Age-Period-Cohort Analysis of Primary Bone Cancer Incidence Rates in the United States (1976-2005)
Age-Period-Cohort Analysis of Primary Bone Cancer Incidence Rates in the United States (1976-2005)
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DOI：
10.1158/1055-9965.epi-11-0136
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发表时间：
2011-08-01
影响因子：
3.8
通讯作者：
Grotmol, Tom
中科院分区：
文献类型：
--
作者：
Anfinsen, Kristin P.;Devesa, Susan S.;Grotmol, Tom
背景：原发性骨癌包括三种主要组织学类型：骨肉瘤(OS)、尤文肉瘤(ES)和软骨肉瘤(CS)。鉴于对原发性骨癌病因的了解有限，我们进行了年龄-时期-队列(APC)分析，以确定发病率是否因出生队列或日历时期而异。研究的目的是检验每种骨癌类型的时间发展，并通过观察到的出生队列相关变化来生成病因假说。方法：APC模型适用于美国白人OS、ES和CS的发病率数据，这些数据来自1976-2005年间美国监测、流行病学和最终结果项目的9个登记机构，覆盖了大约10%的美国人口。结果：1976年至2005年，60岁以上人群OS的发病率下降，这种下降仅发生在以OS为主要恶性肿瘤的患者中。从1986-1995年到1996-2005年，20岁至69岁女性的CS发病率上升了约50%，1935-1975年间出生的连续队列中的发病率也有所上升。男性中CS的发生率和ES的发生率都是稳定的。结论：OS作为老年原发恶性肿瘤的风险降低可能与随着时间的推移减少对寻骨放射性核素的暴露有关。女性CS的增加对应于出生队列中口服避孕药和更年期激素治疗的增加。影响：由于雌激素信号通路已被证明刺激正常和恶性软骨细胞的增殖，雌激素暴露可能增加CS的风险。有必要进行进一步的研究以阐明其可能的病因学意义。癌症流行病学生物标志物；20(8)；1770-7。(C)2011年AACR。
Background: Primary bone cancer comprises three major histologic types: osteosarcoma (OS), Ewing sarcoma (ES), and chondrosarcoma (CS). Given the limited knowledge about the etiology of primary bone cancer, we undertook an age-period-cohort (APC) analysis to determine whether incidence varied by birth cohort or calendar period. The purpose was to examine the temporal development of each bone cancer type and generate etiologic hypotheses via the observed birth cohort-related changes.Methods: An APC model was fitted to incidence data for U. S. whites for OS, ES, and CS obtained from nine registries of the Surveillance, Epidemiology, and End Results program, which covers about 10% of the U. S. population, 1976-2005.Results: The incidence of OS decreased between 1976 and 2005 among those aged over 60 years, a decline that occurred among patients with OS as their primary malignancy only. From 1986-1995 to 1996-2005, the incidence rate of CS among females of 20 to 69 years rose by about 50%, with rates increasing among consecutive cohorts born during 1935-1975. CS rates among males were stable, as were rates of ES.Conclusion: The risk reduction in OS as a primary malignancy at older ages could possibly be related to diminished exposure over time to bone-seeking radionuclides. The CS increase among females corresponds to birth cohorts with rising exposures to oral contraceptives and menopausal hormonal therapy.Impact: As the estrogen signaling pathway has been shown to stimulate proliferation of normal and malignant chondrocytes, estrogen exposure may increase the risk for CS. Further studies are warranted to clarify its possible etiological significance. Cancer Epidemiol Biomarkers Prev; 20(8); 1770-7. (C)2011 AACR.