Division of Public Health, Department of Family & Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT.
Division of Public Health, Department of Family & Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT.
Ann Glob Health. 2014 Sep-Oct;80(5):378-83. doi: 10.1016/j.aogh.2014.09.010.
Tobacco use is a well-established risk factor for cancers of the lung, head and neck, nasopharynx, esophagus, stomach, pancreas, liver, kidney, bladder, leukemia, and cervix. Alcohol consumption is a well-established risk factor for cancers of the head and neck, esophagus, liver, colorectum, and breast for women only. The majority of studies on tobacco and alcohol were conducted in high-income countries (HICs).
The aim of this review was to assess the extent of tobacco and alcohol usage and to compare the cancer burden between low- and high-income regions.
Overall, tobacco smoking is estimated to account for 21% of cancer deaths worldwide (29% in HICs and 18% in low- and middle-income countries [LMICs]). Alcohol consumption is estimated to account for 5% of all cancer deaths worldwide, with similar proportions in LMICs. Cancers of the breast, lung, stomach, liver, head and neck, esophagus, cervix, and nasopharynx, and leukemia are already diagnosed in greater numbers each year in less-developed countries compared with more developed countries. The future burden of tobacco- and alcohol-related cancers on less-developed regions is expected to increase greatly based on demographic effects, with a 69.9% increase in tobacco-related cancer cases and a 68% increase in cancers related to alcohol. Although HICs have experienced a decrease in tobacco prevalence in recent decades, LMICs are still in the early stages of the tobacco epidemic.
Tobacco use and alcohol consumption will clearly remain important risk factors that must be targeted with public health efforts particularly in LMICs.
吸烟是肺癌、头颈部癌、鼻咽癌、食管癌、胃癌、胰腺癌、肝癌、肾癌、膀胱癌、白血病和宫颈癌的已确立的危险因素。饮酒是头颈部癌、食管癌、肝癌、结直肠癌和女性乳腺癌的已确立的危险因素。大多数关于烟草和酒精的研究都是在高收入国家（HIC）进行的。
本综述的目的是评估烟草和酒精的使用程度，并比较低和高收入地区的癌症负担。
总的来说，全球范围内，吸烟估计占全球癌症死亡人数的 21%（HIC 占 29%，中低收入国家占 18%）。酒精消费估计占全球所有癌症死亡人数的 5%，在中低收入国家占相似比例。在欠发达国家，乳腺癌、肺癌、胃癌、肝癌、头颈部癌、食管癌、宫颈癌和鼻咽癌以及白血病的诊断数量每年都在增加，而在较发达国家则较少。基于人口效应，欠发达地区与烟草和酒精相关的癌症的未来负担预计将大幅增加，与烟草相关的癌症病例增加 69.9%，与酒精相关的癌症增加 68%。尽管 HIC 在过去几十年中经历了吸烟率的下降，但 LMIC 仍处于烟草流行的早期阶段。
吸烟和饮酒显然仍将是重要的危险因素，必须通过公共卫生努力加以解决，特别是在 LMIC 中。
