Yang Xiaorong, Man Jinyu, Chen Hui, Zhang Tongchao, Yin Xiaolin, He Qiufeng, Lu Ming
Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China; Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Lung Cancer. 2021 Feb;152:49-57. doi: 10.1016/j.lungcan.2020.12.007. Epub 2020 Dec 9.
Understanding the global trend of lung cancer deaths attributable to smoking is crucial for prioritizing global lung cancer prevention, as well as tobacco control. We assessed patterns of smoking-induced lung cancer deaths at global, regional, and national levels from 1990 to 2017.
We extracted detailed data on lung cancer deaths attributable to smoking from the Global Burden of Disease 2017 Study. The estimated annual percentage change (EAPC) was used to quantify temporal trends in the age-standardized mortality rate (ASMR) of smoking-induced lung cancer.
In 2017, estimated 1.19 million lung cancer deaths were attributable to smoking, accounting for 63.17 % of all lung cancer deaths. The corresponding ASMR decreased by 13.36 % from 17.29/100,000 in 1990 to 14.98/100,000 in 2017, with an EAPC of -0.59 (95 % confidence interval: -0.66, -0.53). The ASMR of lung cancer in most geographic regions has significantly decreased since 1990; however, the EAPC of ASMR in 20 countries exceeded 1 during the same period. The reductions in the ASMR were pronounced in areas with high Socio-demographic Index and high disease burden, and kept pace with the decrease of smoking prevalence at least 10 years ago.
Despite the decline in lung cancer ASMR attributable to smoking over the past 28 years, the corresponding number of lung cancer deaths increased steadily due to population aging and growth. Tobacco prevention needs to be strengthened, especially in countries with high smoking prevalence and countries where the ASMR of smoking-induced lung cancer is increasing.
了解归因于吸烟的肺癌死亡的全球趋势，对于确定全球肺癌预防以及烟草控制的优先事项至关重要。我们评估了1990年至2017年全球、区域和国家层面吸烟所致肺癌死亡的模式。
我们从《2017年全球疾病负担研究》中提取了归因于吸烟的肺癌死亡的详细数据。使用估计的年度百分比变化（EAPC）来量化吸烟所致肺癌年龄标准化死亡率（ASMR）的时间趋势。
2017年，估计有119万例肺癌死亡归因于吸烟，占所有肺癌死亡的63.17%。相应的ASMR从1990年的17.29/10万下降了13.36%，至2017年为14.98/10万，EAPC为-0.59（95%置信区间：-0.66，-0.53）。自1990年以来，大多数地理区域的肺癌ASMR显著下降；然而，同期20个国家的ASMR的EAPC超过了1。在社会人口指数高和疾病负担高的地区，ASMR的下降最为明显，并且至少在10年前就与吸烟流行率的下降保持同步。
尽管在过去28年中归因于吸烟的肺癌ASMR有所下降，但由于人口老龄化和增长，相应的肺癌死亡人数稳步增加。需要加强烟草预防，特别是在吸烟流行率高以及吸烟所致肺癌ASMR正在上升的国家。
