四大主要危险因素所致癌症死亡的国际负担及癌症导致的寿命损失年数：一项基于巴西、俄罗斯、印度、中国、南非、英国和美国人群的研究
International burden of cancer deaths and years of life lost from cancer attributable to four major risk factors: a population-based study in Brazil, Russia, India, China, South Africa, the United Kingdom, and United States.
作者信息
Rumgay Harriet, Cabasag Citadel J, Offman Judith, de Camargo Cancela Marianna, Barchuk Anton, Mathur Prashant, Wang Shaoming, Wei Wenqiang, Sasieni Peter, Soerjomataram Isabelle
机构信息
Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
出版信息
EClinicalMedicine. 2023 Nov 15;66:102289. doi: 10.1016/j.eclinm.2023.102289. eCollection 2023 Dec.
BACKGROUND
We provide a comprehensive view of the impact of alcohol consumption, tobacco smoking, excess body weight, and human papillomavirus (HPV) infection on cancer mortality and years of life lost (YLLs) in Brazil, Russia, India, China, South Africa, the United Kingdom (UK), and United States (US).
METHODS
We collected population attributable fractions of the four risk factors from global population-based studies and applied these to estimates of cancer deaths in 2020 to obtain potentially preventable cancer deaths and their 95% confidence intervals (CIs). Using life tables, we calculated the number and age-standardised rates of YLLs (ASYR).
FINDINGS
In Brazil, Russia, India, China, South Africa, the UK, and the US in 2020, an estimated 5.9 million (3.3 million-8.6 million) YLLs from cancer were attributable to alcohol consumption, 20.8 million (17.0 million-24.6 million) YLLs to tobacco smoking, 3.1 million (2.4 million-3.8 million) YLLs to excess body weight, and 4.0 million (3.9 million-4.2 million) YLLs to HPV infection. The ASYR from cancer due to alcohol consumption was highest in China (351.4 YLLs per 100,000 population [95% CI 194.5-519.2]) and lowest in the US (113.5 [69.6-157.1]) and India (115.4 [49.7-172.7). For tobacco smoking, China (1159.9 [950.6-1361.8]) had the highest ASYR followed by Russia (996.8 [831.0-1154.5). For excess body weight, Russia and the US had the highest ASYRs (385.1 [280.6-481.2] and 369.4 [299.6-433.6], respectively). The highest ASYR due to HPV infection was in South Africa (457.1 [453.3-462.6]). ASYRs for alcohol consumption and tobacco smoking were higher among men than women, whereas women had higher ASYRs for excess body weight and HPV infection.
INTERPRETATION
Our findings demonstrate the importance of cancer control efforts to reduce the burden of cancer death and YLLs due to modifiable cancer risk factors and promote the use of YLLs to summarise disease burden.
FUNDING
Cancer Research UK.
背景
我们全面审视了饮酒、吸烟、超重和人乳头瘤病毒（HPV）感染对巴西、俄罗斯、印度、中国、南非、英国和美国癌症死亡率及寿命损失年数（YLLs）的影响。
方法
我们从基于全球人群的研究中收集了这四种风险因素的人群归因分数，并将其应用于2020年癌症死亡估计数，以获得潜在可预防的癌症死亡人数及其95%置信区间（CIs）。我们使用生命表计算了YLLs的数量和年龄标准化率（ASYR）。
研究结果
2020年在巴西、俄罗斯、印度、中国、南非、英国和美国，估计因饮酒导致的癌症YLLs为590万（330万 - 860万），因吸烟导致的为2080万（1700万 - 2460万），因超重导致的为310万（240万 - 380万），因HPV感染导致的为400万（390万 - 420万）。因饮酒导致的癌症ASYR在中国最高（每10万人口351.4个YLLs [95% CI 194.5 - 519.2]），在美国（113.5 [69.6 - 157.1]）和印度（115.4 [49.7 - 172.7]）最低。对于吸烟，中国（1159.9 [950.6 - 1361.8]）的ASYR最高，其次是俄罗斯（996.8 [831.0 - 1154.5]）。对于超重，俄罗斯和美国的ASYR最高（分别为385.1 [280.6 - 481.2]和369.4 [299.6 - 433.6]）。因HPV感染导致的最高ASYR在南非（457.1 [453.3 - 462.6]）。饮酒和吸烟的ASYR男性高于女性，而超重和HPV感染的ASYR女性更高。
解读
我们的研究结果表明，控制癌症的努力对于减轻可改变的癌症风险因素导致的癌症死亡和YLLs负担非常重要，并促进使用YLLs来总结疾病负担。
资金来源
英国癌症研究中心。
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