O'Lorcain Piaras, Walsh Paul M, Comber Harry
National Cancer Registry, Cork, Ireland.
Eur J Cancer Prev. 2007 Jun;16(3):167-77. doi: 10.1097/01.cej.0000228408.68353.ba.
Premature cancer mortality trends were examined by reviewing cumulative mortality risk ('cumulative risk' hereafter) and potential years of life lost (PYLL) up to and including 64 years of age between 1953 and 2002 in Ireland. Trends were assessed quantitatively by Joinpoint analysis of both measures (with PYLL expressed as an age-standardized rate). The age of 64 years was used for these summary measures to reflect the focus of the Irish Government's cancer strategy on cancer in the under-65 population. Some differences emerged when ranking the significant types of cancer using cumulative risk and PYLL values. In general, however, the two methods generated similar overall trends, although PYLL rates tended to show steeper or longer-term declines, presumably reflecting the greater weight given to deaths at younger ages. Most cancers have, in recent years, shown a downward, or levelling-off of, trend for both sexes. The only exceptions were significant increases for oesophageal cancer in men (both measures), and prostate cancer (cumulative risk), cervical cancer (PYLL rate) and lymphoma in both sexes (cumulative risk). Rankings based on both cumulative risk and PYLL showed that male lung cancer is still the leading cause of premature death from cancer in Ireland, despite recent falls in mortality rates. Breast cancer has consistently been the leading cause of premature cancer death in women since the 1950s. Stomach cancer was once the second leading cause of premature cancer death in women, but since the 1960s it has been replaced by lung cancer. Ovarian cancer, having had a middle ranking for many years has, since the early 1990s, become the third leading cause of premature cancer death for women.
通过回顾1953年至2002年爱尔兰64岁及以下（包括64岁）人群的累积死亡风险（以下简称“累积风险”）和潜在寿命损失年数（PYLL），研究了过早癌症死亡率趋势。通过对这两项指标进行Joinpoint分析（PYLL以年龄标准化率表示）对趋势进行定量评估。采用64岁这一年龄来进行这些汇总指标的分析，以反映爱尔兰政府癌症战略对65岁以下人群癌症问题的关注。在使用累积风险和PYLL值对主要癌症类型进行排名时出现了一些差异。然而，总体而言，这两种方法产生的总体趋势相似，尽管PYLL率往往显示出更陡峭或更长期的下降，这可能反映了对年轻时死亡给予了更大权重。近年来，大多数癌症在男女两性中均呈现下降或趋于平稳的趋势。唯一的例外是男性食管癌（两项指标）、前列腺癌（累积风险）、女性宫颈癌（PYLL率）以及男女两性淋巴瘤（累积风险）出现显著增加。基于累积风险和PYLL的排名显示，尽管近期死亡率有所下降，但男性肺癌仍是爱尔兰过早癌症死亡的主要原因。自20世纪50年代以来，乳腺癌一直是女性过早癌症死亡的主要原因。胃癌曾是女性过早癌症死亡的第二大原因，但自20世纪60年代以来已被肺癌取代。卵巢癌多年来排名居中，自20世纪90年代初以来，已成为女性过早癌症死亡的第三大原因。
