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      Decomposing contribution of age and non-age factors to rapid growth of lung cancer in Xuanwei over past 30 years

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      , , , ,
      BMC Public Health
      BioMed Central
      Lung cancer, Mortality, Age, Non-age

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          Abstract

          Background

          From 1973 to 2005, the lung cancer mortality in Xuanwei had increased constantly. Effect analysis of age and non-age factors on lung cancer is important for local policy-making.

          Methods

          Demographic and death data was collected and used. Factors of lung cancer were classified into age and non-age factors. The contribution of the two factors to lung cancer was evaluated by method of decomposing the differences of mortality rate.

          Results

          For males, the non-age factors were the major contributor to growth of lung cancer mortality, and 78.46 % of all growth was attributed to non-age factors. For females, the non-age factors were the absolute contributor to growth of lung cancer in 1973–1992. From 1992 to 2005, the contribution proportion had reduced to 75.39 %.

          Conclusions

          Aging was one of risk factors for lung cancer in Xuanwei, but not the main factor. It was supposed that multiple environmental risk factors were related with high growth of lung cancer in Xuanwei. Policy-making should focus on the non-age factors.

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          Most cited references40

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          Smoking and carcinoma of the lung; preliminary report.

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            Lung cancer and indoor air pollution in Xuan Wei, China.

            In Xuan Wei County, Yunnan Province, lung cancer mortality is among China's highest and, especially in females, is more closely associated with indoor burning of "smoky" coal, as opposed to wood or "smokeless" coal, than with tobacco smoking. Indoor air samples were collected during the burning of all three fuels. In contrast to wood and smokeless coal emissions, smoky coal emission has high concentrations of submicron particles containing mutagenic organics, especially in aromatic and polar fractions. These studies suggested an etiologic link between domestic smoky coal burning and lung cancer in Xuan Wei.
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              Risk of lung cancer associated with domestic use of coal in Xuanwei, China: retrospective cohort study

              Objective To estimate the risk of lung cancer associated with the use of different types of coal for household cooking and heating. Setting Xuanwei County, Yunnan Province, China. Design Retrospective cohort study (follow-up 1976-96) comparing mortality from lung cancer between lifelong users of “smoky coal” (bituminous) and “smokeless coal” (anthracite). Participants 27 310 individuals using smoky coal and 9962 individuals using smokeless coal during their entire life. Main outcome measures Primary outcomes were absolute and relative risk of death from lung cancer among users of different types of coal. Unadjusted survival analysis was used to estimate the absolute risk of lung cancer, while Cox regression models compared mortality hazards for lung cancer between smoky and smokeless coal users. Results Lung cancer mortality was substantially higher among users of smoky coal than users of smokeless coal. The absolute risks of lung cancer death before 70 years of age for men and women using smoky coal were 18% and 20%, respectively, compared with less than 0.5% among smokeless coal users of both sexes. Lung cancer alone accounted for about 40% of all deaths before age 60 among individuals using smoky coal. Compared with smokeless coal, use of smoky coal was associated with an increased risk of lung cancer death (for men, hazard ratio 36 (95% confidence interval 20 to 65); for women, 99 (37 to 266)). Conclusions In Xuanwei, the domestic use of smoky coal is associated with a substantial increase in the absolute lifetime risk of developing lung cancer and is likely to represent one of the strongest effects of environmental pollution reported for cancer risk. Use of less carcinogenic types of coal could translate to a substantial reduction of lung cancer risk.
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                Author and article information

                Contributors
                yncdccy@126.com
                xyz6292@sina.com
                yncdc-yyf@163.com
                9597722@qq.com
                410793425@qq.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                12 November 2015
                12 November 2015
                2015
                : 15
                : 1116
                Affiliations
                Department of Chronic disease, Yunnan center for disease control and prevention, Dongsi Street, Kunming, China
                Article
                2482
                10.1186/s12889-015-2482-y
                4643511
                26563138
                1c6e0dcb-f546-4c82-9339-b38535fcea19
                © Chen et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 April 2014
                : 10 November 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                lung cancer,mortality,age,non-age
                Public health
                lung cancer, mortality, age, non-age

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