Ko Yang-Ching, Wang Jui-Long, Wu Chao-Chien, Huang Wan-Ting, Lin Meng-Chih
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC.
Chang Gung Med J. 2005 Jun;28(6):387-95.
In Taiwan, lung cancer is the second most common cause of cancer death and its incidence has been rising for the last 50 years. Shifts in histological types and differences in gender distribution have also accompanied the changed incidence of lung malignancies.
A total of 590 lung cancer patients were interviewed at Kaohsiung Chang-Gung Memorial Hospital, a medical center of Southern Taiwan, in 1997 and 2002. A retrospective investigation confirmed the age-adjusted incident rate in the hospital and demographic variations by different histological types for both genders. The statistical differences were evaluated using the heterogeneity chi-squared test and Cox regression.
Results indicated that from 1997 to 2002, the age-adjusted rates of lung cancer decreased by 3.64% at the hospital. The largest percentage of increases in the age-adjusted rate was observed for small cell lung cancer (approximately 8.18%), whereas it decreased by 31.2% for squamous cell carcinoma and increased by 1.62% for adenocarcinoma. Female patients were found to be younger and had longer survival duration. The frequency was the highest for lesions in the upper lobe and patients had more advanced stage in all histological types. The 6-month relative survival rate between the two time-periods did not change appreciably.
The age-adjusted incidence rate of adenocarcinoma at the hospital has increased, as well as small cell lung carcinoma. During the study period, early-staging diagnosis and 6-months survival rate did not change appreciably for the different histological lung cancer patients, suggesting that therapeutic and diagnostic advances, prevention or screening procedures had mild effects in southern Taiwan. Further studies are needed for confirmation of our results.
在台湾,肺癌是癌症死亡的第二大常见原因,且在过去50年中其发病率一直在上升。组织学类型的转变以及性别分布的差异也伴随着肺恶性肿瘤发病率的变化。
1997年和2002年,在台湾南部的医疗中心高雄长庚纪念医院对总共590名肺癌患者进行了访谈。一项回顾性调查确定了该医院年龄调整后的发病率以及不同性别不同组织学类型的人口统计学差异。使用异质性卡方检验和Cox回归评估统计差异。
结果表明,从1997年到2002年,该医院年龄调整后的肺癌发病率下降了3.64%。年龄调整率增加百分比最大的是小细胞肺癌(约8.18%),而鳞状细胞癌下降了31.2%,腺癌增加了1.62%。发现女性患者年龄更小且生存时间更长。上叶病变的发生率最高,所有组织学类型的患者分期都更晚。两个时间段之间的6个月相对生存率没有明显变化。
该医院腺癌以及小细胞肺癌的年龄调整发病率有所上升。在研究期间,不同组织学类型的肺癌患者早期诊断和6个月生存率没有明显变化,这表明治疗和诊断的进展、预防或筛查程序在台湾南部的效果甚微。需要进一步研究来证实我们的结果。