Divergent trends for gastric cancer incidence by anatomical subsite in US adults.
Divergent trends for gastric cancer incidence by anatomical subsite in US adults.
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DOI：
10.1136/gut.2010.236737
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发表时间：
2011-12
期刊：
影响因子：
24.5
通讯作者：
Rabkin CS
中科院分区：
文献类型：
--
作者：
Camargo MC;Anderson WF;King JB;Correa P;Thomas CC;Rosenberg PS;Eheman CR;Rabkin CS
对非贲门胃癌发病率的特定人群分析显示，美国白人的发病率呈不同趋势：40岁及以上人群的发病率下降，但年轻人的发病率上升。为了进一步研究这种异质性，通过解剖子部位评价了发病率趋势。1976-2007年胃癌发病率数据来自美国国家癌症研究所的监测、流行病学和最终结果（SEER）计划和美国疾病控制和预防中心的国家癌症登记计划（NPCR）。按年龄组（25-39岁、40-59岁和60-84岁）、人种/种族和子中心计算发生率和估计的年度百分比变化。基于9个最早的SEER登记中心的数据（覆盖约10%的美国人口），白人和黑人中所有非贲门子部位的发生率均下降，但体癌除外，在1976年至2007年期间增加，估计每年的百分比变化为1.0%（95% CI 0.1%至1.9%），黑人为3.5%（95% CI 1.8%至5.2%）。相比之下，所有非贲门子部位（包括贲门癌）的发病率在其他种族中均有所下降。在NPCR和SEER登记处（覆盖89%的美国人口）的综合数据中，1999年至2007年期间，年轻和中年白人的身体癌显著增加;在种族特异性分析中，非西班牙裔白人的相同年龄组中的发病率显著增加，西班牙裔白人的发病率稳定。在此期间，黑人和其他种族的所有子网站的特定率下降或稳定。胃癌的长期和短期发病率趋势表明解剖学亚部位的分布发生了变化。体癌可能有独特的病因学和不断变化的危险因素暴露，避免进一步调查。
Age-specific analyses of non-cardia gastric cancer incidence reveal divergent trends among US whites: rates are declining in individuals aged 40 years and older but rising in younger persons. To investigate this heterogeneity further, incidence trends were evaluated by anatomical subsite. Gastric cancer incidence data for 1976–2007 were obtained from the US National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program and the US Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR). Incidence rates and estimated annual percentage change were calculated by age group (25–39, 40–59 and 60–84 years), race/ethnicity and subsite. Based on data from the nine oldest SEER registries (covering ~10% of the US population), rates for all non-cardia subsites decreased in whites and blacks, except for corpus cancer, which increased between 1976 and 2007 with estimated annual percentage changes of 1.0% (95% CI 0.1% to 1.9%) for whites and 3.5% (95% CI 1.8% to 5.2%) for blacks. In contrast, rates for all non-cardia subsites including corpus cancer declined among other races. In combined data from NPCR and SEER registries (covering 89% of the US population), corpus cancer significantly increased between 1999 and 2007 among younger and middle-aged whites; in ethnic-specific analyses, rates significantly increased among the same age groups in non-Hispanic whites and were stable among Hispanic whites. Age-specific rates for all subsites declined or were stable in this period among blacks and other races. Long- and short-term incidence trends for gastric cancers indicate a shifting distribution by anatomical subsite. Corpus cancer may have distinctive aetiology and changing risk factor exposures, warranting further investigation.
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