2022-2023年美国不同族裔中归因于吸烟的癌症
Cancer attributable to cigarette smoking by ethnic group in the US in 2022-2023.
文献信息
| PMID | 42777579 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Giulia Collatuzzo |
| 作者单位 | Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milano, Italy. Electronic address: giulia.collatuzzo@unimi.it. |
| 期刊 | Cancer epidemiology |
| SCI 分区 | Q2 |
| IF | 3.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 美国人群的吸烟模式存在差异。我们旨在估计不同种族/族裔群体中吸烟相关癌症的归因分数（AF）。
方法： 为考虑约25年的潜伏期，将1994年至1996年按性别划分的吸烟流行率数据与美国癌症统计（USCS）数据库中近期癌症发病（2022年）和死亡（2023年）记录相链接。估计值针对白人、黑人、西班牙裔、亚裔/太平洋岛民以及阿拉斯加原住民/美洲原住民进行计算。吸烟与癌症关联的相对风险来自荟萃分析。对当前吸烟者和既往吸烟者计算AF及95%置信区间（CI）。
结果： 在所有群体中，肺癌、喉癌和口腔-咽癌在男女两性中均显示出最高的曾经吸烟AF。肺癌的AF范围从亚裔/太平洋岛民女性的65.0%（0.64-0.67）到阿拉斯加原住民/美洲原住民男性的92.0%（0.91-0.92）。在男性中，曾经吸烟可解释阿拉斯加原住民/美洲原住民全部癌症病例和死亡的26.4%（23.0-29.3）和36.7%（33.1-40.0），白人为23.3%（20.8-25.6）和32.9%（29.9-35.6），亚裔/太平洋岛民为22.1%（19.3-24.6）和32.6%（29.2-35.8），黑人为19.9%（17.6-21.9）和31.0%（28.1-33.7），西班牙裔为16.2%（13.6-18.7）和23.5%（20.2-26.6）。在女性中，阿拉斯加原住民/美洲原住民的归因负担最高（病例的19.8%，17.6-21.9；死亡的28.8%，26.2-31.4），而亚裔/太平洋岛民最低（7.7%，6.9-8.6和10.9%，9.7-12.2）。
结论： 既往吸烟仍是美国当前癌症差异的主要原因。阿拉斯加原住民/美洲原住民的负担不成比例地高。白人与黑人之间的相似性表明，癌症差异并非由孤立的吸烟习惯驱动，而是由其他未测量因素驱动。我们的发现强调，迫切需要文化上量身定制的戒烟策略，以减轻癌症差异。
英文摘要
BACKGROUND: Smoking patterns vary in the US population. We aimed at estimating the attributable fraction (AF) of smoking-related cancer across racial/ethnic groups.
METHODS: To account for ~ 25-year latency period, sex-specific smoking prevalence data from 1994 to 1996 were linked with recent cancer incidence (2022) and mortality (2023) records from the United States Cancer Statistics (USCS) database. Estimates were calculated for Whites, Blacks, Hispanics, Asians/Pacific Islanders and Alaskans/Native Americans. Relative risks for smoking-cancer associations were derived from meta-analyses. The AF and 95% confidence intervals (CI) were calculated for current and former smokers.
RESULTS: Lung, laryngeal and oral-pharyngeal cancers exhibited the highest AF for ever smoking in both sexes across all groups. The AF for lung cancer ranged from 65.0% (0.64-0.67) in Asian/Pacific Islander women to 92.0% (0.91-0.92) in Alaskan/Native American men. In men, ever smoking explained 26.4% (23.0-29.3) and 36.7% (33.1-40.0) of total cancer cases and deaths in Alaskan/Native Americans, 23.3% (20.8-25.6) and 32.9% (29.9-35.6) in Whites, 22.1% (19.3-24.6) and 32.6% (29.2-35.8) in Asians/Pacific Islanders, 19.9% (17.6-21.9) and 31.0% (28.1-33.7) in Blacks, 16.2% (13.6-18.7) and 23.5% ( 20.2-26.6) in Hispanics. In women, Alaskan/Native Americans had the highest attributable burden (19.8%, 17.6-21.9 of cases and 28.8%, 26.2-31.4 of deaths), while Asians/Pacific Islanders showed the lowest (7.7%, 6.9-8.6 and 10.9%, 9.7-12.2).
CONCLUSIONS: Past smoking remains a major cause of current cancer disparities in the US. The burden is disproportionately high among Alaskan/Native Americans. Similarities between Whites and Blacks suggest that cancer disparities are driven not by an isolated smoking habit but to other unmeasured factors. Our findings underscore the critical need for culturally tailored smoking cessation strategies to mitigate cancer disparities.