A comparison of the burden of lung cancer attributable to tobacco exposure in China and the USA

Abstract

Background: Tobacco exposure (TE) is the major contributor to lung cancer mortality worldwide. This study aims to clarify the possible reasons underlying the long-term trends and differences in lung cancer mortality attributable to TE in China and the United States of America (USA).Methods: Lung cancer mortality data from China and the USA were obtained from the Global Burden of Disease (GBD) Study 2017. Joinpoint regression analysis was used to assess the magnitude and direction of trends from 1990 to 2017, and the age-period-cohort model (APCM) was used to analyze the temporal trends of lung cancer mortality by age, period, and cohort.Results: For lung cancer attributable to smoking, the age-standardized mortality rates (ASMRs) exhibited an upward trend in China and a downward trend in the USA. The overall net drifts per year were 0.72% for China and −3.03% for the USA, and the local drift values in China and the USA increased by age group. All cohort/period relative risks (RRs) increased in China but decreased in the USA. The longitudinal age curves increased rapidly in China, whereas those in the USA were rose gradually. For lung cancer attributable to secondhand smoke, the ASMRs showed a downward trend in both China and the USA. The overall net drifts per year were −0.48% for China and −3.97% for the USA, and the local drift values in China and the USA also increased by age group. Cohort/period RRs decreased in the USA, and fluctuated in China. The longitudinal age curve trends in China and the USA were similar to those of smoking. Conclusions:The dangers of TE in China remain serious. The rates of lung cancer mortality attributable to TE have increased, especially in older individuals. We recommend that China strengthens the implementation of effective targeted tobacco control policies and other interventions to reduce the burden of lung cancer.

The epidemiological trends in the burden of lung cancer attributable to PM2.5 exposure in China

“…The relevant methods for mortality standardization in the GBD database have been introduced in previous studies [ 16 , 17 ]. To assess the magnitude and direction of trends in the mortality rate of lung cancer over time, we used JoinPoint software (Version 4.7.0.0) to calculate the average annual percentage change (AAPC) and the corresponding 95% CIs by joinpoint regression analysis.…”

The lag effect of 24-year tobacco consumption on lung cancer mortality in Henan Province, China, 1992 to 2016

“…Next, the smoking rate tended to plateau in 2002 (Yang et al 2005), and fell by 1.8% in 2015, which showed a slow decline compared with early 1996. Moreover, the mortality of lung cancer in this region was 22.89/100,000 in 2002, and increased to 36.03/100,000 in 2015(Global Health Data Exchange 2018Wu et al 2020). The mortality of lung cancer showed an increasing trend over the past decade, but the mortality of lung cancer in this region showed no declining trend at present.…”

Global, regional, and national burden of ischemic heart disease attributable to secondhand smoke from 1990 to 2019

“…Moreover, fostering smoke-free environments and providing readily accessible smoking cessation support services, such as counseling and nicotine replacement therapies, are crucial for facilitating smokers’ quitting efforts 20 , 30 . This multifaceted approach demands the collaborative involvement of government agencies, community organizations, and the wider public to foster a healthier living environment and reduce the risk of diseases such as IHD 28 , 31 . In our study, we also observed that the decline in mortality rates among men and the older age groups is slower, and there is a continuous increase in the DALYs rates among the elderly population in middle-income countries.…”