A comparison of the burden of lung cancer attributable to tobacco exposure in China and the USA

Age-period-cohort effect on lung cancer mortality in Spain, 1982-2021

BACKGROUND

The aim of the study is to provide up-to-date information and evaluate the age-period-cohort effects of age-period cohorts on lung cancer (LC) mortality in Spain for the period 1982 to 2021.

METHODS

We analysed deaths by LC and population for the period 1982-2021, available from the Spanish National Institute of Statistics. The LC corresponds to code 162 and codes C33 and C34 of the 9th and 10th editions of the International Classification of Diseases, respectively. Age-period-cohort (A-P-C) modelling was applied to compute the net drift, local drift, longitudinal age curve, and rate ratios (RR) of each period and cohort. A-P-C analysis was performed using the A-P-C Web Tool provided by the National Cancer Institute of the United States.

RESULTS

Estimated relative risk in the male birth cohorts has followed a steady downward trend in all cohorts born since 1922, showing an initial period (1922-1947) of slight decline, followed by a more marked decrease in the cohorts born during the period 1947-1977. In the younger cohorts (1977-1997), the decline appears to have stabilised. In women, a strong cohort effect is observed. In those born after the Spanish Civil War (1936 to 1939), the risk increased until it peaked in the 1960s, after which it started to decrease with the same intensity. Period RR in men decreased from 1987 to 1991 (1.1) to 2017-2021 (0.6), while period RR in women increased during this time (from 0.8 to 1.6).

CONCLUSIONS

The cohort effect observed in women born after the Civil War suggests that the onset of the LC epidemic may have been due to a higher prevalence of women smokers in these cohorts. However, the trend observed in the younger cohorts suggests a possible slowing-down in the increase in mortality risk in the following years.

The lag effect of 24-year tobacco consumption on lung cancer mortality in Henan Province, China, 1992 to 2016

Tobacco exposure is the major risk factor for lung cancer. Previous studies have shown that there is a correlation between tobacco consumption and lung cancer mortality, but they do not show a specific trend. This study established the polynomial distributed lags (PDLs) model to explore the distributional lag effect between tobacco consumption and lung cancer mortality by using the lung cancer mortality rate of residents in Henan Province and the annual per capita tobacco consumption data from 1992 to 2016 and adopted dynamic simulation prediction method to predict lung cancer mortality for the next 20 years. We found that per capita tobacco consumption had a 10-year lag effect on lung cancer mortality. The harm of tobacco consumption did not show in the first 4 years, but after a lag of 4 years or more, the lung cancer mortality in men was higher than that in women, with a peak effect occurring 10 years later. The prediction showed that if per capita tobacco consumption was controlled, lung cancer mortality would show a steady decline trend after 10 years. These results suggested that tobacco consumption and lung cancer mortality were asynchronous, with a lag effect of tobacco use on the occurrence of lung cancer.

FYB methylation in peripheral blood as a potential marker for the early-stage lung cancer: a case-control study in Chinese population

BACKGROUND

Lung cancer (LC) is the leading cause of cancer-related morbidity and mortality in China. Exploring novel biomarkers for the early detection of LC is important.

MATERIALS AND METHODS

We quantified DNA methylation levels of three CpG sites of FYB gene in peripheral blood in 163 early-stage LC cases (88.3% at stage I) and 187 age- and gender-matched healthy controls. Covariates-adjusted odds ratios (ORs) for -10% methylation were calculated by binary logistic regression.

RESULTS

With multiple testing corrections, hypomethylation of FYB_CpG_4 was significantly associated with LC (OR = 2.04, p = 4.50E-04) even with LC at stage I (OR = 1.41, p = 0.003) without obvious bias between genders, but it mainly affected the subjects older than 55 years (OR = 2.04, p = 0.015). Hypomethylation of FYB_CpG_2 was also associated with LC, but only for the males (OR = 1.76, p = 0.018). FYB_CpG_3 methylation had no association with LC, but interestingly its methylation level in the males was only half of that in the females.

DISCUSSION AND CONCLUSIONS

We proposed a novel association between blood-based abnormal FYB methylation and very early-stage LC. The age- and gender-related DNA methylation patterns also revealed the diversity and precision of epigenetic regulations.

Epidemiological Characteristics of Pancreatic Cancer in China From 1990 to 2019

Background

Pancreatic cancer is an aggressive cancer and is predicted to become the second leading cause of cancer-related deaths in China. To understand the epidemic trend of pancreatic cancer and formulate targeted preventive measures, it is important to analyze the incidence and mortality of pancreatic cancer.

Methods

The incidence and mortality data of pancreatic cancer in China were obtained from Global Burden of Disease (GBD) data. We used joinpoint regression analysis to calculate the magnitude and direction of trends, and the age-period-cohort method to analyze the effects of chronological age, time period, and birth cohort.

Results

The age-standardized rates (ASRs) for both incidence and mortality of pancreatic cancer increased from 1990 to 2019, and were higher in males than females. The incidence and mortality rates have increased year by year in the age group above 25 years. The most common age group was 55–79 years, accounting for approximately 50% of all incident cases. In terms of incidence and mortality rates, the overall net drifts were above 0. The local drifts in all age groups were above 0 in both sexes and males, while the local drifts in the 15–39 age groups were below 0 in females. The longitudinal age curves increased with age, with higher incidence and mortality rates, mainly in older age groups. The period rate ratios increased by year. The cohort rate ratios showed an upward trend before 1970 and fluctuated after 1975.

Conclusions

The burden of pancreatic cancer is still very high in China, and attention should be paid to the key population that is, males and older people. The results of our study can be used by policy makers to allocate resources efficiently to improve early diagnosis and treatment, improving the awareness of self-protection, and advocating a healthy lifestyle to prevent pancreatic cancer.

The epidemiological trends in the burden of lung cancer attributable to PM2.5 exposure in China

Objective

PM_2.5, which is a major contributor to air pollution, has large effects on lung cancer mortality. We want to analyse the long-term trends in lung cancer burden attributable to PM_2.5 exposure and provide evidence that can be used for preventive measures and health resource planning.

Methods

Mortality data related to lung cancer were obtained from the Global Burden of Disease (GBD) 2019 project. A joinpoint regression analysis was used to assess the magnitude and direction of the trends in mortality from 1990 to 2019, and the age-period-cohort method was used to analyse the temporal trends in the mortality rate of lung cancer attributable to PM_2.5 exposure by age, period, and cohort.

Results

From 1990 to 2019, the age-standardized mortality rate (ASMR) attributable to PM_2.5 exposure trended slowly upwards, and the ASMR due to ambient PM_2.5 exposure (APE) increased significantly, that due to household PM_2.5 exposure (HPE) decreased. The longitudinal age curves show that the mortality rates due to PM_2.5 exposure among younger individuals were low, and they significantly increased from their levels among those in the 45–49 age group to their levels among those in the over-85 age group. From 1990 to 2019, the period RRs due to APE increased, but those due to HPE decreased. Similar trends were observed in the cohort RRs. The overall net drift per year attributable to PM_2.5 exposure was below 0. The local drift values increased with age and were above 0 for the over-80 age groups. The overall net drifts per year were above zero for APE and below zero for HPE. The corresponding results among males were higher than those among females.

Conclusions

In China, the type of air pollution responsible for lung cancer has changed from household air pollution to ambient air pollution. PM_2.5 exposure is more harmful among males and older people. Ambient air pollution should be emphasized, and China should strengthen its implementation of effective public policies and other interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10765-1.