Wang Zongjie, Zhu Junmin, Wu Yafei, Wei Chongtao, Fang Ya
School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China.
School of Public Health, Xiamen University, Xiamen, Fujian, China; School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Cancer Epidemiol. 2025 Feb;94:102737. doi: 10.1016/j.canep.2024.102737. Epub 2024 Dec 22.
Lung cancer, a leading cause of cancer-related mortality, is significantly influenced by occupational carcinogens. This study aimed to assess and predict global, regional and national trends of lung cancer burden attributable to occupational carcinogens.
Data on the lung cancer burden attributable to nine occupational carcinogens were obtained from the Global Burden of Disease Study 2019. Regions were categorized by the Socio-Demographic Index (SDI). Descriptive statistics, Joinpoint regression, and Age-Period-Cohort (APC) models were employed to analyze trends in mortality and Disability-Adjusted Life Years (DALYs). Using the Slope Index of Inequality and Concentration Index, health inequalities were quantified. The ARIMA-LSTM model was developed to predict the burden from 2020 to 2030.
From 1990-2019, lung cancer deaths and DALYs due to occupational carcinogens increased. Global age-standardized mortality (ASMR) and DALY (ASDR) rates declined, while middle and lower SDI regions increased. Joinpoint regression and APC analysis revealed that the local drift, period, and cohort effects exhibited increasingly unfavorable trends in lower SDI regions, while they were decreasing trends in higher SDI regions. Conversely, age effects increased similarly across all SDI regions. Health inequalities worsened over time. The ARIMA-LSTM model demonstrated global ASMR and ASDR would decrease, while low-middle and low SDI regions were expected to experience substantial increases from 2020 to 2030.
Health inequality of lung cancer burden attributable to occupational carcinogens remained a critical concern, underscoring the urgent need for targeted occupational health policies for low and low-middle SDI regions.
肺癌是癌症相关死亡的主要原因，受到职业致癌物的显著影响。本研究旨在评估和预测职业致癌物所致肺癌负担的全球、区域和国家趋势。
从《2019年全球疾病负担研究》中获取了九种职业致癌物所致肺癌负担的数据。根据社会人口指数（SDI）对地区进行分类。采用描述性统计、Joinpoint回归和年龄-时期-队列（APC）模型分析死亡率和伤残调整生命年（DALYs）的趋势。使用不平等斜率指数和集中指数对健康不平等进行量化。开发了自回归积分滑动平均-长短期记忆（ARIMA-LSTM）模型来预测2020年至2030年的负担。
1990年至2019年，职业致癌物导致的肺癌死亡和DALYs有所增加。全球年龄标准化死亡率（ASMR）和DALY（ASDR）率下降，而中低SDI地区上升。Joinpoint回归和APC分析显示，低SDI地区的局部漂移、时期和队列效应呈现出越来越不利的趋势，而高SDI地区则呈下降趋势。相反，所有SDI地区的年龄效应均有类似增加。随着时间的推移，健康不平等加剧。ARIMA-LSTM模型表明，全球ASMR和ASDR将下降，而中低和低SDI地区预计在2020年至2030年将大幅上升。
职业致癌物所致肺癌负担的健康不平等仍然是一个关键问题，凸显了针对低和中低SDI地区制定有针对性的职业健康政策的迫切需求。
