吸烟导致的肺癌死亡率：具有可变滞后期的多情景分析。

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-10-09 DOI:10.1016/j.annepidem.2025.10.011

María Isolina Santiago-Pérez , Carla Guerra-Tort , Esther López-Vizcaíno , Lucía Martín-Gisbert , Ana Teijeiro , Guadalupe García , Julia Rey-Brandariz , Alberto Ruano-Ravina , Mónica Pérez-Ríos

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引用次数: 0

摘要

目的：吸烟归因死亡率（SAM）的估计取决于对可能影响估计的不同假设的接受程度。我们的目的是通过使用患病率独立方法（PIM）和患病率依赖方法（PDM）来评估肺癌可归因死亡率，这两种方法在暴露（吸烟率）和结果（肺癌死亡率）之间存在不同的滞后。方法：从2011年到2020年，我们按性别和年龄组（35-64岁，65-84岁）对西班牙四种情况的人口归因分数（PAF）和肺癌SAM进行了逐年估算。在其中三种情况下，使用不同的滞后来应用PDM：无滞后、15年滞后和20年滞后。在第四个场景中，应用了PIM。结果：在2011-2020年期间，西班牙考虑20年滞后PDM时，SAM较高（173,526例死亡），而不考虑滞后PDM或PIM时，SAM较低（分别为161,249例和157,390例死亡）。在男性中，无滞后PDM和PIM之间的paf相似（分别为86.7%和87.3%）。然而，当考虑到15年或20年的PDM滞后时，PAF增加到91.0%和92.3%。在女性中，PIM组PAF最低（57.3%），PDM组PAF最高（79.4%）。结论：SAM的估计因使用的方法和滞后而不同。应用15年或20年滞后PDM比不使用滞后PDM或PIM产生更高的SAM估计。因此，在可行的情况下，应使用从接触到结果之间滞后15或20年的吸烟率数据进行准确估计。

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Lung cancer mortality attributable to smoking: a multi-scenario analysis with variable lag periods

Purpose

The estimation of smoking-attributable mortality (SAM) is subject to the acceptance of different assumptions that may influence the estimates. We aimed to assess lung cancer mortality attributable to smoking by using both a prevalence-independent method (PIM) and a prevalence-dependent method (PDM) with different lags between exposure (smoking prevalence) and outcome (lung cancer mortality).

Methods

We estimated the population attributable fractions (PAF) and the lung cancer SAM by sex and age group (35–64, 65–84 years), year-by-year from 2011 to 2020, in four scenarios in Spain. In three of these scenarios, a PDM was applied using different lags: no lag, a 15-year lag and a 20-year lag. In the fourth scenario, a PIM was applied.

Results

In the period 2011–2020 in Spain, the SAM was higher when the 20-year lag PDM was considered (173,526 deaths) and lower when no lag PDM or a PIM was applied (161,249 and 157,390 deaths, respectively). In men, the PAFs were similar between the no lag PDM and the PIM (86.7 % and 87.3 %, respectively). However, when a PDM 15-year or 20-year lag was considered, the PAF increased to 91.0 % and 92.3 %, respectively. In women, the lowest PAF was obtained with the PIM (57.3 %), and the highest with the PDM 20-year lag (79.4 %).

Conclusions

SAM estimates differ depending on the methods and lags used. Applying a 15-year or 20-year lag PDM yields higher SAM estimates than when no lag PDM or a PIM is used. Therefore, when feasible, smoking prevalence data that incorporate a lag of 15 or 20 years between exposure and result should be used for accurate estimates.

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来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.