Yashin Anatoli I, Ukraintseva Svetlana V, Akushevich Igor V, Arbeev Konstantin G, Kulminski Alexander, Akushevich Lucy
Center for Population Health and Aging, Duke University, Durham, NC 27708-0408, USA.
Mech Ageing Dev. 2009 Jan-Feb;130(1-2):98-104. doi: 10.1016/j.mad.2008.03.006. Epub 2008 Mar 25.
The potential gain in life expectancy which could result from the complete elimination of mortality from cancer in the U.S. would not exceed 3 years if one were to consider cancer independently of other causes of death. In this paper, we review evidence of trade-offs between cancer and aging as well as between cancer and other diseases, which, if taken into account, may substantially increase estimates of gain in life expectancy resulting from cancer eradication. We also used the Multiple Causes of Death (MCD) data to evaluate correlations among mortalities from cancer and other major disorders including heart disease, stroke, diabetes, Alzheimer's, Parkinson's diseases, and asthma. Our analyses revealed significant negative correlations between cancer and other diseases suggesting stronger population effects of cancer eradication. Possible mechanisms of the observed dependencies and emerging perspectives of using dependent competing risks models for evaluating the effects of reduction of mortality from cancer on life expectancy are discussed.
如果仅考虑癌症死亡率而不考虑其他死因,那么在美国完全消除癌症死亡率可能带来的预期寿命潜在增长不会超过3年。在本文中,我们回顾了癌症与衰老之间以及癌症与其他疾病之间权衡取舍的证据,若将这些因素考虑在内,可能会大幅提高对根除癌症后预期寿命增长的估计。我们还使用了多死因(MCD)数据来评估癌症死亡率与其他主要疾病(包括心脏病、中风、糖尿病、阿尔茨海默病、帕金森病和哮喘)死亡率之间的相关性。我们的分析揭示了癌症与其他疾病之间存在显著的负相关,这表明根除癌症对人群有更强的影响。本文讨论了观察到的相关性的可能机制,以及使用相依竞争风险模型评估降低癌症死亡率对预期寿命影响的新观点。