Epidemiology of laryngeal cancer.
Epidemiology of laryngeal cancer.
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DOI：
10.1093/oxfordjournals.epirev.a036223
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发表时间：
1980
影响因子：
5.5
通讯作者：
K. Rothman;C. Cann;D. Flanders;M. Fried
中科院分区：
文献类型：
--
作者：
K. Rothman;C. Cann;D. Flanders;M. Fried
来自第三次全国癌症调查的年龄和性别特异性喉癌发病率如图1所示。这种疾病在男性中更为常见，在70岁时达到发病率高峰，约为每10万人中有38例。女性的年龄发病率曲线明显低于男性。值得注意的是，在1970年接受调查的妇女中，发病率高峰出现在60岁之前，在高峰之后，男性发病率与女性发病率的比例显著增加。在这些横断面数据中，男性在70岁之后的年龄特异性发病率下降可能是一个出生队列，而不是年龄现象，因为1900年之前出生的男性不像1900年之后出生的男性那样吸烟严重(7)。康涅狄格州喉癌发病率的出生队列分析支持这一解释，如图2(8)所示。然而，在70岁达到峰值之后的部分下降可能是由于特定年龄发生率的实际下降，反映了“易感”人群的逐渐枯竭。60岁以后女性发病率的下降几乎肯定反映了一种队列现象，因为在第一次世界大战之前出生的女性中，吸烟并不是一种流行的习惯(7)。在第三次全国癌症调查中，黑人男性喉癌的发病率为每10万人年7.9例，而白人为每10万人年7.5例（根据1950年美国人口年龄调整）(6)。然而，在早期的调查中，黑人的比率要低得多，1937年的调查只有2.9,1947年的调查只有5.7。很难说黑人的明显趋势是否代表了真正的长期增长，还是仅仅是一种趋势
Age-and sex-specific incidence of laryngeal cancer from this Third National Cancer Survey is depicted in figure 1. The disease is far more frequent in males, reaching a peak incidence of about 38 cases per 100,000 person-years at age 70. The age incidence curve for females is considerably lower than that for males. It is notable that the peak occurrence comes before 60 years of age for women surveyed in 1970, and that following the peak the ratio of male incidence to female incidence increases markedly. The decline among males in age-specific incidence subsequent to 70 years of age in these cross-sectional data may be a birthcohort, rather than an age phenomenon, because men born before the year 1900 did not smoke as heavily as men born thereafter (7). A birth-cohort analysis of laryngeal cancer incidence in Connecticut supports this interpretation, as shown in figure 2 (8). Part of the decline after the peak at 70 years of age, however, might be attributable to a real decline in agespecific occurrence, reflecting gradual exhaustion of the" susceptible" pool. The decline in female incidence after 60 years of age almost certainly reflects a cohort phenomenon, inasmuch as smoking was not a popular habit for women born before World War I (7).Incidence for laryngeal cancer among black males in the Third National Cancer Survey was 7.9 per 100,000 person-years, compared with 7.5 for whites (ageadjusted to the US population in 1950)(6). The rate for blacks was considerably lower, however, in the earlier surveys, being only 2.9 for the 1937 survey and 5.7 for the 1947 survey (9, 10). It is difficult to say whether the apparent trend for blacks represents a real secular increase or just a