贴几张数据图说明吸烟及环境因素对肺癌发生的影响

来源: 闽姑 2015-03-01 17:00:50 [] [博客] [旧帖] [给我悄悄话] 本文已被阅读: 次 (356633 bytes)
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来源:



http://www.lung.org/lung-disease/lung-cancer/resources/facts-figures/lung-cancer-fact-sheet.html

以下这张图就是方舟子在回答凤凰健康记者有关雾霾与肺癌发生的关系的依据:



肺癌的最大危险因素是吸烟

凤凰健康:在视频中,很明显提到了雾霾和肺癌的关系,您怎么看?

方舟子:肺癌的最大危险因素是吸烟,占90%,空气污染是很次要的因素,占1%。肺癌发生是很缓慢的过程,要十几几十年时间,不是一有危险因素就马上得癌,所以不能把现在中国肺癌发病率上升归为空气污染,更可能的因素是改革开放以来烟民数量的增加。

美国肺癌发病率的变化,与平均每个美国人吸烟量的变化,存在二、三十年的迟滞。可以推知现在中国肺癌发病率的上升,是八十年代以来中国香烟消费量上升的恶果。
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全文如下:


Lung Cancer Fact Sheet

 

 




Mortality

  • Lung cancer is the leading cancer killer in both men and women in the United States. In 1987, it surpassed breast cancer to become the leading cause of cancer deaths in women.1
  • Lung cancer causes more deaths than the next three most common cancers combined (colon, breast and pancreatic). An estimated 158,040 Americans are expected to die from lung cancer in 2015, accounting for approximately 27 percent of all cancer deaths.2
Leading Causes of Cancer Death
  • The number of deaths due to lung cancer has increased approximately 3.5 percent between 1999 and 2012 from 152,156 to 157,499. The number of deaths among men has reached a plateau but the number is still rising among women. In 2012, there were 86,740 deaths due to lung cancer in men and 70,759 in women.1
  • The age-adjusted death rate for lung cancer is higher for men (56.1 per 100,000 persons) than for women (36.4 per 100,000 persons). It also is higher for blacks (48.3 per 100,000 persons) compared to whites (45.6 per 100,000 persons). Black men have a far higher age-adjusted lung cancer death rate than white men, while black and white women have similar rates.1

Prevalence and Incidence

  • Approximately 402,326 Americans living today have ever been diagnosed with lung cancer.3 During 2015, an estimated 221,200 new cases of lung cancer were expected to be diagnosed, representing about 13 percent of all cancer diagnoses.2
  • The majority of living lung cancer patients have been diagnosed within the last five years. Lung cancer is mostly a disease of the elderly. In 2011, 82 percent of those living with lung cancer were 60 years of age or older.3
  • In 2011, Kentucky had the highest age-adjusted lung cancer incidence rates in both men (112.2 per 100,000) and women (79.3 per 100,000). Utah had the lowest age-adjusted cancer incidence rates in both men and women (34.5 per 100,000 and 25.0 per 100,000, respectively).4 These state-specific rates were parallel to smoking prevalence rates.
  • Lung cancer is the most common cancer worldwide, accounting for 1.8 million new cases and 1.6 million deaths in 2012.5
  • The National Institutes of Health estimate that cancer care cost the United States an overall $124.6 billion in 2010, $12.1 billion of which is due to lung cancer. Lost productivity due to early death from cancer lead to an additional $134.8 billion in 2005, $36.1 billion of which was due to lung cancer.6

Gender Differences

  • Each year more men are diagnosed with lung cancer, but more women are living with the disease. The rate of new cases in 2011 showed that men develop lung cancer more often than women (64.8 and 48.6 per 100,000 respectively).3
  • The rate of new lung cancer cases (incidence) over the past 37 years has dropped for men (28% decrease), while it has risen for women (98% increase). In 1975, rates were low for women, but rising for both men and women. In 1984, the rate of new cases for men peaked (102.1 per 100,000) and then began declining. The rate of new cases for women increased further, did not peak until 1998 (52.9 per 100,000), and has now started to decline.3

