Mäkitaro R, Pääkkö P, Huhti E, Bloigu R, Kinnula V L
Dept of Internal Medicine, University of Oulu, Oulu University Hospital, Finland.
Eur Respir J. 1999 Feb;13(2):436-40. doi: 10.1183/09031936.99.13243699.
A prospective epidemiological study was conducted to assess the incidence, diagnosis, histology and surgical treatment of lung cancer in northern Finland. The results were compared with those obtained in a similar survey 20 yrs earlier. Most of the patients with a suspected lung tumour were interviewed (72%) and the information was combined with that obtained from the national cancer registry. All pathological specimens were re-evaluated by a pathologist. A total of 602 new lung cancer cases (85% male, 15% female) were diagnosed during the years 1990-1992, the annual incidence per 100,000 being 63 for males and 9.5 for females. The number not reported to the Finnish Cancer Registry was low (<1%). Lung cancer was confirmed histologically in 381 cases (63%) and in addition cytologically in 135 cases (23%). Squamous cell carcinoma was the most common histological type (40%), the proportion of adenocarcinoma being 26%, small cell carcinoma 24% and large cell carcinoma 4%. The incidence of lung cancer had decreased significantly among males (from 87 to 63 per 100,000) compared with 20 yrs earlier but had increased among females (from 4.1 to 9.5), chiefly on account of adenocarcinoma. The findings of this prospective study show an increase in the incidence of lung adenocarcinoma among females, a histological type which is less closely related to smoking than the other cancers. This suggests that other risk factors may play an increasing role in the aetiology of lung cancer.
在芬兰北部开展了一项前瞻性流行病学研究，以评估肺癌的发病率、诊断、组织学及外科治疗情况。将结果与20年前类似调查的结果进行了比较。对大多数疑似肺部肿瘤患者进行了访谈（72%），并将这些信息与从国家癌症登记处获得的信息相结合。所有病理标本均由病理学家重新评估。1990 - 1992年期间共诊断出602例新肺癌病例（男性占85%，女性占15%），男性每10万人年发病率为63，女性为9.5。未向芬兰癌症登记处报告的病例数很低（<1%）。381例（63%）经组织学确诊为肺癌，另外135例（23%）经细胞学确诊。鳞状细胞癌是最常见的组织学类型（40%），腺癌占26%，小细胞癌占24%，大细胞癌占4%。与20年前相比，男性肺癌发病率显著下降（从每10万人87例降至63例），但女性发病率有所上升（从4.1例升至9.5例），主要是由于腺癌。这项前瞻性研究结果显示女性肺腺癌发病率上升，这种组织学类型与吸烟的关联不如其他癌症紧密。这表明其他危险因素可能在肺癌病因中发挥越来越大的作用。
