Higher Lung Cancer Incidence in Young Women Than Young Men in the United States.
Higher Lung Cancer Incidence in Young Women Than Young Men in the United States.
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DOI：
10.1056/nejmoa1715907
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发表时间：
2018-05-24
期刊：
影响因子：
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通讯作者：
Thun MJ
中科院分区：
文献类型：
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作者：
Jemal A;Miller KD;Ma J;Siegel RL;Fedewa SA;Islami F;Devesa SS;Thun MJ
先前的研究表明，在美国，年轻女性的肺癌发病率高于年轻男性。这种模式是否在当代出生队列中继续存在，如果是的话，是否可以完全用吸烟行为的性别差异来解释，这些都是未知的。我们根据性别、种族或民族、年龄组（30 - 34岁、35 - 39岁、40 - 44岁、45 - 49岁和50 - 54岁）、出生年份（1945 - 1980年）和诊断日历期（1995-1999年、2000-2004年、2005-2009年和2010-2014年）检查了全国人口肺癌发病率，并计算了男女发病率比。我们还使用1970年至2016年全国健康访谈调查的数据，研究了吸烟的流行程度。在过去的二十年中，在所有种族和民族中，30至54岁的男性和女性中，肺癌的年龄特异性发病率普遍下降，但男性的下降幅度更大。因此，在非西班牙裔白人中，女性与男性的发病率比增加，在30至34岁、35至39岁、40至44岁和45至49岁年龄组中超过1.0。例如，在40至44岁的白人中，女性与男性的发病率比从1995-1999年期间的0.88（95%可信区间[CI]， 0.84至0.92）增加到2010-2014年期间的1.17 （95% CI， 1.11至1.23）。性别差异发生率的交叉发生在1965年以后出生的非西班牙裔白人中。不同性别的发病率在非西班牙裔黑人、西班牙裔、非西班牙裔亚洲人和太平洋岛民中趋于一致，但从男性较高的发病率跨越到仅在西班牙裔女性中较高的发病率。1965年以后出生的妇女的吸烟率已接近但一般不超过男子的吸烟率。自20世纪60年代中期以来，男性肺癌发病率高于女性的历史模式在非西班牙裔白人和西班牙裔美国人中已经逆转，而且这并不能完全用吸烟行为的性别差异来解释。未来的研究需要确定年轻女性中肺癌发病率较高的原因。（由美国癌症协会资助。）
Previous studies showed a higher incidence of lung cancer among young women than among young men in the United States. Whether this pattern has continued in contemporary birth cohorts and, if so, whether it can be fully explained by sex differences in smoking behaviors are unknown. We examined the nationwide population-based incidence of lung cancer according to sex, race or ethnic group, age group (30 to 34, 35 to 39, 40 to 44, 45 to 49, and 50 to 54 years), year of birth (1945 to 1980), and calendar period of diagnosis (1995–1999, 2000–2004, 2005–2009, and 2010–2014), and we calculated female-to-male incidence rate ratios. We also examined the prevalence of cigarette smoking, using data from the National Health Interview Survey from 1970 to 2016. Over the past two decades, the age-specific incidence of lung cancer has generally decreased among both men and women 30 to 54 years of age in all races and ethnic groups, but the declines among men have been steeper. Consequently, among non-Hispanic whites, the female-to-male incidence rate ratios increased, exceeding 1.0 in the age groups of 30 to 34, 35 to 39, 40 to 44, and 45 to 49 years. For example, the female-to-male incidence rate ratio among whites 40 to 44 years of age increased from 0.88 (95% confidence interval [CI], 0.84 to 0.92) during the 1995–1999 period to 1.17 (95% CI, 1.11 to 1.23) during the 2010–2014 period. The crossover in sex-specific rates occurred among non-Hispanic whites born since 1965. Sex-specific incidence rates converged among non-Hispanic blacks, Hispanics, and non-Hispanic Asians and Pacific Islanders but crossed over from a higher incidence among men to a higher incidence among women only among Hispanics. The prevalence of cigarette smoking among women born since 1965 has approached, but generally not exceeded, the prevalence among men. The patterns of historically higher incidence rates of lung cancer among men than among women have reversed among non-Hispanic whites and Hispanics born since the mid-1960s, and they are not fully explained by sex differences in smoking behaviors. Future studies are needed to identify reasons for the higher incidence of lung cancer among young women. (Funded by the American Cancer Society.)