Descriptive Studies and Record Linkage

一般描述性研究（00350）：自1980年代末以来，许多西方国家妇女的乳腺癌死亡率一直在下降。在70岁之前确诊的妇女在确诊的五年内死亡率下降，即使是转移性疾病也是如此。2010年诊断时的肿瘤大小平均比1985年以前小，但数据显示，诊断时每个阶段肿瘤大小的缩小只能解释70岁以下女性乳腺癌生存率改善的一小部分。然而，在70岁及以上被诊断为局部乳腺癌的女性中，肿瘤大小的变化约占改善的一半。预测显示，美国新发乳腺癌患者总数预计将增加50%，从2011年的28.3万例增加到2030年的44.1万例。70 ~ 84岁的新发病例比例预计将增加，而50 ~ 69岁的比例预计将从54.7%下降到43.6%。er阳性侵袭性癌症的比例预计将保持在62.6%，而er阴性癌症的比例预计将从16.8%下降到8.6%。相对而言，激素受体（HR）阴性乳腺癌在低风险国家和/或高危人群中更为常见。然而，这些不同人群之间的绝对差异并没有得到很好的确定。在国家癌症研究所监测、流行病学和最终结果18登记数据库（SEER 18）中，使用两个独特的基于人群的分子数据资源来比较马来西亚低风险亚洲人群和高风险非西班牙裔白人人群的乳腺癌亚型发病率。值得注意的是，在美国，所有亚型乳腺癌的绝对风险都更高。先前的报告也表明，女性乳腺癌在亚洲人群中的发病年龄比西方人群早。然而，大多数研究采用的是横断面分析，可能会受到日历期和/或出生队列效应的干扰。浸润性女性乳腺癌数据（1988 - 2009）来自中国、香港、韩国、台湾、新加坡和美国的癌症登记处。在所有亚洲国家和美国，纵向年龄特异性发病率成正比（或相似），发病率持续上升，直到80岁。对一些亚洲国家最近的队列的外推估计实际上显示，发病年龄比美国晚。事实上，最近几代亚洲人的乳腺癌发病率甚至超过了美国历史上的高发病率。据报道，在几种癌症类型中，黑人的诊断年龄比白人要小。然而，美国黑人人口比白人人口年轻，这可能会使年龄比较产生偏差，而这并不能说明一般人群的风险。非西班牙裔黑人和非西班牙裔白人分析了2010年的监测、流行病学和最终结果数据。黑人和白人在癌症诊断年龄上的差异很小。睾丸癌在北欧和北美国家的发病率已被广泛报道，而在其他人群，如东欧、中美洲/南美洲、亚洲和非洲，发病率的评估较少。对1973-2007年选定的全球人群的总体、组织学类型、日历时间和出生队列的睾丸癌发病率进行了评估。睾丸癌的发病率在1973-1977年和2003-2007年间在世界范围内大多数人群中有所增加。欧洲和美国人群中发病率上升的原因尚不清楚。睾丸生殖细胞肿瘤（TGCT）是美国15至44岁男性中最常见的癌症。TGCT的发病率在非西班牙裔白人男性中最高（6.97 / 100000人年），其次是美洲印第安人/阿拉斯加原住民（4.66），西班牙裔白人（4.11），亚洲/太平洋岛民（1.95）和黑人（1.20）。然而，尽管美国非西班牙裔白人男性的TGCT发病率仍然最高，但他们比其他男性处于更有利的疾病阶段，肿瘤也更小。食管癌是一种发生在食道粘膜内层的恶性肿瘤。它是世界上第八大最常见的癌症，因地理区域、种族和性别的显著差异而闻名。鳞状细胞癌和腺癌是食管癌的两种主要类型，它们的预后都很差，但具有不同的组织病理学和流行病学特征，包括：全球发病率、死亡率和生存模式；已知和怀疑的危险因素和保护因素；疾病的体征和症状；常见的诊断和治疗程序，以及公共卫生意义。虽然肛门鳞状细胞癌（SCC）和腺癌（ADC）通常在癌症监测中合并，但它们的病因可能不同。女性的SCC发病率（RR= 1.45; 95%CI 1.40-1.50）高于男性，而ADC （RR=0.68; 95%CI 0.62-0.74）和原位鳞状癌（CIS） （RR=0.36; 95%CI 0.34-0.38）的发病率低于男性。黑人的SCC发生率（RR=0.82; 95%CI 0.77-0.87）和CIS （RR=0.90; 95%CI 0.83-0.98）低于非西班牙裔白人，但ADC发生率较高（RR=1.48; 95%CI 1.29-1.70）。与肛门ADC相比，肛门SCC和CIS的发生率随着时间的推移而急剧增加，这与直肠SCC和ADC的趋势相似。总之，肛门SCC和ADC可能有不同的病因，但可能分别与直肠SCC和ADC有相似的病因。许多恶性肿瘤，包括多发性骨髓瘤及其前体，单克隆γ病的显著性，与血栓栓塞的风险升高有关。关于Waldenstrm巨球蛋白血症（WM）和淋巴浆细胞性淋巴瘤（LPL）患者血栓形成风险的信息有限。通过瑞典患者集中登记获得WM/LPL诊断后静脉和动脉血栓形成的信息，随访至2006年。WM/LPL患者静脉血栓形成的风险显著增加，在诊断后的第一年观察到最高的风险（HR = 4.0, 95% CI 2.5-6.4）。诊断后5年（HR = 2.3, 95% CI 1.7-3.0）和10年（HR = 2.0, 95% CI 1.6-2.5）风险显著升高。血栓预防在WM/LPL中的潜在作用，特别是在诊断后的第一年和使用致血栓药物治疗的患者，需要进行评估，以进一步改善WM/LPL患者的预后。多发性骨髓瘤（MM）是美国第二常见的血液恶性肿瘤。没有研究对美国未来MM发病率或负担按年龄组、种族/民族和性别进行详细预测。使用美国国家癌症研究所监测流行病学和最终结果计划（一种新的年龄-时期-队列预测模型）的1992-2011年癌症发病率数据，以及美国人口普查局的人口预测，构建了2011年至2034年的预测。尽管在2011 - 2034年期间，每10万人年的MM发病率将继续保持相当稳定，但由于人口结构的变化，每年新MM病例总数（负担）预计将在男性中增加65%，在女性中增加61%。几乎所有这些增长都将发生在64 - 84岁的美国老年人中。少数族裔病例的比例预计也会增加，男性从29%增至37%，女性从34%增至38%。

General descriptive studies (00350): Breast cancer mortality rates have been declining among women in many western countries since the late 1980s. Women diagnosed before age 70 have experienced declining death rates within five years of diagnosis, even for metastatic disease. Tumor size at diagnosis in 2010 is smaller on average than seen before 1985, but data show that smaller tumor size within each stage at diagnosis explains only a small proportion of the improvement in breast cancer survival in women under the age of 70. However, changes in tumor size account for about half of the improvements for women diagnosed with localized breast cancer at age 70 and older. Projections show that the total number of new breast cancers is expected to rise by 50% in the United States from 283 000 in 2011 to 441 000 in 2030. The proportion of all new case patients age 70 to 84 years is expected to increase while the proportion ages 