Hu Nanxi, Li Hui, Yu Kaili, Yu Yang, Wu Xiaohua, Huang Xinyi, Lin Hongtao, Zou Shuqing, Li Jinluan
Department of Quality Control, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Cancer Med. 2025 Sep;14(17):e71213. doi: 10.1002/cam4.71213.
In this study, we investigated the global burden, projection, and inequalities of cancer attributable to occupational carcinogen exposure in individuals aged over 40 years.
Using the Global Burden of Disease 2021 dataset, we examined age-standardized disability-adjusted life years (ASR-DALYs) and deaths associated with cancer attributable to occupational carcinogen exposure. Statistical analyses included: the estimated Annual Percentage Change to assess trends (1990-2021); Bayesian age-period-cohort modeling for projections to 2030 and 2050; decomposition analysis to quantify contributions of aging, population growth, and epidemiological changes; and slope and concentration indices (SII, CI) to evaluate health inequalities by sociodemographic index (SDI).
In 2021, the global ASR-DALYs attributable to occupational carcinogen exposure were 239.3 per 100,000 (95% uncertainty intervals [UI]: 180.76-300.91), with significant declines found since 1990. The ASR-deaths in the same year were 11.45 per 100,000 (95% UI: 8.57-14.29). By 2050, ASR-DALYs and ASR-deaths are projected to decline to 177.24 and 8.50 per 100,000, respectively. Men exhibited higher DALYs and mortality (3.92 million DALYs, 0.18 million deaths) compared with women. From 1990 to 2021, high SDI regions exhibited the most substantial decline, whereas low-middle SDI regions experienced the highest increase. The most prominent occupational carcinogens were asbestos (ASR-DALYs: 142.36 per 100,000), silica (50.36 per 100,000), and diesel engine exhaust (20.56 per 100,000). Among the seven types of occupational cancers observe, tracheal, bronchial, and lung cancers exhibited the highest ASR-DALY and ASR-deaths. Population growth is the primary contributor to both DALYs and deaths globally, followed by epidemiological changes.
This study highlights the declining global burden of cancer due to occupational exposure to carcinogens; however, significant disparities persist. Addressing occupational cancer risk in low-SDI regions and under-researched populations is crucial for reducing this health burden.
在本研究中，我们调查了40岁以上人群因职业致癌物暴露导致的癌症的全球负担、预测情况及不平等现象。
我们使用《2021年全球疾病负担》数据集，研究了与职业致癌物暴露相关的癌症的年龄标准化残疾调整生命年（ASR-DALYs）和死亡情况。统计分析包括：用于评估趋势（1990 - 2021年）的估计年度百分比变化；到2030年和2050年的贝叶斯年龄-时期-队列模型预测；用于量化老龄化、人口增长和流行病学变化贡献的分解分析；以及通过社会人口指数（SDI）评估健康不平等的斜率和集中度指数（SII、CI）。
2021年，因职业致癌物暴露导致的全球ASR-DALYs为每10万人239.3（95%不确定区间[UI]：180.76 - 300.91），自1990年以来有显著下降。同年的ASR-死亡人数为每10万人11.45（95% UI：8.57 - 14.29）。到205０年，预计ASR-DALYs和ASR-死亡人数将分别降至每10万人177.24和8.50。男性的DALYs和死亡率高于女性（392万DALYs，18万例死亡）。从1990年到2021年，高SDI地区下降最为显著，而中低SDI地区增长幅度最大。最主要的职业致癌物是石棉（ASR-DALYs每10万人142.36）、二氧化硅（每10万人50.36）和柴油机尾气（每10万人20.56）。在观察到的七种职业癌症类型中，气管、支气管和肺癌的ASR-DALY和ASR-死亡人数最高。人口增长是全球DALYs和死亡人数的主要贡献因素，其次是流行病学变化。
本研究强调了因职业接触致癌物导致的全球癌症负担在下降；然而,显著差异依然存在。解决低SDI地区和研究不足人群的职业癌症风险对于减轻这一健康负担至关重要。
