Fitzsimmons D, Osmond C, George S, Johnson C D
School of Health Science, University of Wales-Swansea, Swansea, UK.
Br J Surg. 2007 Sep;94(9):1162-71. doi: 10.1002/bjs.5751.
The aim of this study was to describe period and cohort effects in incidence and mortality of stomach and pancreatic cancer in England and Wales.
National figures for mortality (1951-2000) and incidence (1971-2000) were analysed using log-linear Poisson regression models to obtain relative risks (RR) for period (year of incidence or death) and cohort (year of birth).
Stomach cancer shows a pronounced cohort effect in mortality with a decline in RR in men from 2.20 (1876) to 0.47 (1946) and a reduction from 2.79 to 0.41 for women. Mortality to incidence ratios are now less than 0.70. Pancreatic cancer mortality (men) RR rose from 0.91 (1951-1955) to a peak 1.11 (1976-1980) and then declined to 0.90 (1996-2000). Women showed a similar pattern. Cohort RR (men) increased to a peak of 1.14 in 1916 and declined to 1.01 in 1946, and continued to fall; the peak occurred slightly later in women. Mortality to incidence ratios were near 1 in the first 20 years, declining to 0.95 in the last 10 years.
Stomach cancer incidence has fallen continuously from 19(th) century birth cohorts onwards. Incidence of pancreatic cancer has fallen in successive birth cohorts after 1920; peak period risk was 1976-1990. Age-standardized mortality and case mortality for pancreatic cancer are declining.
本研究旨在描述英格兰和威尔士胃癌及胰腺癌发病率和死亡率的时期效应与队列效应。
利用对数线性泊松回归模型分析了1951年至2000年的全国死亡率数据以及1971年至2000年的发病率数据，以获得时期（发病或死亡年份）和队列（出生年份）的相对风险（RR）。
胃癌在死亡率方面显示出显著的队列效应，男性的RR从2.20（1876年出生队列）降至0.47（1946年出生队列），女性从2.79降至0.41。死亡率与发病率之比目前低于0.70。胰腺癌死亡率（男性）的RR从0.91（1951 - 1955年）升至峰值1.11（1976 - 1980年），随后降至0.90（1996 - 2000年）。女性呈现类似模式。队列RR（男性）在1916年升至峰值1.14，1946年降至1.01，并持续下降；女性的峰值出现时间稍晚。死亡率与发病率之比在前20年接近1，在最后10年降至0.95。
自19世纪出生队列起，胃癌发病率持续下降。1920年后出生队列的胰腺癌发病率下降；高峰期风险为1976 - 1990年。胰腺癌的年龄标准化死亡率和病例死亡率正在下降。
