Levi Fabio, La Vecchia Carlo
Unité d'épidémiologie du cancer et Registre vaudois des tumeurs, Institut de médecine sociale et préventive (IUMSP), Centre hospitalier universitaire vaudois et Université de Lausanne, CHUV-Falaises 1, 1011 Lausanne, Suisse.
Bull Cancer. 2007 Sep;94(9):775-80.
Trends in cancer mortality in Switzerland over the period 1980-2001 and of incidence in the Swiss Canton of Vaud (640,000 inhabitants) over the period 1974-2003 are reviewed and discussed. Steady declines in cancer mortality were observed, over the last decade, particularly from the mid-1980's, with falls in overall mortality of 11% in men and 8% in women. The fall was of 20 % in male lung, whereas lung cancer has steadily increased in women by 47 %. Substantial declines were observed for stomach and colorectum in both sexes, (cervix) uteri and breast in women. Declines were also observed for leukaemias, Hodgkin's disease and testicular cancer, namely the neoplasms most influenced by therapeutic improvements, while trends in lymphomas and myeloma showed no clear pattern. With reference to incidence in the Vaud population between 1979 and 2003, all major tobacco-related neoplasms have declined by 19% in men aged 35 to 64, but increased by 69% in all age women. In both sexes, age-adjusted incidence of all non-tobacco-related cancers has substantially increased, mostly in younger-middle age (+ 70% in men, + 33% in women). Trends are discussed in the perspective of the European Commission's target of a 15% reduction in total cancer mortality between 2000 and 2015.
本文回顾并讨论了1980 - 2001年期间瑞士癌症死亡率的趋势,以及1974 - 2003年期间瑞士沃州(64万居民)癌症发病率的趋势。在过去十年中,尤其是从20世纪80年代中期开始,观察到癌症死亡率稳步下降,男性总体死亡率下降了11%,女性下降了8%。男性肺癌死亡率下降了20%,而女性肺癌发病率稳步上升了47%。两性的胃癌和结直肠癌、女性的子宫颈癌和乳腺癌死亡率都大幅下降。白血病、霍奇金病和睾丸癌的死亡率也有所下降,这些是受治疗改善影响最大的肿瘤,而淋巴瘤和骨髓瘤的趋势没有明显模式。关于1979年至2003年期间沃州人口的发病率,35至64岁男性中所有主要与烟草相关的肿瘤发病率下降了19%,但所有年龄段女性的发病率上升了69%。在两性中,所有与烟草无关的癌症的年龄调整发病率都大幅上升,主要发生在中青年(男性上升70%,女性上升33%)。本文从欧盟委员会设定的到2015年将癌症总死亡率降低15%的目标角度讨论了这些趋势。