Nemati Saeed, Naji Parnian, Abdi Sepideh, Lotfi Fereshte, Saeedi Elnaz, Mehravar Sepideh A, Fattahi Pedram, Sheikh Mahdi, Vand Rajabpour Mojtaba, Eftekharzadeh Anita, Zendehdel Kazem
Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Biostatistics Groups, Health Sciences Department, University of Leicester, Leicester, UK.
Nicotine Tob Res. 2023 Jan 1;25(1):12-18. doi: 10.1093/ntr/ntac179.
We aimed to calculate the Population Attributable Fraction (PAF) of cancers due to tobacco use in the Eastern Mediterranean Region (EMRO), where water-pipe smoking is prevalent but its effect was not considered in previous studies.
We applied Levin's formula to estimate PAFs of cancers due to tobacco use (defined as all type tobacco including both cigarette and water-pipe). We also calculated PAF of water-pipe smoking separately. Exposure prevalence data were retrieved from representative national and subnational surveys. Data on cancer incidence and death were also and cancer cases were obtained GLOBOCAN 2020. We also obtained associated relative risks from published meta-analyses.
Of the total 715 658 incident adult cancer cases that were reported in 2020 in EMRO, 14.6% (n = 104 800) was attributable to tobacco smoking (26.9% [n = 92 753]) in men versus 3.3% (n = 12 048) in women. Further, 1.0% of incident adult cancers were attributable to current water-pipe use (n = 6825) (1.7% [n = 5568]) in men versus 0.4% (n = 1257 in women).
PAFs of cancers due to tobacco smoking in EMRO were higher in our study than previous reports. This could be due to the neglected role of water-pipe in previous studies that is a common tobacco smoking method in EMRO. The proportion of cancers attributable to water-pipe smoking in EMRO might be underestimated due to lack of research on the risk of cancers associated with water-pipe smoking and also less developed cancer registries in EMRO.
In this study, we found higher PAFs for cancers due to tobacco smoking in the Eastern Mediterranean (EMR) region than previous reports. This difference could be due to ignoring the role of water-pipe smoking in previous studies. In 2020, 1% of incident cancers and 1.3% of cancer-related deaths in EMRO were attributable to water-pipe smoking. We also found a big difference in PAFs of cancers due to tobacco and water-pipe smoking across EMRO countries, with Tunisia, Lebanon, and Jordan having the highest, and Djibouti, Sudan, and Somalia having the lowest proportions of cancers attributable to tobacco and water-pipe smoking.
我们旨在计算东地中海区域（EMRO）因烟草使用导致的癌症人群归因分数（PAF），该地区水烟吸食盛行，但此前的研究未考虑其影响。
我们应用莱文公式来估算因烟草使用（定义为包括香烟和水烟在内的所有类型烟草）导致的癌症PAF。我们还单独计算了水烟吸食的PAF。暴露流行率数据取自具有代表性的国家和次国家级调查。癌症发病率和死亡率数据以及癌症病例也来自《全球癌症观察2020》。我们还从已发表的荟萃分析中获取了相关相对风险。
2020年在EMRO报告的715658例成年癌症新发病例中，14.6%（n = 104800）归因于吸烟（男性为26.9% [n = 92753]，女性为3.3% [n = 12048]）。此外，1.0%的成年癌症新发病例归因于当前的水烟使用（n = 6825）（男性为1.7% [n = 5568]，女性为0.4% [n = 1257]）。
在我们的研究中，EMRO因吸烟导致的癌症PAF高于此前的报告。这可能是由于此前的研究忽视了水烟这一在EMRO常见的吸烟方式的作用。由于缺乏对与水烟吸食相关癌症风险的研究以及EMRO地区癌症登记系统不够完善，EMRO因水烟吸食导致的癌症比例可能被低估。
在本研究中，我们发现东地中海（EMR）地区因吸烟导致的癌症PAF高于此前的报告。这种差异可能是由于此前的研究忽视了水烟吸食的作用。2020年，EMRO地区1%的癌症新发病例和1.3%的癌症相关死亡归因于水烟吸食。我们还发现，EMRO各国因烟草和水烟吸食导致的癌症PAF存在很大差异，突尼斯、黎巴嫩和约旦的比例最高，而吉布提、苏丹和索马里因烟草和水烟吸食导致的癌症比例最低。
