目的:分析1990-2019 年中国归因于吸烟的肺癌疾病负担,为预防和控制肺癌提供参考依据.方法:利用2019 年全球疾病负担研究(GBD2019)数据,选取1990-2019 年不同性别、年龄组和年份归因于吸烟的肺癌相关数据,采用人群归因分值(population attributable fraction,PAF)、粗死亡率和伤残调整寿命年(disability adjusted life year,DALY)等指标,分析中国归因于吸烟的肺癌疾病负担,并采用Joinpoint Re-gression 4.7.0.0 软件计算年度变化百分比(annual percent change,APC).结果:中国肺癌因吸烟引起的归因分值由 1990 年的 58.16%上升为 2019 年的 62.06%,标化死亡率由 1990 年的 18.99/10 万上升为2019 年的24.94/10 万,标化DALY率由1990 年的 442.84/10 万上升为 2019 年的 516.48/10 万.1990 年中国男性归因于吸烟的肺癌标化死亡率、标化 DALY 率分别为37.27/10 万、837.55/10 万,女性分别为3.64/10 万、70.21/10 万;2019 年中国男性归因于吸烟的肺癌标化死亡率、标化DALY率分别为47.66/10 万、961.58/10 万,女性分别为6.08/10 万、107.97/10 万,男性均高于女性.分年龄组发现,归因死亡率及DALY率随着年龄增长不断上升,年龄组高峰2019 年分别在85 +岁组(319.25/10 万)、75~79 岁组(3 902.13/10 万),较1990 年均延后一个年龄组.与1990 年相比,70 岁以上年龄组肺癌归因死亡率、DALY率上升明显,而60 岁以下各年龄组均有所下降.30 年来中国归因标化死亡率和标化DALY率经历了上升、平稳、下降三个阶段,其中2010-2019 年为下降期,APC值分别为-0.715%和-0.864%,但仍高于全球水平.结论:1990-2019 年中国吸烟所致的肺癌疾病负担较严重,男性和老年人群为高危人群,应进一步采用有针对性的干预措施,降低吸烟所带来的肺癌疾病负担.
Objective:To analyze the disease burden of lung cancer attributable to smoking in China from 1990 to 2019 in order to provide reference for the prevention and control of lung cancer.Methods:Based on the data of global burden of disease 2019(GBD2019),the data of lung cancer attributable to smoking from 1990 to 2019 were selected.Population attributable fraction(PAF),crude mortality and disability adjusted life year(DALY)were used to analyze the disease burden of lung cancer attributable to smoking in China,the annual percent change(APC)was calculated by Joinpoint Regression 4.7.0.0.Results:PAF of lung cancer attributable to smoking in China increased from 58.16%in1990 to62.06%in 2019,and the standardized mortality rate increased from 18.99/105 in 1990 to 24.94/105 in 2019,and the standardized DALY rate increased from 442.84/105 in 1990 to 516.48/105 in 2019.In 1990,the standardized mortality rate and standardized DALY rate of lung cancer attributable to smoking were 37.27/105 and 837.55/105 for male,3.64/105 and 70.21/105 for female respectively in China.In 2019,the standardized mortality rate and the standardized DALY rate of lung cancer attributable to smoking were 47.66/105 and 961.58/105 for male,6.08/105 and 107.97/105 for female,respectively.Mortality rate and DALY rate increased with the increase of age.In 2019,the age group of mortality rate and DALY rate peaked at 85 +years(319.25/105)and 75~79 years(3 902.13/105),respectively,one age group later than1990.Compared with1990,the mortality rate and DALY rate of lung cancer attributable to smoking increased significantly in the age groups over 70 years old,but decreased in age groups under 60 years old.In the past 30 years,the standardized mortality rates and standardized DALY rates in China have experienced three stages of increase,stabilization and decrease,in which 2010-2019 was the declining stage,with APC valuesof-0.715%and-0.864%respectively,butstillhigherthanthegloballevel.Conclusion:Thedis-ease burden of lung cancer attributable to smoking is serious in China from 1990 to 2019,and the males and the elder-ly are the high-risk groups.The targeted intervention measures should be further adopted to reduce the disease bur-den of lung cancer attributable to smoking.