2022 年归因于无烟烟草和槟榔消费的全球口腔癌负担：人群归因分数分析。

Global burden of oral cancer in 2022 attributable to smokeless tobacco and areca nut consumption: a population attributable fraction analysis.

机构信息

Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.

Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France.

出版信息

Lancet Oncol. 2024 Nov;25(11):1413-1423. doi: 10.1016/S1470-2045(24)00458-3. Epub 2024 Oct 8.

DOI:10.1016/S1470-2045(24)00458-3

PMID:39393386

Abstract

BACKGROUND

Consuming products that contain smokeless tobacco or areca nut increases the risk of oral cancer. We aimed to estimate the burden of oral cancer attributable to smokeless tobacco or areca nut consumption globally and by type of smokeless tobacco or areca nut product in four major consuming countries.

METHODS

We calculated population attributable fractions (PAFs) using prevalence of current use of smokeless tobacco or areca nut products from national surveys and corresponding risks of oral cancer from the literature. We applied PAFs to national estimates of oral cancer incidence in 2022 from the Global Cancer Observatory's Cancer Today database to obtain cases attributable to smokeless tobacco or areca nut consumption. We modelled 95% uncertainty intervals (UIs) using Monte Carlo simulations.

FINDINGS

Globally, an estimated 120 200 (95% UI 115 300-124 300) cases of oral cancer diagnosed in 2022 were attributable to smokeless tobacco or areca nut consumption, accounting for 30·8% (95% UI 29·6-31·9) of all oral cancer cases (120 200 of 389 800). An estimated 77% of attributable cases were among male patients (92 600 cases, 95% UI 88 000-96 500) and 23% were among female patients (27 600 cases, 26 000-29 000). Regions with the highest PAFs were Melanesia, Micronesia, and Polynesia (78·6%, 95% UI 74·4-80·5), southcentral Asia (57·5%, 54·8-59·5), and southeastern Asia (19·8%, 19·0-20·6). Lower-middle-income countries represented 90·2% of the world total attributable cases (108 400 cases, 95% UI 103 400-112 200).

INTERPRETATION

Our findings suggest that one in three cases of oral cancer globally are attributable to smokeless tobacco or areca nut consumption, and could be prevented through smokeless tobacco and areca nut control. Global cancer control efforts must incorporate further measures to reduce smokeless tobacco and areca nut consumption in populations with the largest attributable burden.

FUNDING

French National Cancer Institute.

摘要

背景

消费含无烟烟草或槟榔的产品会增加罹患口腔癌的风险。我们旨在估计全球范围内由无烟烟草或槟榔消费引起的口腔癌负担，以及在四个主要消费国中由不同类型的无烟烟草或槟榔产品引起的负担。

方法

我们使用来自国家调查的当前使用无烟烟草或槟榔产品的流行率和文献中相应的口腔癌风险，计算人群归因分数（PAF）。我们将 PAF 应用于 2022 年全球癌症观测站《今日癌症》数据库中全球口腔癌发病率的国家估计，以获得归因于无烟烟草或槟榔消费的病例。我们使用蒙特卡罗模拟来模拟 95%置信区间（UI）。

结果

全球范围内，2022 年诊断出的约 120200 例（95%UI 115300-124300）口腔癌病例归因于无烟烟草或槟榔消费，占所有口腔癌病例的 30.8%（95%UI 29.6-31.9）（389800 例中的 120200 例）。估计有 77%的可归因病例发生在男性患者中（92600 例，95%UI 88000-96500），23%发生在女性患者中（27600 例，26000-29000）。PAF 最高的地区是美拉尼西亚、密克罗尼西亚和波利尼西亚（78.6%，95%UI 74.4-80.5）、南亚次大陆（57.5%，54.8-59.5）和东南亚（19.8%，19.0-20.6）。中低收入国家占全球总归因病例的 90.2%（108400 例，95%UI 103400-112200）。