McGlynn Katherine A, Tarone Robert E, El-Serag Hashem B
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, EPS-7060, 6120 Executive Boulevard, Rockville, MD 20854-7234, USA.
Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1198-203. doi: 10.1158/1055-9965.EPI-05-0811.
The incidence rates of liver cancers, both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), are increasing in the U.S. It is possible that the increases are related to common exposures, and if so, similar trends in incidence by gender, age, ethnicity, and calendar period, might exist. To examine this hypothesis, age-specific trends in the incidence of HCC and ICC in the Surveillance, Epidemiology and End Results program (1976-2000) were examined by year of diagnosis and year of birth. Age-period-cohort models were also fit to the data. The incidence of HCC in the most recent time period was twice as high among Black men (8.8/100,000) and women (2.6/100,000) as among White men (4.6/100,000) and women (1.2/100,000). However, between 1976 and 2000, incidence among all four ethnic- and gender-specific groups increased by >90% (White males, 123.2%; White females, 96.8%; Black males, 97.9%; Black females, 91.9%) with young White men experiencing the greatest increases (432%). In contrast, ICC rates were similar for Black (0.93/100,000) and White men (0.92/100,000), but higher for White (0.57/100,000) than Black women (0.39/100,000). Although ICC incidence increased among all groups, the increase was greatest for Black men (138.5%), followed by White men (124.4%), White women (111.1%), and Black women (85.7%) Age-period-cohort analyses of HCC revealed a significant cohort effect among younger men (45-65 years old), but not older men (65-84 years old), suggesting possible differences in etiology. In conclusion, the rates of HCC and ICC approximately doubled between 1976 and 2000. Trends by age, gender, ethnicity, and birth cohort suggest that heterogeneity exists in the factors influencing these rates.
在美国，肝癌（包括肝细胞癌和肝内胆管癌）的发病率正在上升。发病率的上升可能与常见暴露因素有关，如果是这样，按性别、年龄、种族和日历时间划分的发病率可能存在相似趋势。为检验这一假设，利用监测、流行病学和最终结果计划（1976 - 2000年）中按诊断年份和出生年份划分的肝细胞癌和肝内胆管癌发病率的年龄特异性趋势进行了研究。年龄 - 时期 - 队列模型也适用于这些数据。在最近时间段内，黑人男性（8.8/10万）和女性（2.6/10万）的肝细胞癌发病率是白人男性（4.6/10万）和女性（1.2/10万）的两倍。然而，在1976年至2000年期间，所有四个种族和性别特定组的发病率均增加了90%以上（白人男性，123.2%；白人女性，96.8%；黑人男性，97.9%；黑人女性，91.9%），年轻白人男性的发病率增幅最大（432%）。相比之下，黑人男性（0.93/10万）和白人男性（0.92/10万）的肝内胆管癌发病率相似，但白人女性（0.57/10万）的发病率高于黑人女性（0.39/10万）。尽管所有组的肝内胆管癌发病率都有所上升，但黑人男性的增幅最大（138.5%），其次是白人男性（124.4%）、白人女性（111.1%）和黑人女性（85.7%）。肝细胞癌的年龄 - 时期 - 队列分析显示，年轻男性（45 - 65岁）存在显著的队列效应，而老年男性（65 - 84岁）则没有，这表明病因可能存在差异。总之，1976年至2000年期间，肝细胞癌和肝内胆管癌的发病率大约翻了一番。按年龄、性别、种族和出生队列划分的趋势表明，影响这些发病率的因素存在异质性。
