Burden of Lung Cancer Deaths due to Smoking for Men and Women in the WHO Western Pacific and South East Asian Regions

Introduction: Eighty percent of all smokers live in low and middle-income countries of the Asia Pacificregion but actual estimates of the burden of disease due to smoking in the region have yet to be quantified.
Methods: The burden of lung cancer due to smoking for all countries in the WHO Western Pacific and SouthEast Asian regions was calculated from the population attributable fractions (PAFs). Nationally representativesex-specific prevalences of smoking were obtained from the World Health Organization, MEDLINE and/ornational government documents and hazard ratios (HR) for lung cancer due to smoking in Asian and non-Asianpopulations were obtained from published data. The HR and prevalence were then used to calculate PAFs forlung cancer deaths due to smoking, by gender and by country.
Results: The national prevalence of smoking in theAsia Pacific region ranged from 18-65% in men and from 0-50% in women. The fraction of lung cancer deathsattributable to smoking ranged from 0-40% in Asian women and from 21-49% in Asian men. In ANZ, PAFs wereas high as 80% for women and 68% for men. Future estimates of the burden of smoking-related lung cancer inAsia were obtained by assuming a continuation of current smoking habits in these populations. Extrapolatingthe higher HR from the ANZ region to Asia, resulted in an increase in the PAFs to 4-90% in women and from62-85% in men.
Conclusion: The current burden of lung-cancer due to smoking in the Asia-Pacific region issubstantial accounting for up to 50% of deaths from the disease in men and up to 40% in women dependingon the country. If current smoking habits in Asia remain unchanged then the number of people dying fromsmoking-related lung cancer over the next couple of decades is expected to double. It is known that the majorityof lung cancer is due to smoking. This is the first paper to systematically compare current burdens of lung cancerdeaths due to smoking in countries in the Western Pacific and South East Asia and by gender. Findings fromthis paper demonstrate the number of lung cancer deaths that could be prevented if the prevalence of smokingwas eliminated.