Liu Yan, Wen Haoyu, Bai Jianjun, Sun Jinyi, Chen Jiahao, Yu Chuanhua
Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan; Hunan Key Laboratory of Typical Environmental Pollution and Health Hazards, School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan.
Chest. 2024 Feb;165(2):446-460. doi: 10.1016/j.chest.2023.09.028. Epub 2023 Oct 6.
This study investigated the impact of epidemiologic and sociodemographic changes in tracheal, bronchus, and lung cancer associated with residential radon, solid fuels, and particulate matter.
What are the influencing factors of tracheal, bronchus, and lung cancer disease burden attributable to the three pollutants?
Data were obtained from the Global Burden of Disease 2019. Age-standardized mortality rate (ASMR) and sociodemographic index (SDI) values were collected from 21 regions, and restricted cubic splines and quantile regression were used to investigate the relationship between ASMR or age-standardized disability-adjusted life years rate (ASDR), and SDI. Additionally, five countries with different SDIs were selected, and the Bayesian age-period-cohort model was used to predict the ASMR trends from 2020 to 2030.
High SDI quintiles were associated with increased residential radon pollution. The disease burden attributed to these three pollutants was particularly severe in the middle SDI quintiles. Older adults aged 80 to 89 years had the highest age-specific mortality, and the disease burden was greater in male patients than in female patients with these cancers attributed to the pollutants. The highest ASMR attributable to particulate matter when the SDI was 0.7. As the SDI increased, the disease burden caused by radon increased, whereas the burden caused by solid fuels decreased. Projections have indicated a rise in the death burden in patients with this cancer from particulate pollution in China, India, and Uganda over the next decade.
The disease burden of tracheal, bronchus, and lung cancer attributed to the three pollutants was influenced by SDI, sex, and age. Older men are more susceptible to be affected. More preventive interventions may be required for men at younger ages to reduce the high death burden of older men. However, it is necessary to give due attention to women in specific countries in the future.
本研究调查了与住宅氡、固体燃料和颗粒物相关的气管、支气管和肺癌的流行病学及社会人口学变化的影响。
三种污染物导致气管、支气管和肺癌疾病负担的影响因素有哪些？
数据来自《2019年全球疾病负担》。从21个地区收集年龄标准化死亡率（ASMR）和社会人口学指数（SDI）值，并使用受限立方样条和分位数回归来研究ASMR或年龄标准化残疾调整生命年率（ASDR）与SDI之间的关系。此外，选择了五个具有不同SDI的国家，并使用贝叶斯年龄-时期-队列模型预测2020年至2030年的ASMR趋势。
高SDI五分位数与住宅氡污染增加有关。这三种污染物导致的疾病负担在中等SDI五分位数中尤为严重。80至89岁的老年人具有最高的年龄别死亡率，并且由于这些污染物导致的这些癌症男性患者的疾病负担大于女性患者。当SDI为0.7时，颗粒物导致的ASMR最高。随着SDI的增加，氡导致的疾病负担增加，而固体燃料导致的负担下降。预测表明，在未来十年中，中国、印度和乌干达因颗粒物污染导致的这种癌症患者的死亡负担将会上升。
三种污染物导致的气管、支气管和肺癌的疾病负担受SDI、性别和年龄的影响。老年男性更容易受到影响。可能需要对年轻男性采取更多的预防干预措施，以降低老年男性的高死亡负担。然而，未来有必要对特定国家的女性给予应有的关注。
