烟草暴露对上海市35岁及以上居民恶性肿瘤死亡的归因分析  

Evaluating Malignant Tumor Mortality Attributable to Smoke Exposure in Residents Aged 35 Years Old and Above in Shanghai

作　　者：鲍萍萍[1] 王春芳[2] 汪晶[1] 虞慧婷[2] 姚海宏[1] 郭寒冰[3] 甘泉 施燕[1] 仲伟鉴[1,2] 

机构地区：[1]上海市疾病预防控制中心慢性非传染病与伤害防治所,上海200336 [2]上海市疾病预防控制中心疾病预防控制信息所,上海200336 [3]国际防痨和肺部疾病联合会中国办公室,北京100600

出　　处：《环境与职业医学》2016年第10期931-936,共6页Journal of Environmental and Occupational Medicine

基　　金：第四轮公共卫生三年行动计划重点学科建设项目(编号:15GWZK0801;15GWZK0901);上海市卫生和计划生育委员会科研课题(编号:20124383)

摘　　要：[目的]采用人群归因健康效应评价方法,定量评估上海市35岁及以上居民吸烟所致恶性肿瘤死亡及寿命和劳动力损失情况,为公共卫生政策的制定提供科学依据。[方法]综合利用2013年上海市慢性病及其危险因素监测数据和全球疾病负担研究烟草暴露导致恶性肿瘤死亡的相对危险度,测算上海市35岁及以上居民吸烟所致恶性肿瘤死亡发生例数、寿命和劳动力损失情况。[结果]2013年上海市35岁及以上人群吸烟相关的主要恶性肿瘤死亡率为312.55/10万,男性为409.39/10万,女性为218.89/10万。其中,归因于吸烟的恶性肿瘤死亡有9 994人(男性9 548人,女性446人),吸烟归因危险度百分比是33.82%。潜在寿命损失为155 455人年,平均每人的寿命损失为15.55年,劳动力损失为28 897人年。在吸烟相关的恶性肿瘤死亡中,人群吸烟归因危险度百分比最高的是肺癌(64.46%),其次是鼻咽癌(55.03%)和食道癌(51.05%)。归因于吸烟的肺癌死亡人数最多,为5 998人,潜在寿命损失为85 979人年,劳动力损失为13 428人年。归因于吸烟的恶性肿瘤早死指数女性稍大于男性,分别为16.07年和15.53年。归因于吸烟的肝癌和鼻咽癌早死指数较大,分别为20.74年和20.38年,膀胱癌早死指数较小,为10.64年。[结论]上海市居民归因于吸烟的恶性肿瘤死亡人数众多,造成较大的潜在减寿年数损失和劳动力损失,以肺癌为主。[ Objective ] To quantitatively estimate smoking attributable deaths, potential life lost, and labor loss of malignant tumor in Shanghai residents at 35 years old and above using population attributable health effect evaluation method, and to provide scientific evidence for making public health policy. [ Methods ] Smoking rates from 2013 Shanghai Non-communicable Disease and Behavioral Risk Factor Surveillance System and relative risks of smoke exposure from Global Burden of Disease Study were used to calculate deaths of malignant tumor, years of potential life lost （YPLL）, and labor loss attributable to smoke exposure. [ Results ] The mortality rate of major malignant tumors was 312.55/105 among the population aged 35 years and above in 2013 （409.39/105 for male and 218.89/105 for female）. There were 9 994 deaths of malignant tumor attributable to smoking （9 548 for male and 446 for female） and the attributable risk percent was 33.82%. The YPLL was 155 455 person years, the life lost per person was 15.55 years, and the loss of labor was 28 897 person years. Lung cancer had the highest population attributable risk percent associated with cigarette smoking （64.46%）, followed by nasopharynx cancer （55.03%） and esophageal cancer （51.05%）. The number of lung cancer deaths attributable to smoke exposure was 5 998, the YPLL was 85 979 person years, and the loss of labor was 13 428 person years. The index of life lost due to smoking attributable cancer was higher for female than that for male, being 16.07 years and 15.53 years respectively. The index of life lost of liver cancer and nasopharynx cancer attributable to smoke exposure were higher than other types of malignant tumor, being 20.74 years and 20.38 years respectively, whereas the smallest index was bladder cancer of 10.64 years. [ Gonclusion ] A large number of smoking attributable malignant tumor fatalities are identified in Shanghai, resulting in great years of potential life lost and years of labor loss. Lung cancer is the leading one

关 键 词：烟草暴露 恶性肿瘤 人群归因危险度百分比 归因死亡例数 潜在寿命损失年 

分 类 号：R18[医药卫生—流行病学]