Estimation of cancer incidence and mortality attributable to smoking in China.
BACKGROUND
Tobacco smoking, as a cause of cancer, is common in China. Few studies have been conducted to assess the burden of tobacco-related cancer in the Chinese population.


METHODS
We calculated the proportion of cancers attributable to tobacco smoking to estimate the burden of tobacco-related cancer. Population attributable fraction was calculated based on the assumption of total avoidance of smoking. Data on smoking prevalence were from two large-scale national surveys of representative samples of the Chinese population. Data on relative risk were derived from the meta-analyses and large-scale studies. Cancer mortality and incidence were originated from the third national death cause survey and cancer registries in China.


RESULTS
We estimated that a total of 405,112 deaths of cancer were attributable to smoking in China in 2005, including 372,264 among men (32.7% of all cancer deaths) and 32,848 among women (5.0%). A total of 495,221 cancer cases were attributable to smoking, including 454,785 among men (30.0% of all cancer cases) and 40,436 among women (3.9%). Involuntary smoking was responsible for 11,507 lung cancer deaths (11.1%) among non-smoking women.


CONCLUSIONS
Tobacco smoking is responsible for one-third of the total cancer deaths among men. Involuntary smoking is an important individual risk factor for lung cancer among non-smoking women. There is a need to continue and strengthen tobacco-control programs and initiatives to reduce smoking-related cancer burden in China.
Wang
Jian-Bing
JB
Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China. wangjianbing1980@yahoo.com
Jiang
Yong
Y
Wei
Wen-Qiang
WQ
Yang
Gong-Huan
GH
Qiao
You-Lin
YL
Boffetta
Paolo
P
D002423:Cause of Death; D002681:China / Q000453:epidemiology; D003625:Data Collection; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D008297:Male; D015201:Meta-Analysis as Topic; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality*; D009423:Nervous System Neoplasms / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution; D014026:Nicotiana
D014028:Tobacco Smoke Pollution