Lung Cancer Incidence Trend by Sex

Racial/Ethnic Differences

  • Blacks are more likely to develop and die from lung cancer than persons of any other racial or ethnic group. The age-adjusted lung cancer incidence rate among black men is approximately 32 percent higher than for white men, even though their overall exposure to cigarette smoke, the primary risk factor for lung cancer, is lower.3,7
  • The lung cancer incidence rate for black women is roughly equal to that of white women, despite the fact that they smoke fewer cigarettes.3,7

Survival Rates

  • The lung cancer five-year survival rate (17.8%) is lower than many other leading cancer sites, such as the colon (65.4%), breast (90.5%) and prostate (99.6%).3
  • The five-year survival rate for lung cancer is 54.0 percent for cases detected when the disease is still localized (within the lungs). However, only 15 percent of lung cancer cases are diagnosed at an early stage. For distant tumors (spread to other organs) the five-year survival rate is only 4.0 percent.3
  • Over half of people with lung cancer die within one year of being diagnosed.3

Lung Cancer Diagnosis and Survival by Stage

Smoking-Attributable Lung Cancer

  • Smoking, a main cause of small cell and non-small cell lung cancer, contributes to 80 percent and 90 percent of lung cancer deaths in women and men, respectively. Men who smoke are 23 times more likely to develop lung cancer. Women are 13 times more likely, compared to never smokers.8
  • Between 2005 and 2010, an average of 130,659 Americans (74,300 men and 56,359 women) died of smoking-attributable lung cancer each year. Exposure to secondhand smoke causes approximately 7,330 lung cancer deaths among nonsmokers every year.9
  • Nonsmokers have a 20-30 percent greater chance of developing lung cancer if they are exposed to secondhand smoke at home or work.10

Other Causes

  • It has been estimated that active smoking is responsible for close to 90 percent of lung cancer cases; radon causes 10 percent, occupational exposures to carcinogens account for approximately 9 to 15 percent and outdoor air pollution 1 to 2 percent. Because of the interactions between exposures, the combined attributable risk for lung cancer can exceed 100 percent.11
  • Exposure to radon is estimated to be the second leading cause of lung cancer, accounting for an estimated 21,000 lung cancer deaths each year (range of 8,000 to 45,000). Radon is a tasteless, colorless and odorless gas that is produced by decaying uranium and occurs naturally in soil and rock. The majority of these deaths occur among smokers since there is a greater risk for lung cancer when smokers also are exposed to radon.12
  • Lung cancer can also be caused by occupational exposures, including asbestos, uranium, and coke (an important fuel in the manufacture of iron in smelters, blast furnaces, and foundries). The combination of asbestos exposure and smoking greatly increases the risk of developing lung cancer.13
  • Nonsmoking asbes­tos workers are five times more likely to develop lung cancer than non­smokers not ex­posed to asbestos; if they also smoke, the risk factor jumps to 50 or higher.11 Environmental exposures also can increase the risk of lung cancer death.14

Lung Cancer Attributable Cases

For more information on lung cancer, please review the Lung Cancer Morbidity and Mortality Trend Report on our website at www.lung.org or call the American Lung Association at 1-800-LUNG-USA FREE (1-800-586-4872 FREE).

Sources:


1. Centers for Disease Control and Prevention. National Center for Health Statistics. CDC WONDER On-line Database, compiled from Compressed Mortality File 1999-2012 Series 20 No. 2R, 2014.
2. American Cancer Society. Cancer Facts and Figures, 2015.
3. U.S. National Institutes of Health. National Cancer Institute. SEER Cancer Statistics Review, 1975-2011.
4. U.S. National Institutes of Health. National Cancer Institute. State Cancer Profiles web tool, accessed October 6, 2014.
5. 
World Health Organization. International Agency for Research on Cancer. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Lung Cancer. Accessed November 10, 2014.
6. U.S. National Institutes of Health. National Cancer Institute. Cancer Trends Progress Report – 2011/2012 Update. Costs of Cancer Care.
7. Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 2010. Analysis by the American Lung Association, Research and Program Services Division using SPSS software.
8. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the U.S. Surgeon General, 2004.
9. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014.
10. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, 2006.
11. Alberg AJ, Samet JM. Epidemiology of Lung Cancer. Chest. 2003; 123:21-49.
12. U.S. Environmental Protection Agency. A Citizen’s Guide to Radon. January 2013.
13. U.S. Department of Health and Human Services. National Toxicology Program. 12th Report on Carcinogens (RoC). June 10, 2011.
14. Jerrett M, et al. Spatial Analysis of Air Pollution and Mortality in Los Angeles. Epidemiology. November 2005; 16(6):727-36.

