吸烟、烹饪用固体燃料与癌症死亡率：中国西南地区的前瞻性队列研究
Smoking, Solid Fuel Use for Cooking, and Cancer Mortality: A Prospective Cohort Study in Southwestern China.
作者
作者单位
- Department of Epidemiology and Health Statistics, School of Public Health, Chengdu Medical College, Chengdu, Sichuan, China.
- Pengzhou Disease Control and Prevention Center, Pengzhou, Sichuan, China.
- Sichuan Center for Disease Control and Prevention, Chengdu, China.
- Sichuan Health Information Center, Chengdu, China.
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China.
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China.
- Sichuan Provincial Health and Health Commission, Chengdu, China.
摘要
中文
吸烟和固体燃料是中国成年人常见的暴露，但关于它们与癌症死亡率关联的证据仍不一致，且联合效应研究不足。利用中国嘉道理生物银行（China Kadoorie Biobank）四川彭州站点数据，我们应用Cox比例风险模型检验吸烟、烹饪燃料使用及其共同暴露与总癌症和主要部位特异性癌症死亡率的关联。在55,404名参与者中，61.63%为女性，75.15%报告烹饪，46.38%报告吸烟；随访期间发生2,030例癌症死亡。当前吸烟和固体燃料烹饪与总癌症死亡率风险分别增加27%和18%相关。18岁前开始吸烟使总癌症死亡率增加37%，食管癌死亡率增加107%，肺癌死亡率增加86%。每日吸烟量更高、吸烟持续时间更长和累积吸烟量更大均与总癌症、食管癌和肺癌死亡率正相关。与既不吸烟也不使用固体燃料者相比，单独使用固体燃料使总癌症死亡率增加24%，而单独吸烟使总死亡率增加32%，食管癌死亡率增加144%。同时暴露于吸烟和固体燃料者死亡率风险更高，总癌症达49%，食管癌达198%，肺癌达94%。这些发现凸显了戒烟和推广清洁烹饪燃料对癌症预防的关键重要性。
English
Smoking and solid fuel are common exposures among Chinese adults, yet evidence regarding their associations with cancer mortality remains inconsistent, and their joint effects are insufficiently studied. Using data from the Pengzhou site of the China Kadoorie Biobank in Sichuan Province, we applied Cox proportional hazards models to examine associations of smoking, cooking fuel use, and co-exposure with mortality from overall cancer and major site-specific cancers. Among 55,404 participants, 61.63% were women, 75.15% reported cooking, and 46.38% reported smoking; 2030 cancer deaths occurred during follow-up. Current smoking and solid fuel cooking were associated with 27% and 18% higher risks of overall cancer mortality. Initiation before 18 years increased overall cancer mortality by 37%, esophageal cancer mortality by 107%, and lung cancer mortality by 86%. Higher daily cigarette consumption, longer smoking duration, and greater cumulative smoking were each positively associated with mortality from overall cancer, esophageal cancer, and lung cancer. Compared with individuals who neither smoked nor used solid fuels, solid fuel use alone increased overall cancer mortality by 24%, while smoking alone increased overall mortality by 32% and esophageal cancer mortality by 144%. Individuals exposed to both smoking and solid fuel use had higher mortality risks, reaching 49% for overall cancer, 198% for esophageal cancer, and 94% for lung cancer. These findings highlight the critical importance of quitting smoking and promoting clean cooking fuels for cancer prevention.
分类与指标
- 研究类型
- 临床研究
- 病种
- 肺癌
- JCR 分区
- Q2
- 影响因子
- 4.9
- 新锐分区
- 2区