Rao Shuting, Wu Haijiang, Zhang Guibin, Dong Wenli, Cui Luzhe, Wang Yashu, Deng Xinna
Department of Oncology, Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei, China.
PLoS One. 2025 May 7;20(5):e0322646. doi: 10.1371/journal.pone.0322646. eCollection 2025.
Understanding the tracheal, bronchus, and lung (TBL) cancer burden caused by tobacco exposure in India can help local governments implement targeted measures for prevention and treatment of the disease.
The burden of TBL cancer deaths and disability-adjusted life years (DALYs) attributable to tobacco exposure from 2000 to 2021 were presented by age, sex, and region. A Joinpoint model was used to analyze temporal trends of the disease, while decomposition analysis was conducted to quantify the contributions of population growth, aging, and epidemiological changes. In addition, the age-period-cohort (APC) model was implemented to assess the effects of age, period, and cohort on tobacco-related TBL cancer deaths and DALYs burden. Finally, age-standardized deaths and DALYs rates for TBL cancer attributable to tobacco exposure were projected through 2035.
In 2021, Mizoram recorded the highest age-standardized rates of TBL cancer deaths and DALYs attributable to tobacco exposure, regardless of sex. Uttar Pradesh and West Bengal consistently exhibited the highest number of deaths and DALYs associated with tobacco exposure across the three age groups analyzed. Population growth and aging are the primary drivers behind the increasing burden of TBL cancer. Overall, the risk of tobacco-related lung cancer death increased with age. There are differential period and cohort effects between male and female populations. In the future, the increase in age-standardized rates of deaths and DALYs attributable to secondhand smoke exposure will be more pronounced among males.
Despite ongoing efforts to control the tobacco epidemic, the burden of TBL cancer related to tobacco remains high in India. Each state in India should adopt targeted measures based on local conditions to address the health threats posed by tobacco.
了解印度烟草暴露所致气管、支气管和肺癌（TBL）的疾病负担，有助于地方政府实施针对性的疾病防治措施。
按年龄、性别和地区呈现2000年至2021年烟草暴露所致TBL癌症死亡和伤残调整生命年（DALY）的负担。采用Joinpoint模型分析该疾病的时间趋势，同时进行分解分析以量化人口增长、老龄化和流行病学变化的贡献。此外，实施年龄-时期-队列（APC）模型以评估年龄、时期和队列对烟草相关TBL癌症死亡和DALY负担的影响。最后，预测了到2035年烟草暴露所致TBL癌症的年龄标准化死亡和DALY率。
2021年，无论性别，米佐拉姆邦的烟草暴露所致TBL癌症死亡和DALY的年龄标准化率最高。在分析的三个年龄组中，北方邦和西孟加拉邦的烟草暴露相关死亡和DALY数量一直最高。人口增长和老龄化是TBL癌症负担增加的主要驱动因素。总体而言，烟草相关肺癌死亡风险随年龄增加。男性和女性人群存在不同的时期和队列效应。未来，二手烟暴露所致死亡和DALY的年龄标准化率在男性中上升将更为明显。
尽管在控制烟草流行方面不断努力，但印度与烟草相关的TBL癌症负担仍然很高。印度每个邦应根据当地情况采取针对性措施，以应对烟草带来的健康威胁。
