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癌症监测系列[已校正]:脑及其他中枢神经系统癌症:发病率和死亡率的近期趋势

Cancer surveillance series [corrected]: brain and other central nervous system cancers: recent trends in incidence and mortality.

作者信息

Legler J M, Ries L A, Smith M A, Warren J L, Heineman E F, Kaplan R S, Linet M S

机构信息

Cancer Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7344, USA.

出版信息

J Natl Cancer Inst. 1999 Aug 18;91(16):1382-90. doi: 10.1093/jnci/91.16.1382.

Abstract

BACKGROUND

During the 1980s, the incidence of primary malignant brain and other central nervous system tumors (hereafter called brain cancer) was reported to be increasing among all age groups in the United States, while mortality was declining for persons younger than 65 years. We analyzed these data to provide updates on incidence and mortality trends for brain cancer in the United States and to examine these patterns in search of their causes.

METHODS

Data on incidence, overall and according to histology and anatomic site, and on relative survival were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute for 1975 through 1995. Mortality data were obtained from the National Center for Health Statistics. Medicare procedure claims from the National Cancer Institute's SEER-Medicare database were used for imaging trends. Statistically significant changes in incidence trends were identified, and annual percent changes were computed for log linear models.

RESULTS/CONCLUSIONS: Rates stabilized for all age groups during the most recent period for which SEER data were available, except for the group containing individuals 85 years of age or older. Mortality trends continued to decline for the younger age groups, and the steep increases in mortality seen in the past for the elderly slowed substantially. Patterns differed by age group according to the site and grade of tumors between younger and older patients. During the last decade, use of computed tomography scans was relatively stable for those 65-74 years old but increased among those 85 years old or older.

IMPLICATIONS

Improvements in diagnosis and changes in the diagnosis and treatment of elderly patients provide likely explanations for the observed patterns in brain cancer trends.

摘要

背景

在20世纪80年代,据报道美国所有年龄组的原发性恶性脑肿瘤和其他中枢神经系统肿瘤(以下简称脑癌)发病率都在上升,而65岁以下人群的死亡率却在下降。我们分析了这些数据,以提供美国脑癌发病率和死亡率趋势的最新情况,并研究这些模式以探寻其原因。

方法

从美国国立癌症研究所的监测、流行病学和最终结果(SEER)计划中获取了1975年至1995年期间的发病率数据(包括总体发病率、按组织学和解剖部位分类的发病率)以及相对生存率数据。死亡率数据来自国家卫生统计中心。利用国家癌症研究所SEER - 医疗保险数据库中的医疗保险程序索赔数据来分析成像趋势。确定了发病率趋势的统计学显著变化,并计算了对数线性模型的年度百分比变化。

结果/结论:在可获得SEER数据的最近时期,除了85岁及以上年龄组外,所有年龄组的发病率都趋于稳定。较年轻年龄组的死亡率趋势继续下降,过去老年人中死亡率的急剧上升大幅放缓。年轻患者和老年患者之间,肿瘤的部位和分级导致年龄组之间的模式有所不同。在过去十年中,65 - 74岁人群的计算机断层扫描使用率相对稳定,但85岁及以上人群的使用率有所增加。

启示

诊断的改善以及老年患者诊断和治疗的变化可能是观察到的脑癌趋势模式的原因。

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