Luo Qingwei, Steinberg Julia, Yu Xue Qin, Weber Marianne, Caruana Michael, Yap Sarsha, Grogan Paul B, Banks Emily, O'Connell Dianne L, Canfell Karen
The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.
J Epidemiol Community Health. 2022 Jun 24;76(9):792-9. doi: 10.1136/jech-2021-218252.
While many high-income countries including Australia have successfully implemented a range of tobacco control policies, smoking remains the leading preventable cause of cancer death in Australia. We have projected Australian mortality rates for cancer types, which have been shown to have an established relationship with cigarette smoking and estimated numbers of cancer deaths attributable to smoking to 2044.
Cancer types were grouped according to the proportion of cases currently caused by smoking: 8%-30% and >30%. For each group, an age-period- cohort model or generalised linear model with cigarette smoking exposure as a covariate was selected based on the model fit statistics and validation using observed data. The smoking-attributable fraction (SAF) was calculated for each smoking-related cancer using Australian smoking prevalence data and published relative risks.
Despite the decreasing mortality rates projected for the period 2015-2019 to 2040-2044 for both men and women, the overall number of smoking-related cancer deaths is estimated to increase by 28.7% for men and 35.8% for women: from 138 707 (77 839 men and 60 868 women) in 2015-2019 to 182 819 (100 153 men and 82 666 women) in 2040-2044. Over the period 2020-2044, there will be 254 583 cancer deaths (173 943 men and 80 640 women) directly attributable to smoking, with lung, larynx, oesophagus and oral (comprising lip, oral cavity and pharynx) cancers having the largest SAFs.
Cigarette smoking will cause over 250 000 cancer deaths in Australia from 2020 to 2044. Continued efforts in tobacco control remain a public health priority, even in countries where smoking prevalence has substantially declined.
包括澳大利亚在内的许多高收入国家已成功实施了一系列烟草控制政策，但吸烟仍是澳大利亚可预防癌症死亡的首要原因。我们预测了澳大利亚各类癌症的死亡率，这些癌症已被证明与吸烟存在既定关联，并估算了到2044年归因于吸烟的癌症死亡人数。
根据目前吸烟导致的病例比例对癌症类型进行分组：8%-30%和>30%。对于每组，根据模型拟合统计数据和使用观察数据进行的验证，选择以吸烟暴露为协变量的年龄-时期-队列模型或广义线性模型。使用澳大利亚吸烟流行率数据和公布的相对风险，计算每种与吸烟相关癌症的吸烟归因分数（SAF）。
尽管预计2015-2019年至2040-2044年期间男性和女性的死亡率都会下降，但与吸烟相关的癌症死亡总数预计男性将增加28.7%，女性将增加35.8%：从2015-2019年的138707例（男性77839例，女性60868例）增至2040-2044年的182819例（男性100153例，女性82666例）。在2020-2044年期间，将有254583例癌症死亡（男性173943例，女性80640例）直接归因于吸烟，其中肺癌、喉癌、食管癌和口腔癌（包括唇癌、口腔癌和咽癌）的SAF最高。
2020年至2044年期间，吸烟将在澳大利亚导致超过25万例癌症死亡。即使在吸烟流行率已大幅下降的国家，继续开展烟草控制工作仍是公共卫生的重点。
