Levi Fabio, Lucchini Franca, Negri Eva, La Vecchia Carlo
Cancer Epidemiology Unit and Cancer Registries of Vaud and Neuchâtel, Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland.
Cancer. 2004 Dec 15;101(12):2843-50. doi: 10.1002/cncr.20666.
In May 2004, 10 additional countries joined the European Union (EU), including a total of 75 million inhabitants. Most of these were from central and eastern European countries with comparably high cancer mortality rates and with relatively unfavorable trends. Therefore, it is important to provide updated mortality data regarding major cancers in various countries and to analyze trends for the current population of the EU.
The authors considered mortality rates (directly standardized to the world standard population) for all cancers and for 8 major cancer sites in the year 2000 in the 25 countries of the EU and analyzed corresponding trends since 1980 using data derived from the World Health Organization data base.
For men, overall cancer mortality in the year 2000 varied by a factor > 2 between the highest rate of 258.5 per 100,000 men in Hungary and the lowest rate of 122.0 per 100,000 men in Sweden. Central and Eastern European accession countries had the highest rates not only for lung and other tobacco-related cancers but also for gastrointestinal cancers and leukemias. The geographic pattern was different and the range of variation was smaller for women, i.e., between 136.7 per 100,000 women in Denmark and 76.4 per 100,000 women in Spain in the year 2000. In the EU as a whole, lung cancer mortality in men peaked at 55.4 per 100,000 men in 1988 and declined thereafter to 46.7 per 100,000 men in 2000. Gastric cancer steadily declined from 19.7 per 100,000 men in 1980 to 10.1 per 100,000 men in 2000. Other major sites showed moderately favorable trends over the last few years. In women, breast cancer peaked at 21.7 per 100,000 in 1989 and declined to 18.9 per 100,000 in 2000. Mortality from gastric, (cervix) uterus, and intestinal cancers demonstrated steady decreases, but lung cancer increased from 7.7 per 100,000 women in 1980 to 11.1 per 100,000 women in 2000. The increase in lung cancer mortality in women age < 55 years was 38% between 1990 and 2000 (from 2.16 per 100,000 women to 2.99 per 100,000 women), reflecting the spread of tobacco smoking among women in the EU over the last few decades.
The priority for further reduction of cancer mortality in the EU remains tobacco control together with more widespread availability of modern diagnostic and treatment procedures for neoplasms that are amenable to treatment.
2004年5月，又有10个国家加入欧盟（EU），新增总人口达7500万。其中大多数来自中欧和东欧国家，这些国家的癌症死亡率相对较高，且呈相对不利的趋势。因此，提供各国主要癌症的最新死亡率数据，并分析欧盟当前人口的趋势非常重要。
作者研究了欧盟25个国家2000年所有癌症以及8个主要癌症部位的死亡率（直接标准化为世界标准人口），并利用世界卫生组织数据库中的数据，分析了自1980年以来的相应趋势。
2000年，男性总体癌症死亡率在匈牙利每10万名男性中高达258.5例的最高值与瑞典每10万名男性中低至122.0例的最低值之间相差超过2倍。中东欧加入国不仅肺癌和其他与烟草相关癌症的死亡率最高，胃肠道癌症和白血病的死亡率也最高。女性的地理分布模式不同，变化范围较小，即2000年丹麦每10万名女性中有136.7例，西班牙每10万名女性中有76.4例。在整个欧盟，男性肺癌死亡率在1988年达到每10万名男性中55.4例的峰值，此后下降至2000年的每10万名男性中46.7例。胃癌死亡率从1980年的每10万名男性中19.7例稳步下降至2000年的每10万名男性中10.1例。其他主要部位在过去几年呈现出适度有利的趋势。女性方面，乳腺癌死亡率在1989年达到每10万名女性中21.7例的峰值，并在2000年降至每10万名女性中18.9例。胃癌、子宫癌和肠道癌的死亡率呈稳步下降趋势，但肺癌死亡率从1980年的每10万名女性中7.7例增至2000年的每10万名女性中11.1例。1990年至2000年，年龄小于55岁女性的肺癌死亡率上升了38%（从每10万名女性中2.16例增至每10万名女性中2.99例），这反映了过去几十年欧盟女性吸烟率的上升。
欧盟进一步降低癌症死亡率的首要任务仍然是控烟，同时更广泛地提供针对可治疗肿瘤的现代诊断和治疗手段。
