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生命体征:2004-2013 年美国与烟草相关的癌症发病率和死亡率的差异。

Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality - United States, 2004-2013.

出版信息

MMWR Morb Mortal Wkly Rep. 2016 Nov 11;65(44):1212-1218. doi: 10.15585/mmwr.mm6544a3.

Abstract

BACKGROUND

Tobacco use causes at least 12 types of cancer and is the leading preventable cause of cancer.

METHODS

Data from the United States Cancer Statistics dataset for 2004-2013 were used to assess incidence and death rates and trends for cancers that can be caused by tobacco use (tobacco-related cancers: oral cavity and pharynx; esophagus; stomach; colon and rectum; liver; pancreas; larynx; lung, bronchus, and trachea; kidney and renal pelvis; urinary bladder; cervix; and acute myeloid leukemia) by sex, age, race, ethnicity, state, county-level poverty and educational attainment, and cancer site.

RESULTS

Each year during 2009-2013, on average, 660,000 persons in the United States received a diagnosis of a tobacco-related cancer, and 343,000 persons died from these cancers. Tobacco-related cancer incidence and death rates were higher among men than women; highest among black men and women; higher in counties with low proportion of college graduates or high level of poverty; lowest in the West; and differed two-fold among states. During 2004-2013, incidence of tobacco-related cancer decreased 1.3% per year and mortality decreased 1.6% per year, with decreases observed across most groups, but not at the same rate.

CONCLUSIONS

Tobacco-related cancer declined during 2004-2013. However, the burden remains high, and disparities persist among certain groups with higher rates or slower declines in rates.

IMPLICATIONS FOR PUBLIC HEALTH PRACTICE

The burden of tobacco-related cancers can be reduced through efforts to prevent and control tobacco use and other comprehensive cancer control efforts focused on reducing cancer risk, detecting cancer early, improving cancer treatments, helping more persons survive cancer, improving cancer survivors' quality of life, and better assisting communities disproportionately impacted by cancer.

摘要

背景

烟草使用可导致至少 12 种癌症,是癌症的主要可预防病因。

方法

使用美国癌症统计数据集 2004-2013 年的数据,评估可归因于烟草使用的癌症(烟草相关癌症:口腔和咽;食管;胃;结肠和直肠;肝;胰腺;喉;肺、支气管和气管;肾和肾盂;膀胱癌;子宫颈;和急性髓系白血病)的发病率、死亡率和趋势,按性别、年龄、种族、民族、州、县贫困和教育程度以及癌症部位进行分析。

结果

在 2009-2013 年期间,每年美国平均有 66 万人被诊断患有烟草相关癌症,有 34.3 万人死于这些癌症。烟草相关癌症的发病率和死亡率在男性中高于女性;在黑人和女性中最高;在大学毕业生比例低或贫困程度高的县最高;在西部最低;各州之间相差两倍。在 2004-2013 年期间,烟草相关癌症的发病率每年下降 1.3%,死亡率每年下降 1.6%,大多数人群均观察到下降,但下降速度不同。

结论

在 2004-2013 年期间,烟草相关癌症的发病率有所下降。然而,负担仍然很高,某些群体的发病率较高或下降速度较慢,差异仍然存在。

对公共卫生实践的启示

通过预防和控制烟草使用以及其他侧重于降低癌症风险、早期发现癌症、改善癌症治疗、帮助更多人战胜癌症、提高癌症幸存者生活质量以及更好地协助受癌症影响不成比例的社区的综合癌症控制努力,可以降低烟草相关癌症的负担。

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