204 个国家和地区 1990 年至 2019 年归因于职业致癌物的气管、支气管和肺癌全球负担：2019 年全球疾病负担研究结果。
Global burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in 204 countries and territories, from 1990 to 2019: results from the global burden of disease study 2019.
机构信息
Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China.
Department of Radiation Oncology, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China.
出版信息
Ann Med. 2023 Dec;55(1):2206672. doi: 10.1080/07853890.2023.2206672.
BACKGROUND
Occupational-related cancers are a substantial global health issue. The largest proportion of occupational-related cancers is tracheal, bronchus, and lung (TBL) cancer. This study aimed to explore the geographical and temporal trends in occupational carcinogens related to TBL cancer.
METHODS
Data on TBL cancer attributable to occupational carcinogens were collected from the Global Burden of Disease Study 2019. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs), and corresponding average annual percentage change (AAPC) were evaluated and stratified by geographic location, socio-demographic index (SDI) quintiles, age, and sex.
RESULTS
Globally, ASRs of deaths and DALYs in TBL cancer attributable to occupational carcinogens showed a downward trend (AAPC = - 0.69%, - 1.01%) while increases were observed in the low, low-middle, and middle SDI quintiles. Although males accounted for 82.4% and 81.5% of deaths and DALYs in 2019, respectively, it showed an upward trend of ASRs in females (AAPC = 0.33%, 0.02%). Occupational exposure to asbestos, silica and diesel engine exhaust were the top three causes of age-standardized TBL cancer deaths and DALYs. Over the past three decades, the percentage of age-standardized TBL cancer deaths and DALYs attributable to occupational asbestos and silica exposure decreased by 18.24, 6.71 and 20.52%, 4.00% globally, but increased significantly in lower SDI regions, while the burden attributable to occupational diesel engine exhaust exposure increased by 32.76, 37.23% worldwide.
CONCLUSIONS
Occupational exposure remains an important risk factor for TBL cancer. The burden of TBL cancer attributable to occupational carcinogens showed obvious heterogeneity which decreased in higher SDI but increased in lower SDI regions. The burden of males was significantly higher than females, but the females showed an increasing trend. Occupational exposure to asbestos was the main causes of the burden. Therefore, effective prevention and control measures tailored to local conditions are necessary.
背景
职业相关癌症是一个重大的全球健康问题。最大比例的职业相关癌症是气管、支气管和肺癌（TBL）。本研究旨在探讨与 TBL 癌症相关的职业致癌物的地理和时间趋势。
方法
从 2019 年全球疾病负担研究中收集了归因于职业致癌物的 TBL 癌症数据。评估了与职业致癌物相关的 TBL 癌症死亡人数和年龄标准化死亡率（ASR）、残疾调整生命年（DALY）以及相应的平均年百分比变化（AAPC），并按地理位置、社会人口指数（SDI）五分位数、年龄和性别进行分层。
结果
全球归因于职业致癌物的 TBL 癌症死亡率和 DALY 的 ASR 呈下降趋势（AAPC=-0.69%，-1.01%），而在低、低中、中和中 SDI 五分位数中则呈上升趋势。尽管 2019 年男性占 TBL 癌症死亡人数和 DALY 的 82.4%和 81.5%，但女性的 ASR 呈上升趋势（AAPC=0.33%，0.02%）。职业接触石棉、二氧化硅和柴油发动机废气是导致年龄标准化 TBL 癌症死亡和 DALY 的前三大原因。在过去三十年中，全球归因于职业接触石棉和二氧化硅导致的年龄标准化 TBL 癌症死亡人数和 DALY 的比例分别下降了 18.24%、6.71%和 20.52%、4.00%，但在 SDI 较低的地区显著上升，而归因于职业接触柴油发动机废气的负担则增加了 32.76%、37.23%。
结论
职业接触仍然是 TBL 癌症的一个重要危险因素。与职业致癌物相关的 TBL 癌症负担存在明显的异质性，在 SDI 较高的地区下降，而在 SDI 较低的地区上升。男性的负担明显高于女性，但女性呈上升趋势。职业接触石棉是负担的主要原因。因此，需要制定有针对性的有效的预防和控制措施。
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