The global burden of urinary bladder cancer
The global burden of urinary bladder cancer
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DOI：
10.1080/03008880802285032
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发表时间：
2008-09-01
影响因子：
--
通讯作者：
Parkin, D. Maxwell
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文献类型：
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作者：
Parkin, D. Maxwell
关于膀胱癌发病率的统计数据特别难以解释，因为分类不断变化，同一个体中多种癌症的计数变化，最重要的是，不同数据集中的非侵入性癌症的变量。死亡率统计数据几乎肯定更具可比性，但作为疾病风险的间接估计数，需要进行一些谨慎的解释，因为不同人群之间以及随着时间的推移，生存率存在差异。据估计，膀胱癌是全世界第九大最常见的癌症原因（2002年有357 000例），也是第13大最多的癌症死亡原因（145 000例死亡）。男性的发病率是女性的三至四倍。在许多南欧和东欧国家、非洲和中东部分地区以及北美，发病率很高。估计死亡率最高的是埃及，其死亡率是欧洲最高死亡率的三倍多，是美国的八倍。在美国，白人的发病率高于黑人。一般来说，在西方国家，发病率一直在上升，但在许多国家，这种增长已经放缓或停止。死亡率在大多数情况下正在下降。发展中国家的趋势变化较大。在某种程度上，地理和时间趋势与已知风险因素的流行有关，特别是接触烟草（造成近三分之一的膀胱癌死亡），以及在某些特定地区，血吸虫病。
Statistics on the incidence of bladder cancer are particularly hard to interpret, because of changing classification, variations in counting of multiple cancers in the same individual and, most importantly, the variable inclusion of non-invasive cancers in different data sets. Mortality statistics are almost certainly more comparable, but as indirect estimators of disease risk, require some cautious interpretation, because of differing survival between populations, and over time. Cancer of the bladder is estimated to be the ninth most common cause of cancer worldwide (357 000 cases in 2002) and the 13th most numerous cause of death from cancer (145 000 deaths). Rates in males are three to four times those in females. Incidence rates are high in many southern and eastern European countries, in parts of Africa and the Middle East, and in North America. The highest estimated mortality is in Egypt, where rates are more than three times greater than the highest rates in Europe and eight times those in the USA. In the USA, the incidence in whites is higher than in blacks. In general, in Western countries, incidence rates have been rising, but the increase has slowed or stopped in many. Mortality rates are, for the most part, decreasing. Trends are more variable in developing countries. To some extent, the geography and time trends are related to prevalence of known risk factors, especially exposure to tobacco (responsible for almost one-third of bladder cancer deaths) and, in some specific areas, schistosomiasis.