Estimating smoking-attributable lung cancer mortality in Chinese adults from 2000 to 2020: a comparison of three methods
Menée en Chine, cette étude estime, pour les années 2000, 2005, 2010, 2015 et 2020 et à l'aide de trois méthodes, la part des décès par cancer du poumon attribuable au tabagisme
Background: Smoking is a significant public health concern in China and a leading cause of lung cancer deaths among adults. This study aims to employ three methods to estimate smoking-attributable lung cancer mortality among Chinese adults from 2000 to 2020. Methods: Population attributable fractions (PAFs) of lung cancer deaths caused by smoking were estimated using lagged smoking prevalence, Peto-Lopez, and dose–response relationship methods, separately. Smoking exposure was obtained from national tobacco surveys in China, and relative risks (RR) were derived from a meta-analysis of state-of-the-art studies among the Chinese population. Finally, we estimated the sex- and age-stratified smoking-attributable lung cancer deaths in Chinese population in 2000, 2005, 2010, 2015, and 2020. Results: The PAFs estimated using 5- and 10-year lagged smoking prevalence method (45–47%) and Peto-Lopez method (46–47%) were similar, while PAFs calculated using the dose–response method were highest (47–58%). The PAFs were consistently higher in males than in females. Age-specific PAFs estimated by lagged smoking prevalence method (54–60%) and the Peto-Lopez method (57–61%) in males were similar and relatively stable, with slight decreases in older populations, while the dose–response relationship-based PAFs increased with age and fluctuated by year. By using the above methods, smoking-attributable lung cancer deaths were estimated to be 134,100, 134,600, 136,600, and 155,300 in 2000 increasing to 310,300, 301,100, 306,000, and 314,700 in 2020, respectively. Conclusion: The estimation from dose–response methods could better reflect the smoking effect, however, high-quality data and accurate estimation of parameters are necessary.