Garfinkel L, Mushinski M
American Cancer Society, USA.
Stat Bull Metrop Insur Co. 1999 Jul-Sep;80(3):23-32.
Earlier predictions of morbidity and mortality improvements for the four leading sites of cancer are beginning to occur. After decades of increases, incidence and mortality rates for all cancers combined have declined since 1992. Between 1990 and 1996 the age-adjusted death rates for all cancers had dropped 3.7 percent to 166.9 per 100,000 and incidence rates had decreased 2.8 percent to 388.6. The overall decreases were greater among men than women; male mortality rates dropped 6.2 percent and incidence dropped 5.2 percent for men versus 1.8 and 1.9 percent, respectively, for women. Lung cancer incidence among men continued its more than 10-year decline in age-adjusted rates and mortality rates dropped for a fifth consecutive year to 68.2 per 100,000 population. Among women, lung cancer incidence rates began to plateau in the mid-1990s similar to the pattern experienced by men a decade earlier. The rates of prostate cancer have begun to decrease but remain 65 to 75 percent higher among black men than white. Mortality rates dropped 9.5 percent among white men but only 2.0 percent among blacks since 1990. By 1996 even breast cancer death rates were declining ahead of the predicted decrease by the end of the century. Mortality rates for all women combined was 24.3 per 100,000 population, 24.0 for white women and 30.8 for blacks, 11.3, 12.1 and 2.5 percent, respectively lower than in 1990. The previously noted decreases in colorectal cancer mortality and incidence continue with age-adjusted rates dropping to 16.8 and 42.7 per 100,000 population, respectively, in 1996.
对四种主要癌症发病和死亡情况改善的早期预测开始成为现实。在经历了数十年的上升之后，自1992年起，所有癌症的发病率和死亡率总和均出现下降。1990年至1996年间，所有癌症的年龄调整死亡率下降了3.7%，降至每10万人166.9例，发病率下降了2.8%，降至每10万人388.6例。总体下降幅度男性大于女性；男性死亡率下降了6.2%，发病率下降了5.2%，而女性死亡率和发病率分别下降了1.8%和1.9%。男性肺癌的年龄调整发病率持续下降超过10年，死亡率连续第五年下降，降至每10万人68.2例。在女性中，肺癌发病率在20世纪90年代中期开始趋于平稳，类似于男性十年前的情况。前列腺癌发病率已开始下降，但黑人男性的发病率仍比白人高65%至75%。自1990年以来，白人男性的死亡率下降了9.5%，而黑人仅下降了2.0%。到1996年，甚至乳腺癌死亡率也提前于世纪末的预测开始下降。所有女性的死亡率为每10万人24.3例，白人女性为24.0例，黑人女性为30.8例，分别比1990年低11.3%、12.1%和2.5%。之前提到的结直肠癌死亡率和发病率的下降仍在继续，1996年年龄调整发病率分别降至每10万人16.8例和42.7例。
