Inskip Peter D
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892, USA.
Cancer. 2003 Aug 1;98(3):562-70. doi: 10.1002/cncr.11554.
This study was undertaken to determine whether cancer of the brain and central nervous system (CNS) occurs together with other types of cancer more often or less often than would be expected due to chance.
The study was based on data collected by the Surveillance, Epidemiology, and End Results (SEER) Program for cancers diagnosed in the U.S. between 1973 and 1998. The standardized incidence ratio (SIR) for new malignancies was estimated as the number of patients diagnosed with a particular type of cancer (observed), divided by the number of diagnoses expected based on person-years of follow-up and incidence rates for SEER cancer registries.
Among patients who were diagnosed first with cancer of the brain or CNS, statistically significant excesses were observed for cancers of bone (SIR = 14.4), soft tissue (SIR = 4.6), brain and CNS (SIR = 5.9), salivary gland (SIR = 5.1), and thyroid gland (SIR = 2.7) in addition to acute myelocytic leukemia (SIR = 4.1) and melanoma of the skin (SIR = 1.7). Excess risk of new malignancies was markedly greater after first cancers of the brain or CNS diagnosed in childhood compared with similar diagnoses in adulthood. In reverse associations, significant excesses of cancer of the brain and CNS were observed only after diagnoses of acute lymphocytic leukemia (SIR = 7.4) and cancer of the testis (SIR = 1.8) or the thyroid gland (SIR = 1.7).
Cancer treatment appears to have been the major factor underlying most of the positive associations between brain cancer and primary cancers of other types, with a probable lesser contribution from shared genetic susceptibility. Results provide little or no evidence that brain cancer shares important etiologic factors with the common cancers of adulthood.
本研究旨在确定脑和中枢神经系统（CNS）癌症与其他类型癌症同时发生的频率是否高于或低于随机预期。
该研究基于监测、流行病学和最终结果（SEER）计划收集的数据，这些数据来自1973年至1998年在美国诊断出的癌症。新恶性肿瘤的标准化发病率（SIR）估计为诊断出特定类型癌症的患者数量（观察值）除以根据随访人年数和SEER癌症登记处的发病率预期的诊断数量。
在首先被诊断为脑或CNS癌症的患者中，除急性髓细胞白血病（SIR = 4.1）和皮肤黑色素瘤（SIR = 1.7）外，还观察到骨癌（SIR = 14.4）、软组织癌（SIR = 4.6）、脑和CNS癌（SIR = 5.9）、唾液腺癌（SIR = 5.1）和甲状腺癌（SIR = 2.7）的统计学显著超额。与成年期的类似诊断相比，儿童期首次诊断为脑或CNS癌症后新恶性肿瘤的超额风险明显更高。在反向关联中，仅在诊断为急性淋巴细胞白血病（SIR = 7.4）、睾丸癌（SIR = 1.8）或甲状腺癌（SIR = 1.7）后观察到脑和CNS癌的显著超额。
癌症治疗似乎是脑癌与其他类型原发性癌症之间大多数正相关关系的主要潜在因素，共同遗传易感性的贡献可能较小。结果几乎没有或没有提供证据表明脑癌与成年期常见癌症共享重要的病因学因素。