50 to 69 years is expected to decrease from 54.7% to 43.6%. The proportion of ER-positive invasive cancers is expected to remain nearly the same at 62.6%, whereas the proportion of ER-negative cancers is expected to decrease from 16.8% to 8.6%. Hormone receptor (HR) negative breast cancers are relatively more common in low-risk than high-risk countries and/or populations. However, the absolute variations between these different populations are not well established. Two unique population-based resources with molecular data were used to compare incidence rates for breast cancer subtypes between a low-risk Asian population in Malaysia and high-risk non-Hispanic white population in the National Cancer Institutes surveillance, epidemiology, and end results 18 registries database (SEER 18). Notably, there was a greater absolute risk for all subtypes of breast cancer in United States. Previous reports also have suggested that female breast cancer is associated with earlier ages at onset among Asian than Western populations. However, most studies utilized cross-sectional analyses that may be confounded by calendar-period and/or birth cohort effects. Invasive female breast cancer data (19882009) were obtained from cancer registries in China, Hong Kong, South Korea, Taiwan, Singapore, and the United States. Longitudinal age-specific rates were proportional (or similar) among all Asian countries and the United States with incidence rates rising continuously until age 80 years. The extrapolated estimates for the most recent cohorts in some Asian countries actually showed later ages at onset than in the United States. Indeed, the Asian breast cancer rates in recent generations are even surpassing the historically high rates in the United States. Younger ages at diagnosis for blacks compared with whites have been reported for several cancer types. However, the US black population is younger than the white population, which may bias age comparisons that do not account for the general populations at risk. Non-Hispanic blacks and non-Hispanic whites were analyzed the Surveillance, Epidemiology, and End Results data for the year 2010. Most differences between blacks and whites in the age at cancer diagnosis were small. Incidence rates of testicular cancer in Northern European and North American countries have been widely reported, whereas rates in other populations, such as Eastern Europe, Central/South America, Asia, and Africa, have been less frequently evaluated. Testicular cancer incidences rates overall and by histologic type by calendar time and birth cohort for selected global populations 1973-2007 were assessed. Incidence rates of testicular cancer increased between 1973-1977 and 2003-2007 in most populations evaluated worldwide. Reasons for the rising incidence rates among European and American populations remain unexplained. Testicular germ cell tumors (TGCT) are the most commonly occurring cancers among men between the ages of 15 and 44 years in the United States (U.S.). The incidence of TGCT was highest among non-Hispanic white men (6.97 per 100,000 man-years) followed in declining order by rates among American Indian/Alaska Native (4.66), Hispanic white (4.11), Asian/Pacific Islander (1.95), and black men (1.20). However, while non-Hispanic white men in the U.S. continue to have the highest incidence of TGCT, they present at more favorable stages of disease