Han Siyu, Zhao Shiyu, Zhong Ran, Li Peizhe, Pang Yuewen, He Shuang, Duan Junyao, Gong Huijie, Shi Jing, Liu Li, Yan Yongji
Department of Urology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Public Health. 2025 Jan 8;12:1506542. doi: 10.3389/fpubh.2024.1506542. eCollection 2024.
Smoking is a well-established risk factor for kidney cancer. Analyzing the latest global spatio-temporal trends in the kidney cancer burden attributable to smoking is critical for informing effective public health policies.
Using data from the 2021 GBD database, we examined deaths, disability-adjusted life years (DALYs), and age-standardized rate (ASR) of kidney cancer attributable to smoking across global, regional, and national levels. Trends in ASRs were assessed through estimated annual percentage change (EAPC). We conducted a cross-country analysis to evaluate disparities in the kidney cancer burden from 1990 to 2021, with absolute and relative inequalities measured by the slope index of inequality and concentration index, respectively. Correlation analysis was conducted by the Spearman rank order correlation method. Additionally, we projected age-standardized death and DALYs rates up to 2036 using Bayesian age-period-cohort (BAPC) models in R.
Globally, kidney cancer deaths attributable to smoking increased by 67.64%, from 9,673 in 1990 to 16,216 in 2021. Despite this increase, the age-standardized death rate (ASDR) dropped from 0.25 to 0.19 per 100,000 (EAPC: -0.93). Similarly, the age-standardized disability-adjusted life years rate (ASDALY) decreased from 6.17 to 4.37 per 100,000 (EAPC: -1.15). Geographically, areas with a higher Socio-demographic Index (SDI) were the most affected. The positive correlation between higher SDI and increased deaths highlights the role of economic and social factors in disease prevalence. Cross-country analysis shows that while relative inequalities between groups are improving, absolute differences in health burdens continue to grow. Furthermore, projections indicate a gradual decline in ASDR and ASDALY for both sexes from 2022 to 2036.
Between 1990 and 2021, both the global ASDR and ASDALY attributable to smoking in kidney cancer, which are positively correlated with SDI, have declined. However, significant demographic and geographic disparities persist, with the disease burden remaining higher in older populations and regions with elevated SDI levels. Moreover, while the overall burden is projected to decline annually over the next 15 years, it is expected to remain significantly higher in men. These findings emphasize the need for region-specific health prevention strategies to reduce smoking-related kidney cancer.
吸烟是肾癌公认的危险因素。分析归因于吸烟的肾癌负担的最新全球时空趋势对于制定有效的公共卫生政策至关重要。
利用2021年全球疾病负担（GBD）数据库的数据，我们在全球、区域和国家层面研究了归因于吸烟的肾癌死亡人数、伤残调整生命年（DALYs）和年龄标准化率（ASR）。通过估计年度百分比变化（EAPC）评估年龄标准化率的趋势。我们进行了一项跨国分析，以评估1990年至2021年肾癌负担的差异，分别用不平等斜率指数和集中指数衡量绝对和相对不平等。采用Spearman等级相关法进行相关性分析。此外，我们使用R语言中的贝叶斯年龄-时期-队列（BAPC）模型预测了到2036年的年龄标准化死亡率和伤残调整生命年率。
在全球范围内，归因于吸烟的肾癌死亡人数增加了67.64%，从1990年的9673例增加到2021年的16216例。尽管有所增加，但年龄标准化死亡率（ASDR）从每10万人0.25例降至0.19例（EAPC：-0.93）。同样，年龄标准化伤残调整生命年率（ASDALY）从每10万人6.17例降至4.37例（EAPC：-1.15）。在地理上，社会人口指数（SDI）较高的地区受影响最大。较高的SDI与死亡人数增加之间的正相关突出了经济和社会因素在疾病流行中的作用。跨国分析表明，虽然群体之间的相对不平等在改善，但健康负担的绝对差异仍在扩大。此外，预测表明，从2022年到2036年，男女的年龄标准化死亡率和伤残调整生命年率都将逐渐下降。
1990年至2021年期间，归因于吸烟的肾癌全球年龄标准化死亡率和伤残调整生命年率均有所下降，且与SDI呈正相关。然而，显著的人口和地理差异仍然存在，老年人群和SDI水平较高地区的疾病负担仍然较高。此外，虽然预计未来15年总体负担将逐年下降，但预计男性的负担仍将显著更高。这些发现强调需要制定针对特定区域的健康预防策略，以减少与吸烟相关的肾癌。
