Micheli A, Verdecchia A, Capocaccia R, De Angelis G, Gatta G, Sant M, Valente F, Berrino F
Divisione di Epidemiologia, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Tumori. 1992 Feb 29;78(1):13-21. doi: 10.1177/030089169207800104.
Female breast cancer incidence and prevalence in Italy have been estimated by region and vast areas from population-based survival data of breast cancer patients and 1970-1987 specific mortality data using a mathematical model. Italian age-standardized incidence rates (ASR) for 1987 range from 70 to 90 per 100,000 women-year in the Northern regions, 55 to 73 in the Center, and 45 to 72 in the South. Overall, the ASR is about 80 in the North, 70 in the Center and 60 in the South. In the absence of competitive mortality, breast cancer cumulative risk in the 0-74 years life span is about 7 women out of 100 in the North, 6 in the Center and 5 in the South. The decreasing risk pattern from North to Center then South appears less evident when under 45 age-specific rates are considered. Very high levels for young age-groups are present both in the North (Liguria and Emilia Romagna) and South (Sardinia and Apulia). The incidence pattern by age differs from region to region and over the considered period, suggesting that a birth-cohort effect is crossing the whole country. Using to model, it can be estimated that the risk by cohort increases from the generations born at the beginning of the century to those born in the 40s, after which, for subsequent generations, it has been decreasing in all the considered areas and is similar in the North and South. We can infer that for the whole country the incidence will increase up to the years 2000-2010 when those birth-cohorts at higher risk will also be at higher risk for age. In 1987, about 250,000 Italian women had a present or past history of breast cancer: for the 1970-1987 period, prevalence has increased by approximately 5,500 cases per year.
利用数学模型，基于乳腺癌患者的人群生存数据以及1970 - 1987年的特定死亡率数据，按地区和大片区域估算了意大利女性乳腺癌的发病率和患病率。1987年意大利北部地区的年龄标准化发病率（ASR）为每10万名女性年70至90例，中部为55至73例，南部为45至72例。总体而言，北部的ASR约为80，中部为70，南部为60。在不存在竞争性死亡的情况下，0至74岁寿命期内乳腺癌的累积风险在北部约为每100名女性中有7例，中部为6例，南部为5例。当考虑45岁以下的年龄别发病率时，从北到中再到南的风险递减模式似乎不太明显。北部（利古里亚和艾米利亚 - 罗马涅）和南部（撒丁岛和普利亚）的年轻年龄组发病率都非常高。年龄别发病率模式因地区而异，且在所考虑的时期内也有所不同，这表明出生队列效应正在贯穿整个国家。通过建模可以估计，队列风险从世纪初出生的几代人到40年代出生的几代人有所增加，此后，对于随后几代人，在所有考虑的地区风险都在下降，且南北相似。我们可以推断，对于整个国家来说，发病率将持续上升至2000 - 2010年，届时那些高风险出生队列在该年龄段也将处于更高风险。1987年，约25万意大利女性有乳腺癌现患或既往史：在1970 - 1987年期间，患病率每年约增加5500例。
