| Objective:To clarify the epidemiological characteristics of lung cancer mortality in Shenyang,and to explore the acute effects of short-term exposure to air pollutants and meteorological factors on lung cancer mortality,with a view to providing references for policy formulation related to the reduction of lung cancer mortality in Shenyang.Methods:1.Descriptive epidemiological methods were employed to analyze the trends of lung cancer mortality,standardized mortality and age-specific mortality in Shenyang from 2008 to 2020,while a Joinpoint regression model was utilized to analyze the temporal trends of standardized lung cancer mortality among Shenyang residents,and the annual percentage change(APC)and its 95%confidence interval(CI)were calculated.2.An ecological research method was employed to assess the acute effects of atmospheric pollution and meteorological characteristics on lung cancer mortality in Shenyang from 2013 to 2020.Analysis of the acute effects of short-term exposure to atmospheric pollutants and meteorological factors on lung cancer mortality in Shenyang from 2013 to 2020 was conducted using a distribution lagged nonlinear model(DLNM).The distribution characteristics of gender and age(<65 and≥65 years old)were further elucidated to clarify the susceptible population.Results:1.From 2008 to 2020,a total of 58,302 cases of lung cancer died in Shenyang,including 36,417 males and 21,885 females.The crude mortality rate of lung cancer in Shenyang was 61.21/100,000,while the standardized mortality rate was 31.43/100,000.The standardized mortality rate was 38.74/100,000 for men and 23.66/100,000 for women,with men being higher than women(P<0.05).Age-specific mortality rates showed an increasing trend with increasing age.The Joinpoint regression results for the whole population and male lung cancer standardized mortality rate showed 1 inflection point(2014),increasing from 2008 to 2014 with annual percentage change(APC)of 5.020%and 5.774%,respectively,with no statistically significant change from 2014 to 2020(P>0.05).Joinpoint regression results of standardized mortality rate of lung cancer in women showed no statistically significant changes(P>0.05).2.From 2013 to 2020,there were 41,025 deaths due to lung cancer in Shenyang.The average daily concentrations of inhalable particulate matter with diameter<10μm(PM10),particulate matter with diameter<2.5 μm(PM2.5),sulfur dioxide(SO2),nitrogen dioxide(NO2),carbon monoxide(CO)and ozone(O3)were 94.96μg/m3,55.34μg/m3,48.18μg/m3,41.37μg/m3,1.02mg/m3 and 89.35μg/m3,respectively.PM10,PM2.5,NO2 were the main pollutants exceeding the standard.Except for O3,Except for O3,the concentration of other pollutants showed a decreasing trend with the increase of year.The seasonal changes of each pollutant are obvious,with PM10,PM2.5,SO2,NO2 and CO concentrations significantly higher in winter than in summer,while O3 is the opposite.The average daily temperature is 9.02℃,the average daily pressure is 1010.32hPa,the average daily relative humidity is 61.29%,and the average daily wind speed is 2.16m/s.The periodic and seasonal changes of temperature,pressure and relative humidity are obvious,and the changes of average wind speed are not significant.3.Among air pollutants,short-term exposure to PM10,PM2.5,NO2 and CO are associated with an increased risk of lung cancer death.The cumulative expose-response curve of short-term exposure to PM2.5,PM10 and CO on lung cancer death was approximately "J" shaped,with the risk of lung cancer death increasing with the increase of pollutant concentration.The cumulative expose-response curve of shortterm NO2 exposure to lung cancer death was approximately inverted "U" shaped,with an increased risk of lung cancer death at concentrations of 40-100μg/m3.Among meteorological factors,short-term exposure to air pressure was associated with an increased risk of lung cancer death.The cumulative exposure-response curve of shortterm exposure to air pressure on lung cancer death was approximately "U" shaped,with the risk of lung cancer mortality decreasing and then increasing as the air pressure increased.4.Short-term exposure to high concentrations of PM2.5,PM10,NO2,CO(The 95th percentile)and high air pressure showed a cumulative risk effect on lung cancer death,using the median concentrations of each pollutant and meteorological factors as reference values.The cumulative risk effect of short-term exposure to high levels of PM2.5 on lung cancer mortality lasted until a lag of 4 days,with the maximum cumulative effect at a lag of 2 days(RR=1.065,95%CI:1.023,1.109).The cumulative risk effect of short-term exposure to high levels of PM10 on lung cancer mortality lasted until a lag of 14 days,with the maximum RR value at a lag of 14 days(RR=1.079,95%CI:1.021,1.140).The cumulative lagged effect of short-term exposure to high concentrations of NO2 on lung cancer death lasted until a lag of 9 days,with a maximum hazard effect at a lag of 2 days(RR=1.072,95%CI:1.032,1.113).The cumulative lagged effect of short-term exposure to high concentrations of CO lasted until a lag of 5 days,with a maximum hazard effect at a lag of 2 days(RR=1.076,95%CI:1.039,1.114).The cumulative lagged effect of high air pressure on lung cancer mortality was significant from lag 4 days and lasted until lag 14 days,with the maximum risk effect at lag 14 days(RR=1.088,95%CI:1.009,1.160).5.In the stratified analysis of age and sex,the health effects of short-term exposure to each pollutant and meteorological factors differed to some extent among subgroups.Males and the<65 years age group were more sensitive to PM2.5,PM10,NO2,and CO exposure,and females and the ≥65 years age group were more sensitive to air pressure.Conclusions:1.From 2008 to 2020,the death rate of lung cancer in Shenyang increased first and then decreased.It is necessary to strengthen the prevention and treatment of lung cancer in Shenyang,and vigorously promote the implementation of lung cancer screening and early diagnosis and treatment.2.Short-term exposure to air pollutants and meteorological factors are associated with increased risk of lung cancer death among residents in Shenyang,among which PM2.5,PM10,NO2,CO and air pressure short-term exposure has a significant effect on the risk of lung cancer death.There is a cumulative risk effect of short-term exposure to high levels,and the lag time of the effect of different factors on lung cancer mortality is not consistent.3.Significant differences in lung cancer mortality were observed between genders and ages when exposed to short-term air pollutants and meteorological factors,with PM2.5,PM10,NO2,and CO having a significant effects on males and those in the<65 years age group,and air pressure having significant effects on females and those in the ≥65 years age group.The results of the study clarify the direction and focus for the development of strategies related to lung cancer mortality reduction,and have important public health implications for improving the survival rate of lung cancer patients in our city. |
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