and with smaller tumors than do other men. Esophageal cancer is a malignant tumor that develops in the inner layers of the mucosa (lining) of the esophagus. It is the 8th most common cancer worldwide and is known for its marked variation by geographic region, ethnicity and gender. The two main types of esophageal cancer, squamous cell carcinoma and adenocarcinoma, share a poor prognosis, but have distinct histopathological and epidemiologic profiles including: global incidence, mortality and survival patterns; known and suspected risk factors and protective factors; signs and symptoms of disease; common procedures for diagnosis and treatment, and public health significance. Although anal squamous cell carcinoma (SCC) and adenocarcinoma (ADC) are generally combined in cancer surveillance, their etiologies likely differ. Women have higher rates of SCC (rate ratio [RR]=1.45; 95%CI 1.40-1.50) and lower rates of ADC (RR=0.68; 95%CI 0.62-0.74) and squamous carcinoma in situ (CIS) (RR=0.36; 95%CI 0.34-0.38) than men. Blacks had lower rates of SCC (RR=0.82; 95%CI 0.77-0.87) and CIS (RR=0.90; 95%CI 0.83-0.98) than non-Hispanic whites, but higher rates of ADC (RR=1.48; 95%CI 1.29-1.70). Rates of anal SCC and CIS have increased strongly over time, in contrast to rates of anal ADC, similar to trends observed for rectal SCC and ADC. In sum, anal SCC and ADC likely have different etiologies, but may have similar etiologies to rectal SCC and ADC, respectively. Many malignancies, including multiple myeloma and its precursor, monoclonal gammopathy of unknown significant, are associated with an elevated risk of thromboembolism. There is limited information on the risk of thrombosis in patients with Waldenstrm macroglobulinemia (WM) and lymphoplasmacytic lymphoma (LPL). Information on occurrence of venous and arterial thrombosis after the diagnosis of WM/LPL was obtained through the centralized Swedish Patient Register, with follow-up to 2006. Patients with WM/LPL had a significantly increased risk of venous thrombosis and the highest risk was observed during the first year following diagnosis (HR = 4.0, 95% CI 2.5-6.4). The risk was significantly elevated 5 (HR = 2.3, 95% CI 1.7-3.0) and 10 years after diagnosis (HR = 2.0, 95% CI 1.6-2.5). The potential role of thromboprophylaxis in WM/LPL, especially during the first year after diagnosis and in patients treated with thrombogenic agents, needs to be assessed to further improve outcome in WM/LPL patients. Multiple myeloma (MM) is the second most common hematological malignancy in the United States (US). No study has made detailed forecasts of future MM incidence or burden in the US by age group, race/ethnicity, and sex. Forecasts were constructed for 2011 through 2034 using 1992-2011 cancer incidence data from the National Cancer Institutes Surveillance Epidemiology and End Results Program, a novel age-period-cohort forecasting model, and population projections from the US Census Bureau. Though the MM incidence per 100,000 person-years will continue to be quite stable during 2011 2034, because of demographic changes, the total number of new MM cases per year (burden) is expected to increase by 65% in men and 61% in women. Almost all of these increases will occur among older Americans ages 64 84 years. The percentage of minority cases is also expected to increase, from 29% to 37% among men and from 34% to 38% among women.