Cervical cancer in Canada: Changing patterns in incidence and mortality
Cervical cancer in Canada: Changing patterns in incidence and mortality
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DOI：
10.1046/j.1525-1438.2001.011001024.x
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发表时间：
2001-01-01
影响因子：
4.8
通讯作者：
Mao, Y
中科院分区：
文献类型：
--
作者：
Liu, S;Semenciw, R;Mao, Y
加拿大安大略省、萨斯喀彻温省和不列颠哥伦比亚省子宫颈癌发病率和死亡率的数据被用来检查按年龄、日历时期和出生队列划分的时间趋势。宫颈鳞癌的年龄调整发病率从1970-72年的11.1/10万妇女下降到1994-96年的5.3，而同期子宫腺癌的发病率从1.1/10万妇女上升到1.5/10万妇女。年龄调整死亡率从1953-55年间的每10万名妇女7.9人下降到1995-97年间的1.9人。1953-72年按年龄划分的死亡率模式与1973-97年不同；年轻妇女在前一时期死亡率下降幅度较大，而老年妇女在后一时期受益较大。年龄-时期-队列模型显示，队列效应导致宫颈鳞癌发病率的下降趋势和腺癌的上升趋势，而周期和队列效应都解释了观察到的死亡率趋势。结果表明，巴氏涂片筛查在减少宫颈鳞癌方面发挥了重要作用。导致宫颈腺癌增加的原因尚不清楚。
Data on incidence of cervical cancer by histologic subtype and mortality for the Canadian provinces of Ontario, Saskatchewan, and British Columbia were used to examine time trends by age, calender period, and birth cohort. Age-adjusted incidence rate of squamous cell carcinoma of the cervix decreased from 11.1 per 100,000 women in 1970-72 to 5.3 in 1994-96, while the rate for cervical adenocarcinoma increased from 1.1 per 100,000 women to 1.5 over the same period. Age-adjusted mortality rate declined from 7.9 per 100,000 women in 1953-55 to 1.9 in 1995-97. The patterns in age-specific mortality rates in 1953-72 were different from those in 1973-97; younger women experienced larger reductions in mortality during the earlier period while older women benefited to a greater extent during the latter period. Age-period-cohort modeling showed that cohort effects were responsible for the decreasing trends in incidence of squamous cell carcinoma of the cervix and increasing trends in adenocarcinoma, and both period and cohort effects account for the observed trends in mortality. The results suggest that Pap smear screening has played a significant role in the reduction in squamous cell cervical carcinoma. The causes for the increase in cervical adenocarcinoma are unclear.