Powell J, McConkey C C
Department of Public Health and Epidemiology, University of Birmingham, UK.
Eur J Cancer Prev. 1992 Apr;1(3):265-9. doi: 10.1097/00008469-199204000-00008.
The incidence of cancer of the oesophagus and stomach in the West Midlands region of England have been analysed for the 25 years 1962-86. Overall, cancer of the oesophagus is increasing (from 3.45 per 100,000 in 1962-66 to 4.37 in 1982-86) and stomach cancer is decreasing (19.22 and 16.54 respectively). However, when analysed by histological type and subsite the picture is very different. In oesophagus, squamous cell carcinoma shows only a slight increase whereas for adenocarcinoma the increase is highly significant (from 0.14 to 0.76). In stomach, cardia shows a very similar pattern to adenocarcinoma of oesophagus (increasing from 0.75 to 2.96) but pyloric antrum is decreasing (from 2.63 to 2.32). The rapid changes in investigative procedures over the period have resulted in increasing numbers with histological confirmation and subsite specification but despite these confounding factors, comparative analyses still indicate a real increase in adenocarcinoma of oesophagus and cardia. Although the incidence of both are greater in men than in women, the proportional rates of increase, particularly for cardia, are very similar in both sexes, indicating a common aetiological factor or factors. Analysis by social-economic group reveals that the increases observed are not uniform throughout the population but are relatively higher in professional classes (1 and 2).
对1962年至1986年这25年间英国西米德兰兹地区食管癌和胃癌的发病率进行了分析。总体而言，食管癌发病率在上升（从1962 - 1966年的每10万人3.45例增至1982 - 1986年的4.37例），而胃癌发病率在下降（分别为19.22例和16.54例）。然而，按组织学类型和亚部位分析时，情况则大不相同。在食管癌中，鳞状细胞癌仅略有上升，而腺癌的上升则极为显著（从0.14例增至0.76例）。在胃癌中，贲门部的变化模式与食管癌的腺癌非常相似（从0.75例增至2.96例），但幽门窦发病率在下降（从2.63例降至2.32例）。在此期间，调查程序的快速变化导致经组织学确诊和亚部位明确的病例数增加，尽管存在这些混杂因素，但比较分析仍表明食管癌和贲门腺癌的发病率确实在上升。虽然两者发病率男性均高于女性，但特别是贲门癌，两性的上升比例非常相似，表明存在一个或多个共同的病因因素。按社会经济群体分析显示，观察到的发病率上升在整个人口中并不均匀，在专业阶层（1级和2级）中相对较高。
