Age-incidence relationships and time trends in cervical cancer in Sweden
Age-incidence relationships and time trends in cervical cancer in Sweden
复制标题
DOI：
10.1023/a:1012761717028
复制
发表时间：
2001-01-01
影响因子：
13.6
通讯作者：
Mutanen, P
中科院分区：
文献类型：
--
作者：
Hemminki, K;Li, XJ;Mutanen, P
年龄-发病率关系是致癌机制的重要信息。这些先前已被评估为宫颈鳞状细胞癌（SCC），但未用于腺癌。目的是通过年龄、时期和队列特定分析和泊松回归模型来评估两种类型的宫颈癌是否在相对年轻的年龄表现出最大的年龄发病率，如横断面分析所示。瑞典家庭癌症数据库用于分析1958-1996年间诊断的宫颈鳞状细胞癌和腺癌的年龄发病率关系，分别包括15,118例和1866例。居住地区和社会经济地位被纳入分析，因为它们是宫颈癌的危险因素。宫颈鳞状细胞癌的分析证实发病率最高的年龄为35-39岁。腺癌的数据也显示了相似的早期最大值，但不同出生队列的曲线差异很大。在随访结束时，腺癌的发病率在年轻年龄组中显著增加。子宫内膜腺癌、阴道和外阴鳞状细胞癌与宫颈癌有一些共同的危险因素，但没有显示出早期发病率最高。结果还表明，大约在1960年前后，也就是有组织的人口筛查的10年前，宫颈鳞状细胞癌的发病率有所下降，这可能是由于引入了机会性巴氏试验。有组织的筛查的好处是发病率进一步下降。宫颈癌独特的年龄-发病率关系需要生物学解释。
Age-incidence relationships are informative of carcinogenic mechanisms. These have been previously assessed for cervical squamous cell carcinoma (SCC) but not for adenocarcinoma. The aim was to assess by means of age-, period- and cohort- specific analyses and Poisson regression modelling whether the two types of cervical cancer show an age-incidence maximum at a relatively young age, as shown in cross-sectional analyses. The Swedish Family-Cancer Database was used to analyse age-incidence relationships in cervical SCC and adenocarcinoma diagnosed in years 1958-1996, including a total of 15,118 and 1866 cases, respectively. Area of residence and socio-economic status were included in analyses because they were risk factors of cervical cancer. The analysis of cervical SCC confirmed an incidence maximum at ages 35-39 years. The data for adenocarcinoma also suggested a similar early age maximum but the curves differed extensively by birth cohort. The incidence of adenocarcinoma increased substantially at young age groups towards the end of follow-up. Endometrial adenocarcinoma and vaginal and vulvar SCC, which share some risk factors with cervical cancer, did not show an early age incidence maximum. The results also showed that there was a decrease in the incidence of cervical SCC around year 1960, almost 10 years before the organized population screening, probably due to introduced opportunistic pap testing. The benefits of the organized screening were observed as a further decline in the incidence rates. The unique age-incidence relationships in cervical cancer call for biological explanations.