Time trends in tobacco-attributable cancer mortality in Poland — direct estimation method

Abstract

Introduction. Since the 20th century tobacco smoking has had an enormous impact on morbidity and mortality in the adult population, and it remains the greatest single preventable health risk factor worldwide. Cancer is the se­cond leading cause of death in Poland, with lung cancer as the primary cause of cancer-related death in Polish men and women. Given these statistics, this manuscript aims to estimate tobacco-attributable cancer mortality in Poland. Material and methods. Data on cancer mortality come from the WHO Mortality Statistics database. Data on smoking prevalence in Poland come from standardized surveys based on nationally representative samples. Data on relative risks come from the Cancer Prevention Study II. Tobacco-attributable fractions were calculated using standard me­thodology for calculating population-based attributable fractions. Results. In 2014, there were over 24 thousand tobacco-attributed cancer deaths in men. Lung cancer tops the list of ranked cancer types, with a tobacco-attributable fraction of 93%. Next is laryngeal (TAF = 90%), oropharyngeal (TAF = 86%) and esophageal (TAF = 80%) cancer. Overall, two-thirds of the considered cancer deaths were attributed to tobacco smoke (TAF = 75%). In 2014, there were over 7.5 thousand of cancer deaths related to smoking in women. Here, both laryngeal and lung cancer (both TAF = 76%) top the ranked list. Next are esophageal (TAF = 61%) and oropharyngeal (TAF = 51%) cancers, and when combined almost half of all considered cancer deaths were attributed to tobacco smoke (TAF = 44%). Conclusions. Tobacco smoking and tobacco-attributable cancer mortality remain one of the greatest health burdens in Poles. Each year over 30 thousand Polish men and women die of cancer caused by smoking. All these deaths could be avoided.