目的 分析2011—2020年苏州市归因于室外PM2.5污染的肺癌早死寿命损失。方法 利用2019年全球疾病负担研究(GBD 2019)项目中的中国数据,选择死亡数、死亡率、早死寿命损失年(YLL)和每千人损失寿命年(YLL率)作为分析指标,分析苏州归因于PM2.5的肺癌疾病负担,评估PM2.5国家一级标准(15 μg/m3)下的肺癌患者健康改善情况。结果 苏州市大气颗粒物PM2.5浓度从2011年的52.15 μg/m3下降到2020年的32.61 μg/m3,下降了37.47%,APC=-6.28%(t=-3.855,P=0.005)。2011—2020年苏州市30岁以上人群因肺癌死亡35 192人,死亡数呈现上升趋势,APC=3.12%(95%CI:2.04%~4.20%,t=5.581,P=0.001)。肺癌死亡率从2011年的61.49/10万上升到2017年的77.86/10万,APC=3.46%(95%CI:2.09%~4.83%,t=4.876,P=0.005),2017年至2020年死亡率逐年下降,但变化趋势无统计学意义(t=-0.933,P=0.525)。2011—2020年苏州市归因于PM2.5的肺癌死亡人数累计11 114例,2011—2017年归因于PM2.5的肺癌死亡人数逐年增加,2017年达到最高峰。归因于PM2.5所致肺癌的YLL为225 239.55人年,YLL率为4.65‰,均为男性显著高于女性;YLL和YLL率在2011—2016年逐年增加,2016年达到最高峰。结论 2011—2020年肺癌对苏州市居民造成严重的疾病负担,归因于PM2.5暴露的肺癌疾病负担在不同性别人群中存在差异。改善空气质量,有助于提高居民健康状况。
Abstract
Objective To analyze the premature death and life loss of lung cancer attributable to outdoor PM2.5 pollution in Suzhou city from 2011 to 2020. Methods Based on Chinese data from the Global Burden of Disease Study 2019 (GBD 2019),the number of deaths,mortality,years of life lost early (YLL) and years of life lost per 1 000 people (YLL rate) were selected as the analysis indicators to analyze the burden of lung cancer attributable to PM2.5 in Suzhou City,and to evaluate the health improvement of lung cancer patients under the PM2.5 Level 1 national standard (15 μg/m3). Results The PM2.5 concentration decreased by 37.47% from 52.15 μg/m3 in 2011 to 32.61 μg/m3 in 2020,APC=-6.28% (t=-3.855,P=0.005).There were 35 192 deaths due to lung cancer among people over 30 years old in Suzhou City from 2011 to 2020,and the death rate showed an increasing trend,APC=3.12% (95%CI:2.04%~4.20%,t=5.581,P=0.001).The mortality rate of lung cancer increased from 61.49 per 100 000 in 2011 to 77.86 per 100 000 in 2017,APC=3.46% (95%CI:2.09%~4.83%,t=4.876,P=0.005).The mortality rate decreased year by year from 2017 to 2020,but the trend was not statistically significant (t=-0.933,P=0.525).The cumulative number of lung cancer deaths attributed to PM2.5 in Suzhou City from 2011 to 2020 was 11 114.The number of lung cancer deaths attributed to PM2.5 increased year by year from 2011 to 2017,peaking in 2017.The YLL of lung cancer attributed to PM2.5 was 225 239.55 person-years,and the YLL rate was 4.65‰,which was significantly higher in males than that in females.YLL and YLL rate increased year by year from 2011 to 2016,and reached the peak in 2016. Conclusion Lung cancer caused a serious disease burden for Suzhou residents from 2011 to 2020.The burden of lung cancer attributable to PM2.5 exposure is different in different gender groups.Improving air quality will help improve the health of residents.
关键词
PM2.5 /
肺癌 /
YLL /
YLL率 /
疾病负担
Key words
PM2.5 /
Lung cancer /
Years of life lost /
Years of life lost per 1 000 people /
Burden of disease
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参考文献
[1] 赫捷,李霓,陈万青,等.中国肺癌筛查与早诊早治指南(2021,北京)[J].中华肿瘤杂志,2021,43(3):243-268.
[2] 白羽,倪洋,曾强.基于队列研究的空气污染中PM2.5与肺癌关联性的Meta分析[J].公共卫生与预防医学,2020,31(4):5-8.
[3] Xia SY,Huang DS,Jia H,et al.Relationship between atmospheric pollutants and risk of death caused by cardiovascular and respiratory diseases and malignant tumors in Shenyang,China,from 2013to 2016:an ecological research.Chin Med J.2019,132(19):2269-2277.
[4] 王情,朱欢欢,杜鹏,等.京津冀及周边地区"十四五"及中长期PM2.5污染控制目标的健康效益预估研究[J].环境科学研究,2021,34(1):220-228.
[5] Xue YG,Wang LX,Zhang YM,et al.Air pollution:A culprit of lung cancer[J].J Hazard Mater,2022,15(434):128937.
[6] World Health Organization. WHO methods and data sources for global burden of disease estimates 2000-2011[M].Geneva,2013.
[7] Fitzmaurice C,Akinyemiju TF,Al Lami FH,et al.Global,Regional,and National Cancer Incidence,Mortality,Years of Life Lost,Years Lived With Disability,and Disability-Adjusted Life-Years for 29 Cancer Groups,1990 to 2016[J].JAMA Oncology,2018,4(11):1553-1568.
[8] Yang XR,Zhang TC,Zhang XW,et al.Global burden of lung cancer attributable to ambient fine particulate matter pollution in 204 countries and territories,1990-2019[J].Environ Res,2022,204:112023.
[9] 赵兰慧,黎倩欣,袁晓霞,等.2017—2019年广州市PM2.5空气污染所致肺癌疾病负担研究[J].现代预防医学,2021,48(20):3683-3688.
[10] 王临池,周金意,韩仁强,等.江苏省2015年肺癌流行现况与2006—2015年变化趋势分析[J].中国肿瘤,2020,29(8):579-585.
[11] Yang XR,Zhang TC,Zhang XW,et al.Global burden of lung cancer attributable to ambient fine particulate matter pollution in 204 countries and territories,1990-2019[J].Environ Res,2022,204(Pt A):112023.
[12] Institute For Health Metrics And Evaluation.GBD compare data visualization2019[EB/OL].(2020-10-15) [2020-12-14].https://vizhub.healthdata.org/gbd-compare/.
[13] Pope CA,Burnett RT,Thun MJ,et al.Lung cancer,cardiopulmonary mortality,and long-term exposure to fine particulate air pollution.JAMA,2002,287(9):1132-1141.
[14] 罗鹏飞,林萍,周金意.肺癌与大气污染关系的流行病学研究进展[J].中国肿瘤,2017,26(10):792-797.
基金
江苏省预防医学科研课题(Y2018032);苏州市科技局民生科技项目(SS201807、SYS2018098、SKYD2022152);苏州市重大疾病、传染病预防和控制关键技术研究(GWZX201901);姑苏卫生人才培养项目(GSWS2019024);苏州市卫生青年骨干人才“全国导师制”项目(Qngg202032)