TRENDS IN CANCER MORTALITY IN 15 INDUSTRIALIZED COUNTRIES, 1969-1986
TRENDS IN CANCER MORTALITY IN 15 INDUSTRIALIZED COUNTRIES, 1969-1986
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DOI：
10.1093/jnci/84.5.313
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发表时间：
1992-03-04
影响因子：
10.3
通讯作者：
SWERDLOW, AJ
中科院分区：
文献类型：
--
作者：
HOEL, DG;DAVIS, DL;SWERDLOW, AJ
背景：评估癌症的趋势提供了一种手段，可以衡量抗击癌症的进展，估计未来对护理和治疗的需求，并提供可能解释最近变化的因果因素变化的线索。目的：这项研究旨在评估15个工业化国家中与高死亡率相关的主要癌症部位的趋势。为了突出地区之间的差异，我们将这些国家分为六个地理区域：美国、东欧、西欧、东亚、大洋洲和北欧国家。此外，还将这些地区的癌症死亡率趋势与美国的发病率模式进行了比较。方法：使用世界卫生组织提供的数据来评估1969年至1986年肺癌、乳腺癌、前列腺癌、胃癌和结直肠癌以及所有其他被认为是一组的地点的特定年龄死亡率趋势。我们还收集和分析了1973年至1986年来自国家癌症研究所监测、流行病学和最终结果(SEER)计划的相同地点和年龄组的数据。结果：在1969至1986年间，在所研究的六个地区中，45岁及以上人群中记录的肺癌、乳腺癌和前列腺癌死亡率在大多数年龄段都有所增加，而胃癌死亡率则大幅下降。在除东欧和东亚以外的所有地区，45-54岁男性肺癌死亡人数的增加都已大幅放缓或逆转。肠癌的发病趋势因年龄和地区而异。对于所有其他被视为一组的地点，在大多数地区，年龄超过的人的人数都出现了增加。在东欧，45-54岁人群中几种主要癌症的发病率高得令人不安，而且增长迅速。总体而言，美国癌症发病率的趋势与死亡率的趋势相似。然而，对于肠癌来说，发病率增加了，而死亡率下降了。结论：我们报告的趋势不能仅仅用吸烟或衰老的变化来解释。癌症发病率和死亡率变化的其他原因需要确定。影响：我们发现癌症死亡率和发病率的上升和下降趋势对卫生保健规划很重要，也可能为癌症预防研究提供机会。
Background: Assessing trends in cancer provides a means for gauging progress against the disease, estimating future demands for care and treatment, and suggesting clues about shifting causal factors that may account for the more recent changes. Purpose: This study was designed to evaluate trends in the major sites of cancer associated with high mortality rates in 15 industrialized countries. To highlight differences among regions, we grouped these countries into six geographic areas: United States, Eastern Europe, Western Europe, East Asia, Oceania, and Nordic countries. In addition, cancer mortality trends in these regions were compared with incidence patterns in the United States. Methods: Data provided by the World Health Organization were used to evaluate age-specific mortality trends from 1969 through 1986 for lung, breast, prostate, stomach, and colorectal cancers and for all other sites considered as a group. We also assembled and analyzed data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute for the same sites and age groups from 1973 through 1986. Results: Over the period 1969 through 1986, recorded cancer mortality in persons aged 45 years and older in the six regions studied has increased for lung, breast, and prostate cancers in most age groups, while the decline in stomach cancer mortality is substantial. The increase in lung cancer deaths in men aged 45-54 years has slowed greatly or reversed in all areas except Eastern Europe and East Asia. Trends for intestinal cancer vary by age and region. For all other sites considered as a group, increases have occurred for persons older than 64 years in most regions. In Eastern Europe, there are disturbingly high rates and rapid increases for several of the major forms of cancer in persons aged 45-54 years. In general, trends for cancer incidence in the United States parallel those for mortality. For intestinal cancer, however, incidence has increased while mortality has declined. Conclusions: The trends we report cannot be explained solely by changes in cigarette smoking or aging. Other causes of changes in cancer incidence and mortality need to be determined. Implications: The increasing and decreasing trends in mortality from and incidence of cancer that we found are important for health care planning and may also suggest opportunities for research in cancer prevention.