欧洲食管癌发病率和死亡率的趋势。
Trends in oesophageal cancer incidence and mortality in Europe.
作者信息
Bosetti Cristina, Levi Fabio, Ferlay Jacques, Garavello Werner, Lucchini Franca, Bertuccio Paola, Negri Eva, La Vecchia Carlo
机构信息
Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa l9, Milan, Italy.
出版信息
Int J Cancer. 2008 Mar 1;122(5):1118-29. doi: 10.1002/ijc.23232.
To monitor recent trends in mortality from oesophageal cancer in 33 European countries, we analyzed the data provided by the World Health Organization over the last 2 decades, using also joinpoint regression. For selected European cancer registration areas, we also analyzed incidence rates for different histological types. For men in the European Union (EU), age-standardized (world population) mortality rates were stable around 6/100,000 between the early 1980s and the early 1990 s, and slightly declined in the last decade (5.4/100,000 in the early 2000s, annual percent change, APC = -1.1%). In several western European countries, male rates have started to level off or decline during the last decade (APC = -3.4% in France, and -3.0% in Italy). Also in Spain and the UK, which showed upward trends in the 1990 s, the rates tended to level off in most recent years. A levelling of rates was observed only more recently in countries of central and eastern Europe, which had had substantial rises up to the late 1990 s. Oesophageal cancer mortality rates remained comparatively low in European women, and overall EU female rates were stable around 1.1-1.2/100,000 over the last 2 decades (APC = -0.1%). In northern Europe a clear upward trend was observed in the incidence of oesophageal adenocarcinoma, and in Denmark and Scotland incidence of adenocarcinoma in men is now higher than that of squamous-cell carcinoma. Squamous-cell carcinoma remained the prevalent histological type in southern Europe. Changes in smoking habits and alcohol drinking for men, and perhaps nutrition, diet and physical activity for both sexes, can partly or largely explain these trends.
为监测33个欧洲国家食管癌死亡率的近期趋势,我们分析了世界卫生组织在过去20年提供的数据,并使用了Joinpoint回归分析。对于选定的欧洲癌症登记地区,我们还分析了不同组织学类型的发病率。在欧盟,20世纪80年代初至90年代初,男性年龄标准化(世界人口)死亡率稳定在6/10万左右,在过去十年中略有下降(21世纪初为5.4/10万,年变化百分比,APC=-1.1%)。在几个西欧国家,男性死亡率在过去十年中开始趋于平稳或下降(法国APC=-3.4%,意大利APC=-3.0%)。在西班牙和英国,20世纪90年代呈上升趋势,但近年来死亡率也趋于平稳。中欧和东欧国家直到20世纪90年代末死亡率一直在大幅上升,只是最近才趋于平稳。欧洲女性的食管癌死亡率相对较低,在过去20年中,欧盟女性总体死亡率稳定在1.1-1.2/10万左右(APC=-0.1%)。在北欧,食管腺癌的发病率呈明显上升趋势,在丹麦和苏格兰,男性腺癌的发病率现在高于鳞状细胞癌。鳞状细胞癌仍然是南欧最常见的组织学类型。男性吸烟和饮酒习惯的改变,以及男女营养、饮食和体育活动的改变,可能部分或很大程度上解释了这些趋势。