Gender differences in the trend of colorectal cancer incidence in Singapore, 1968-2002
Gender differences in the trend of colorectal cancer incidence in Singapore, 1968-2002
复制标题
DOI：
10.1007/s00384-007-0421-9
复制
发表时间：
2008-05-01
影响因子：
2.8
通讯作者：
Verkooijen, Helena M.
中科院分区：
文献类型：
--
作者：
de Kok, Inge M. C. M.;Wong, Chia Siong;Verkooijen, Helena M.
背景和目标 在过去的几十年里，新加坡结直肠癌的发病率呈急剧上升趋势。在这项基于人群的研究中，我们描述了新加坡结直肠癌发病率的变化，并通过年龄阶段队列 (APC) 建模探讨了这些变化背后的原因。方法我们纳入了 1968 年至 2002 年间向新加坡癌症登记处报告的所有 22,609 例结直肠癌病例。使用年龄阶段 (AP) 和年龄队列 (AC) 模型的泊松回归用于确定诊断时年龄、日历周期和出生队列的影响。结果 男性结直肠癌1968 年至 2002 年间，癌症发病率从每 10 万人年 20 人增至 40 人。这种增加在老年男性中最为明显，AC 对他们来说有显着的影响。女性结直肠癌发病率一直上升到 1992 年（从每 10 万人年 16 例增加到 29 例），此后趋于稳定。对于 65 岁以下的女性，我们观察到显着的 AP 效应，对应于 1978 年左右结直肠癌发病率的突然上升。 结论 这项研究表明，新加坡结直肠癌发病率存在重要的性别差异，男性发病率不断上升，而女性发病率稳定。男性发病率的增加主要归因于最年长年龄组的发病率增加，这可能是由于生命早期接触饮食和生活方式危险因素的增加。女性结直肠癌风险的稳定可能是由于较少接触生活方式危险因素和预防性去除癌前病变。
Background and aims Over the past decades, incidence trends of colorectal cancer are sharply increased in Singapore. In this population-based study we describe changes in colorectal cancer incidence in Singapore and explore the reasons behind these changes through age-period cohort (APC) modeling.Methods We included all 22,609 colorectal cancer cases reported to the Singapore Cancer Registry between 1968 and 2002. Poisson regression, using age-period (AP) and age-cohort (AC) models was used to determine the effects of age at diagnosis, calendar period, and birth cohort.Results Male colorectal cancer rates between 1968 and 2002 from 20 to 40 per 100,000 person years. The increase was sharpest among older men, for whom there was a significant AC effect. Female colorectal cancer rates increased until 1992 (from 16 to 29 per 100,000 person years) and stabilized afterward. For women under 65 years, we observed a significant AP effect, corresponding to a sudden rise in colorectal cancer incidence around 1978.Conclusions This study demonstrates important gender differences in colorectal cancer incidence in Singapore, with increasing rates among men, and stabilized rates in women. The increase in men is mainly attributable to an incidence increase in the oldest age groups, probably due to increased exposure to dietary and lifestyle risk factors earlier in life. The stabilization in female colorectal cancer risk could be due to lower exposure to lifestyle risk factors and prophylactic removal of precancerous lesions.