2015年青岛市归因于吸烟的癌症疾病负担研究

目的 分析青岛市2015年归因于吸烟的癌症疾病负担，为进一步控烟策略提供科学依据。方法 利用青岛市2015年人口数据、死因监测数据，以吸烟影响比表示吸烟的暴露分布，估计归因于吸烟的癌症死亡人数及其造成的期望寿命损失。结果 青岛市2015年归因于吸烟的癌症死亡数为4 148人（占癌症总死亡人数的29.13%），其中男性3 195人（33.00%），女性953人（20.92%）。死亡人数伴随年龄组增大呈现上升趋势，在45~岁年龄组明显增加，在60~岁年龄组达到顶点。在与吸烟相关的癌症中，吸烟归因分值最高的5种癌症依次为肺癌（60.04%）、鼻咽癌（37.95%）、口腔癌（35.41%）、食管癌（35.14%）和膀胱癌（14.93%）；归因于吸烟的死亡数最高的5种癌症依次为肺癌（3 122人）、肝癌（339人）、食管癌（293人）、胃癌（185人）和胰腺癌（55人）。青岛市居民归因于吸烟的癌症死亡所导致的期望寿命损失为0.87岁，其中男性1.19岁，女性0.45岁。结论 青岛市居民归因于吸烟的癌症疾病负担较重，降低吸烟率，保护不吸烟者免受二手烟污染等控烟措施势在必行。

Burden of disease attributable to cigarette smoking in Qingdao in 2015

Objective To estimate the burden of cancers attributable to smoking among the Qingdao population in 2015 and provide scientific basis for further tobacco control strategy. Methods According to the characteristics of different diseases, we calculated the population attributable fractions of different diseases, death and impact of life expectancy which caused by smoking, using smoking impact ratio as exposure levels. The sex-age-specific mortality attributable to smoking was collected from Qingdao Municipal Center for Disease Control and Prevention by the online report system. The population was obtained from the Qingdao Municipal Bureau of Statistics. Results In 2015, tobacco smoking caused an estimated 4 148 cancer deaths (3 195 in male and 953 in female), accounting for 29.13% of total cancer deaths (33.00% in male and 20.92% in female). The mortality increased with age, and increased significantly at age of 45-years. It reached the peak at age of 60-years. Lung cancer showed the greatest PAF (60.04%), followed by nasopharynx cancer (37.95%), oral cancer (35.41%), esophageal cancer (35.14%) and bladder cancer (14.93%). The leading cancers due to smoking in terms of mortality were lung (3 122), liver (339), esophageal (293) and stomach (185), and pancreatic cancer (55). The loss of life expectancy caused by cancer deaths attributable to smoking was 0.87 years (1.19 years in male and 0.45 years in female). Conclusions The burden of cancers attributable to smoking in Qingdao reached a high level. Tobacco control measures such as reducing the smoking rate and protecting non-smokers from secondhand smoke pollution are imperative.