Age-Period-Cohort Analysis of Thyroid Cancer Incidence in Korea.
Age-Period-Cohort Analysis of Thyroid Cancer Incidence in Korea.
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DOI：
10.4143/crt.2014.110
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发表时间：
2015-07
影响因子：
4.6
通讯作者：
Lee JS
中科院分区：
文献类型：
--
作者：
Oh CM;Jung KW;Won YJ;Shin A;Kong HJ;Lee JS
韩国是世界上甲状腺癌发病率最高的国家，而且发病率还在持续增加。本研究的目的是确定韩国甲状腺癌发病率的年龄-时期-队列效应。使用韩国国家癌症登记数据库，分析了1997年至2011年期间根据性别和组织学类型划分的甲状腺癌年龄标准化发病率和年百分比变化（APC）。根据性别，使用内在估计方法应用了半周期队列模型。从1997年到2011年，男性和女性的甲状腺癌发病率急剧上升。在组织学类型中，乳头状癌增加最多，男性APC为25.1%（95%置信区间[CI]，22.7%至27.5%），女性为23.7%（95% CI，21.9%至25.5%），而未分化癌在两种性别中均未显示出显著增加。在所有出生队列中观察到甲状腺癌的总体发病率随时间推移而增加。一个年龄-时期-队列模型表明，时期效应急剧增加，从1997年到2011年，男性和女性的时期效应都显著增加。年龄效应呈倒U型趋势。从1952年到1977年，队列效应往往略有增加或保持不变，然后下降。周期效应可以解释甲状腺癌发病率的急剧增加，强烈提示甲状腺筛查的作用。
South Korea has the highest incidence rate of thyroid cancer in the world, and the incidence rate continues to increase. The aim of this study was to determine the age-period-cohort effects on the incidence of thyroid cancer in Korea. Using the Korean National Cancer registry database, age-standardized incidence rates and annual percent changes (APCs) in thyroid cancer according to sex and histologic type were analyzed between 1997 and 2011. Age-period-cohort models were applied using an intrinsic estimator method according to sex. In both men and women, the incidence of thyroid cancer showed a sharp increase from 1997 through 2011. Among the histologic types, papillary carcinoma showed the greatest increase, with APCs of 25.1% (95% confidence interval [CI], 22.7% to 27.5%) in men and 23.7% (95% CI, 21.9% to 25.5%) in women, whereas anaplastic carcinoma did not show a significant increase in either sex. An increase in overall thyroid cancer incidence over time was observed in all birth cohorts. An age-period-cohort model indicated a steeply increasing period effect, which increased prominently from 1997 to 2011 in both men and women. The age effect showed an inverted U-shaped trend. The cohort effect tended to show a slight increase or remain constant from 1952 to 1977, followed by a decrease. The period effect can explain the sharp increase in thyroid cancer incidence, strongly suggesting the role of thyroid screening.