Abstract

BackgroundSmoking is widely recognized as one of the most prevalent and preventable causes of many cancer types. This study aimed to quantify the population attributable fraction (PAF) of the lung cancer burden for smoking in Mongolia.MethodsLung cancer incidence and lung cancer-related death data came from the population-based national registry covering the period 2007–2016. Smoking prevalence data came from the STEPwise approach (STEP) national survey. The lung cancer-related disease burden was calculated and expressed in Disability Adjusted Life Years (DALYs) lost by gender and by year. This was combined with current smoking and former smoking prevalence data, and relative risks (RR) of lung cancer-related deaths for current smokers and former smokers versus never smokers from region-specific cohort studies to estimate the PAF of lung cancer attributable to “ever-smoking” in Mongolia.ResultsBetween 2007 and 2016, lung cancer accounted for the loss of over 63,000 DALYs in Mongolia. The PAF of lung cancer-related deaths attributable to current and former smoking combined was 58.1% (95% IR = 43.1%-72.2%) for men and 8.9% (95% IR = 4.1% -13.5%) for women. Smoking-attributable DALYs loss amounted to 2589 years (95% IR = 1907–3226) in 2016.ConclusionsA considerable health loss may be prevented with an effective anti-smoking policy. In Mongolia, more than one third of lung cancer-related DALY loss is attributable to active smoking, and thus is potentially preventable. Furthermore, a gender-specific tobacco control policy may be worthwhile because of the large gender difference in smoking exposure in Mongolia. Next to this, age specific policy, including a smoke–free generation policy for adolescents, with targeted education, and mass media campaigns is needed.

Highlights

  • Smoking is a major risk factor for many cancer types [1]

  • Between 2007 and 2016, lung cancer accounted for the loss of over 63,000 disability-adjusted life years (DALYs) in Mongolia

  • In Mongolia, more than one third of lung cancer-related DALY loss is attributable to active smoking, and is potentially preventable

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Summary

Introduction

Smoking is a major risk factor for many cancer types [1]. It is the second largest contributor to the global disease burden, accounting for 148.6 million disability-adjusted life years (DALYs) lost in 2015 [2]. Almost 70% of all lung cancer deaths among adults are attributable to smoking [3]. Tobacco smoking is the most established risk factor for lung cancer, the effects of smoking used to be larger in Western countries than Asian countries [4,5]. In the US the population attributable fraction (PAF) of lung cancer deaths caused by smoking was 90% for men and 87% for women [7]. The lower risk of smoking-related lung cancer death in Asian countries may be explained by the different socioeconomic conditions, genetic susceptibility and different smoking behaviours in these countries [9]. This study aimed to quantify the population attributable fraction (PAF) of the lung cancer burden for smoking in Mongolia

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