Lung cancer incidence in young women vs. young men: A systematic analysis in 40 countries
Lung cancer incidence in young women vs. young men: A systematic analysis in 40 countries
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DOI：
10.1002/ijc.32809
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发表时间：
2020-08-01
影响因子：
6.4
通讯作者：
Jemal, Ahmedin
中科院分区：
文献类型：
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作者：
Fidler-Benaoudia, Miranda M.;Torre, Lindsey A.;Jemal, Ahmedin
以前的研究报告了男女之间肺癌发病率的趋同。我们研究了五大洲40个国家的年轻女性与年轻男性的肺癌发病率。按5年年龄组（30-64岁）和5年日历期（1993-2012年）划分的肺癌和支气管癌病例摘自五大洲癌症发病率。按年龄组和出生队列计算女性与男性的发病率比（IRR）和95%置信区间（95%CI）。在所有国家，男性的特定年龄肺癌发病率普遍下降，而女性的发病率因国家而异，大多数国家的趋势稳定或下降，尽管与男性相比速度较慢。因此，最近出生队列中女性与男性的IRR有所增加，其中加拿大、丹麦、德国、新西兰、荷兰和美国的IRR显着高于统一。例如，在荷兰，45-49岁年龄段的IRR在1948年和1963年出生的人中分别从0.7（95% CI：0.6-0.8）增加到1.5（95% CI：1.4-1.7）。在另外23个国家也发现了类似的模式，尽管不重要。这些交叉在很大程度上是由女性腺癌发病率的增加所驱动的。在有吸烟史数据的国家，妇女吸烟率接近但很少超过男子。总之，与年轻男性相比，年轻女性肺癌发病率更高是普遍存在的，不能完全用吸烟模式的性别差异来解释。未来的研究需要确定年轻女性肺癌发病率升高的原因。
Previous studies have reported converging lung cancer rates between sexes. We examine lung cancer incidence rates in young women vs. young men in 40 countries across five continents. Lung and bronchial cancer cases by 5-year age group (ages 30-64) and 5-year calendar period (1993-2012) were extracted from Cancer Incidence in Five Continents. Female-to-male incidence rate ratios (IRRs) and 95% confidence intervals (95%CIs) were calculated by age group and birth cohort. Among men, age-specific lung cancer incidence rates generally decreased in all countries, while in women the rates varied across countries with the trends in most countries stable or declining, albeit at a slower pace compared to those in men. As a result, the female-to-male IRRs increased among recent birth cohorts, with IRRs significantly greater than unity in Canada, Denmark, Germany, New Zealand, the Netherlands and the United States. For example, the IRRs in ages 45-49 year in the Netherlands increased from 0.7 (95% CI: 0.6-0.8) to 1.5 (95% CI: 1.4-1.7) in those born circa 1948 and 1963, respectively. Similar patterns, though nonsignificant, were found in 23 additional countries. These crossovers were largely driven by increasing adenocarcinoma incidence rates in women. For those countries with historical smoking data, smoking prevalence in women approached, but rarely exceeded, those of men. In conclusion, the emerging higher lung cancer incidence rates in young women compared to young men is widespread and not fully explained by sex differences in smoking patterns. Future studies are needed to identify reasons for the elevated incidence of lung cancer among young women.