GEOGRAPHICAL VARIATION OF CANCER MORTALITY IN ITALY
GEOGRAPHICAL VARIATION OF CANCER MORTALITY IN ITALY
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DOI：
10.1093/ije/14.4.538
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发表时间：
1985-12-01
影响因子：
7.7
通讯作者：
LAVECCHIA, C
中科院分区：
文献类型：
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作者：
FACCHINI, U;CAMNASIO, M;LAVECCHIA, C
分析了意大利广大地理区域（北部/中部/南部）各种癌症或癌症组的死亡证明率分布。与南部地区相比，该国北部地区的男女癌症总死亡率均显着升高（按 34-64 岁的截断率计算，男性约为 70%，女性约为 30%），而中部地区总体处于中等水平。北部地区呼吸道癌和其他烟草相关肿瘤（不包括膀胱）的死亡率较高，男性的北/南比率范围从肺癌和大多数呼吸道部位的 1.5 到食道癌的 4.0 左右。在年轻（40-49 岁）男性中，这些差异几乎没有趋于平衡的趋势。北部地区胃癌、大肠癌、肝癌和大多数其他消化部位癌症的死亡证明率较高。意大利南部的胃癌死亡率较低令人好奇，因为这里是该国最贫穷的地区。在北部，所有其他常见肿瘤（子宫除外）的死亡证明率也有所上升。然而，对于非上皮肿瘤来说，地理差异似乎更为有限。由于南部死亡认证的准确性较低，意大利不同地理区域之间癌症死亡率的巨大差异不容忽视。一些差异可以用现有的癌症成因知识来解释（例如乳腺癌和卵巢肿瘤的生殖因素，食道癌的酒精和烟草）。然而，南方地区呼吸道癌死亡率较低，很难完全用烟草消费来解释。同样，南北差异也不能与工业化的非特定后果相关，因为在高度工业化和主要是北部农村地区，癌症死亡率同样升高。可以想象，饮食因素也可以解释一些差异。然而，目前，对于单一国家内癌症死亡率这种相当特殊的地理分布有明显的一般性解释。
The distribution of death certification rates from various cancers or groups of cancers in broad Italian geographical areas (north/centre/south) was analyzed. In both sexes, total cancer mortality was considerably elevated in the north of the country compared to southern regions (around 70% for males and 30% for females in the truncated 34-64 rate), and generally intermediate in central areas. Northern mortality rates were higher for respiratory cancers and other tobacco related neoplasms (excluding bladder), with a north/south ratio ranging from 1.5 for lung and most respiratory sites to about 4.0 for oesophageal cancer in males. There was little tendency towards a levelling of these differences in younger (40-49 year old) males. Northern areas showed higher death certification rates for cancers of the stomach, large bowel, liver and most other digestive sites. The lower gastric cancer mortality registered in southern Italy is curious, since this is the poorest part of the country. Death certification rates from all other common neoplasms (uterus apart) were also elevated in the north. The geographical variation, however, appeared more limited for non-epithelial neoplasms. The substantial differences in cancer mortality between various Italian geographical areas can hardly be dismissed as due to lower death certification accuracy in the south. Some of the differences can be explained in terms of available knowledge of the causes of cancer (eg reproductive factors for breast and ovarian neoplasms, alcohol plus tobacco for oesophageal cancer). However, the lower mortality from respiratory cancers in southern areas can only with some difficulty be totally explained in terms of tobacco consumption. Likewise, the north/south variation cannot be related to non-specific consequences of industrialization, since cancer mortality was similarly elevated in highly industrialized and chiefly rural northern areas. It is conceivable that dietary factors may also explain some of the differences. However, at present, there is obvious general explanation for this quite peculiar geographical distribution of cancer mortality within a single country.