranged from 8.7% to 34.6%. Prevalence was much lower among females. For all countries considered, our mortality estimates were higher than GLOBOCAN estimates that do not consider prevalence: Overall, we estimated 2405 lung cancer deaths for 2008 compared to 531 deaths estimated by GLOBOCAN. Up to 2030, lung cancer deaths are expected to increase in general and by over 100% in Benin and Niger. Even under the assumption of decrease in smoking prevalence, lung cancer mortality will rise.
On the bases of detailed smoking prevalence information, our findings implicate a higher lung cancer burden in low income countries. The epidemiologic transition in African low-income countries alludes to the need for targeted health prevention efforts.
可靠的死亡率数据在发展中国家较为匮乏。此外，风险因素的流行信息几乎无法获得，因此在估计死亡率时并未考虑这些因素。
作者使用经过验证的统计模型，并结合来自世卫组织 STEPS 调查的代表性吸烟流行率数据，来估算六个撒哈拉以南非洲国家（贝宁、马拉维、莫桑比克、尼日尔、塞拉利昂、斯威士兰）的肺癌死亡率。结果与参考数据库（GLOBOCAN）进行了比较。使用不同的吸烟流行率情景，估算了未来的肺癌死亡人数。
男性当前中度吸烟的流行率范围为 8.7%至 34.6%。女性的流行率要低得多。对于所有考虑的国家，我们的死亡率估计值高于不考虑流行率的 GLOBOCAN 估计值：总体而言，我们估计 2008 年有 2405 例肺癌死亡，而 GLOBOCAN 估计为 531 例。到 2030 年，预计所有国家的肺癌死亡人数都会增加，而在贝宁和尼日尔，预计会增加 100%以上。即使假设吸烟流行率下降，肺癌死亡率也会上升。
根据详细的吸烟流行率信息，我们的发现表明，低收入国家的肺癌负担更高。非洲低收入国家的流行病学转变暗示需要有针对性的健康预防措施。
