Vizcaino A Paloma, Moreno Victor, Lambert Rene, Parkin D Maxwell
Unit of Descriptive Epidemiology, International Agency for Research on Cancer, Lyon, France.
Int J Cancer. 2002 Jun 20;99(6):860-8. doi: 10.1002/ijc.10427.
The purpose of our study was to examine the incidence patterns of 2 major histologic types of esophageal cancer, in selected countries world-wide and to identify components of birth cohort, period and age as determinants of observed time trends using regression modeling. The roles of temporal changes in specification of histology of tumors and of classification of cancers at the gastroesophageal junction as esophageal or gastric in origin were taken into consideration. In all, 56,426 esophageal cancer cases were included. The results indicate that the incidence rate of squamous cell carcinoma of the esophagus has been relatively stable in most of the countries analyzed, although increasing trends were observed in Denmark and the Netherlands (Eindhoven) among men and in Canada, Scotland and Switzerland among women. There was a significant increase in the incidence of esophageal adenocarcinomas in both sexes in the United States (among whites and blacks), Canada and South Australia and in 6 European countries (Scotland, Denmark, Iceland, Finland, Sweden and Norway). In France the increase was limited to men and in Switzerland the increase was observed only in women. Modeling was unable to distinguish which trends were the results of changes in risk between generations (as cohort effects), or changes in all age groups simultaneously (as a period effect).
我们研究的目的是在全球选定国家中考察两种主要组织学类型食管癌的发病模式，并使用回归模型确定出生队列、时期和年龄因素作为观察到的时间趋势的决定因素。我们还考虑了肿瘤组织学分类的时间变化以及胃食管交界部癌症归为食管或胃起源的分类变化所起的作用。总共纳入了56426例食管癌病例。结果表明，在所分析的大多数国家中，食管鳞状细胞癌的发病率相对稳定，不过在丹麦和荷兰（埃因霍温）男性中以及在加拿大、苏格兰和瑞士女性中观察到上升趋势。在美国（白人和黑人中）、加拿大和南澳大利亚以及6个欧洲国家（苏格兰、丹麦、冰岛、芬兰、瑞典和挪威），食管腺癌的发病率在两性中均显著上升。在法国，这种上升仅限于男性，而在瑞士，仅在女性中观察到上升。建模无法区分哪些趋势是代际间风险变化（作为队列效应）的结果，哪些是所有年龄组同时变化（作为时期效应）的结果。