*Racial and ethnic minority terminology reflects those terms used by the Centers For Disease Control.

所有跟帖: 

这是针对美国人群的统计。雾霾天到北京走走就会怀疑是否适用于中国。 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 03/01/2015 postreply 17:07:34

北京雾霾天气是什么时候开始?雾都伦敦烟雾事件的确令12,000人死亡,是癌症死亡吗? -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (405 bytes) () 03/01/2015 postreply 17:26:23

是的,雾霾是个大坏蛋。但结论要有数据支持,才有说服力。 -欲千北- 给 欲千北 发送悄悄话 欲千北 的博客首页 (0 bytes) () 03/01/2015 postreply 17:38:07

现在还没法统计影响。我不知道柴静的片子里到底到说了啥。但说这种严重空气污染对肺癌只有1%的贡献又有什么证据呢?是负责的态度吗? -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 03/01/2015 postreply 17:47:03

2003年发表在Chest上的研究文章---11. Alberg AJ, Samet JM. Epidemiology of L -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (432 bytes) () 03/01/2015 postreply 17:55:10

谢谢提供文献。但现在大家关注的话题是国内的雾霾,估计这篇文章不会包括对呼吸这种空气的Epidemiological study -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 03/01/2015 postreply 18:06:31

不是我提供的~.~,是ALA制图时的依据---白"图"黑"据" -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (4391 bytes) () 03/01/2015 postreply 18:11:18

那估计还是米国的数据。中国这种雾霾是前所未有的,真的很难说结果会怎么样。也许跟以前伦敦大雾有类似之处, -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (218 bytes) () 03/01/2015 postreply 18:31:06

那个1%-2%的数据来源是1981年所做的一个估计值,针对美国当时的空气质量所做的“estimate”。 -Lily168- 给 Lily168 发送悄悄话 Lily168 的博客首页 (0 bytes) () 03/01/2015 postreply 18:28:09

多谢帮助解读。 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 03/01/2015 postreply 18:31:55

我想再过十年二十年,我们才能认识雾霾对中国人健康的影响 -吃与活- 给 吃与活 发送悄悄话 吃与活 的博客首页 (262 bytes) () 03/01/2015 postreply 18:06:33

呃,火山爆发了可能会有大饥荒,大胖纸才能活下来,您还周福满干嘛呢:) -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 03/01/2015 postreply 18:10:39

你说的也对,不过我并不认为自己那么运气,上次发生此事是几亿年前。那些没经过雾霾考验的恐龙灭绝了 -吃与活- 给 吃与活 发送悄悄话 吃与活 的博客首页 (24 bytes) () 03/01/2015 postreply 18:17:52

吸烟调查比较容易,不吸烟或吸烟。雾霾调查较难。空中粒子不是均匀分布的 -志在千里- 给 志在千里 发送悄悄话 (2887 bytes) () 03/01/2015 postreply 21:02:08

好帖,点赞 -吃与活- 给 吃与活 发送悄悄话 吃与活 的博客首页 (21 bytes) () 03/01/2015 postreply 17:23:22

一个人不在貌美,尤其是男生.得有基本的逻辑思维及判断能力. -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (0 bytes) () 03/01/2015 postreply 18:02:22

能做“方粉”的人一定有逻辑清晰的头脑,不随波逐流的见识,经常还要有悲天悯人的情怀 -吃与活- 给 吃与活 发送悄悄话 吃与活 的博客首页 (33 bytes) () 03/01/2015 postreply 18:31:03

方粉就方粉呗.别人给封的,免费而得,不要白不要.这年头啥都贵~~ -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (0 bytes) () 03/01/2015 postreply 18:57:16

是啊,在美国这样低污染的篁环境里,空气污染只占1-2%,这种统计能适用于中国吗? -5678910- 给 5678910 发送悄悄话 (0 bytes) () 03/01/2015 postreply 20:10:37

柴静的视频里不是有一个中国的研究成果吗,无什么不相信呢? -5678910- 给 5678910 发送悄悄话 (0 bytes) () 03/01/2015 postreply 20:12:44

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