中国1990—2019年归因于吸烟的前列腺癌、膀胱癌和肾癌疾病负担研究

An analysis of disease burden of prostate,bladder and kidney cancers attributable to smoking in China from 1990 to 2019

目的评价1990—2019年中国归因于吸烟的前列腺癌、膀胱癌和肾癌的疾病负担。方法基于2019年全球疾病负担研究,采用人群归因分值(PAF)、死亡和伤残调整寿命年(DALY)为指标分析中国归因于吸烟的前列腺癌、膀胱癌和肾癌的疾病负担现状,并采用joinpoint回归模型计算年度百分比变化率(APC)和平均年度百分比变化率(AAPC),描述1990—2019年3种癌症归因于吸烟的疾病负担变化趋势。结果2019年因吸烟导致的膀胱癌死亡人数和DALY分别为18800例和393106人年,标化死亡率和DALY率分别每年平均下降0.41%和0.39%。2019年归因于吸烟的前列腺癌死亡人数和DALY分别为5016例和98276人年,标化死亡率和DALY率每年平均下降0.28%和0.25%。2019年吸烟所致肾癌死亡人数和DALY分别为4935例和120620人年,标化死亡率和DALY率每年平均上升3.03%和2.98%。2019年男性归因于吸烟的疾病负担远高于女性,吸烟所致的疾病负担随年龄增长呈上升趋势,中老年人群的疾病负担最大。结论中国归因于吸烟的泌尿系统癌症疾病负担形势较为严峻,且存在人群差异。男性和中老年人群为高危人群。3种癌症中,膀胱癌的吸烟归因疾病负担最高,肾癌的吸烟归因疾病负担在1990—2019年间上升幅度最大。

Objective To analyze the disease burden of prostate,bladder and kidney cancers attributable to smoking in China from 1990 to 2019.Methods Based on the global burden of disease study 2019,the current situation of the disease burden of prostate,bladder and kidney cancers attributable to smoking was analyzed by using the population attributable fraction(PAF),deaths and disability-adjusted life years(DALYs).Furthermore,the annual percent change(APC)and the average annual percent change(AAPC)were calculated by joinpoint regression analysis to describe the long-term trends of the smoking-attributable burden of these three cancers from 1990 to 2019.Results There were an estimated 18800 cases of deaths and 393106 person-years of DALYs for bladder cancer caused by smoking in 2019.The age-standardized mortality and DALY rate decreased by 0.41%and 0.39%per year from 1990 to 2019,respectively.For prostate cancer,smoking was estimated to have caused 5016 cases of deaths and 98276 person-years of DALYs in 2019.The age-standardized mortality and DALY rate decreased by 0.28%and 0.25%per year from 1990 to 2019,respectively.For kidney cancer,the deaths and DALYs attributable to smoking were 4935 cases and 120620 person-years,respectively.The standardized mortality and DALY rates increased by 3.03%and 2.98%per year from 1990 to 2019.Additionally,males suffered from a higher disease burden of these three cancers attributable to smoking than females.The elderly population had a higher smoking-attributable disease burden than the younger population.Conclusion The situation of the disease burden of bladder,prostate and kidney cancers attributable to smoking is still serious in China,which has substantial disparities in different groups.Specifically,males and the elderly are the high-risk groups for the smokingattributable burden.Among the three cancers,bladder cancer has the highest burden and kidney cancer has the largest burden increase during 1990-2019.