Brain and other central nervous system cancers: Recent trends in incidence and mortality
Brain and other central nervous system cancers: Recent trends in incidence and mortality
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DOI：
10.1093/jnci/91.16.1382
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发表时间：
1999-08-18
影响因子：
10.3
通讯作者：
Linet, MS
中科院分区：
文献类型：
--
作者：
Legler, JM;Ries, LAG;Linet, MS
背景资料：在1980年代，据报告，在美国所有年龄组中，原发性恶性脑肿瘤和其他中枢神经系统肿瘤（以下称为脑癌）的发病率都在上升，而65岁以下的人的死亡率则在下降。我们分析了这些数据，以提供美国脑癌发病率和死亡率趋势的最新情况，并检查这些模式以寻找其原因。研究方法：从1975年至1995年国家癌症研究所的监测、流行病学和最终结果（SEER）计划中获得了关于发病率、总体和根据组织学和解剖部位以及相对生存率的数据，从国家卫生统计中心获得了死亡率数据。来自国家癌症研究所SEER-Medicare数据库的Medicare程序索赔用于成像趋势。确定了发病率趋势的统计学显著变化，仅计算了对数线性模型的年度百分比变化。结果/结论：在SEER数据可用的最新时期内，所有年龄组的发生率稳定，但包含85岁或以上个体的组除外。年轻年龄组的死亡率趋势继续下降，过去老年人死亡率的急剧增加大幅放缓。根据年轻患者和老年患者之间的肿瘤部位和级别，不同年龄组的模式不同。在过去的十年中，65-74岁的人使用计算机断层扫描相对稳定，但在85岁或以上的人中有所增加。含义：诊断的改进以及老年患者诊断和治疗的变化为观察到的脑癌趋势模式提供了可能的解释。
Background: During the 1980s, the incidence of primary malignant brain and other central nervous system tumors (hereafter called brain cancer) was reported to be increasing among all age groups in the United States, while mortality was declining for persons younger than 65 years. We analyzed these data to provide updates on incidence and mortality trends for brain cancer in the United States and to examine these patterns in search of their causes. Methods: Data on incidence, overall and according to histology and anatomic site, and on relative survival were obtained from the Surveillance, Epidemiologyl and End Results (SEER) Program of the National Cancer Institute for 1975 through 1995, Mortality data were obtained from the National Center for Health Statistics. Medicare procedure claims from the National Cancer Institute's SEER-Medicare database were used for imaging trends. Statistically significant changes in incidence trends were identified, and annual percent changes mere computed for log linear models. Results/Conclusions: Rates stabilized for all age groups during the most recent period for which SEER data were available, except for the group containing individuals 85 years of age or older, Mortality trends continued to decline for the younger age groups, and the steep increases in mortality seen in the past for the elderly slowed substantially, Patterns differed by age group according to the site and grade of tumors between younger and older patients. During the last decade, use of computed tomography scans was relatively stable for those 65-74 years old but increased among those 85 years old or older. Implications: Improvements in diagnosis and changes in the diagnosis and treatment of elderly patients provide likely explanations for the observed patterns in brain cancer trends.