1980年至2005年期间法国的癌症发病率和死亡率。

Cancer incidence and mortality in France over the period 1980-2005.

作者信息

Belot A, Grosclaude P, Bossard N, Jougla E, Benhamou E, Delafosse P, Guizard A-V, Molinié F, Danzon A, Bara S, Bouvier A-M, Trétarre B, Binder-Foucard F, Colonna M, Daubisse L, Hédelin G, Launoy G, Le Stang N, Maynadié M, Monnereau A, Troussard X, Faivre J, Collignon A, Janoray I, Arveux P, Buemi A, Raverdy N, Schvartz C, Bovet M, Chérié-Challine L, Estève J, Remontet L, Velten M

机构信息

Service de biostatistique, hospices civils de Lyon, centre hospitalier Lyon-Sud, 69424 Lyon, France; Université Lyon-I, 69622 Villeurbanne, France; UMR 5558, laboratoire biostatistique santé, CNRS, bâtiment 4D, 106, chemin du Grand Revoyet, 69495 Pierre-Bénite cedex, France; Département des maladies chroniques et des traumatismes, institut de veille sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice, France.

Registre des cancers du Tarn, France.

出版信息

Rev Epidemiol Sante Publique. 2008 Jun;56(3):159-175. doi: 10.1016/j.respe.2008.03.117. Epub 2008 Jun 10.

DOI:10.1016/j.respe.2008.03.117

PMID:18547762

Abstract

BACKGROUND

The objective of this study was to provide updated estimates of national trends in cancer incidence and mortality for France for 1980-2005.

METHODS

Twenty-five cancer sites were analysed. Incidence data over the 1975-2003 period were collected from 17 registries working at the department level, covering 16% of the French population. Mortality data for 1975-2004 were provided by the Inserm. National incidence estimates were based on the use of mortality as a correlate of incidence, mortality being available at both department and national levels. Observed incidence and mortality data were modelled using an age-cohort approach, including an interaction term. Short-term predictions from that model gave estimates of new cancer cases and cancer deaths in 2005 for France.

RESULTS

The number of new cancer cases in 2005 was approximately 320,000. This corresponds to an 89% increase since 1980. Demographic changes were responsible for almost half of that increase. The remainder was largely explained by increases in prostate cancer incidence in men and breast cancer incidence in women. The relative increase in the world age-standardised incidence rate was 39%. The number of deaths from cancer increased from 130,000 to 146,000. This 13% increase was much lower than anticipated on the basis of demographic changes (37%). The relative decrease in the age-standardised mortality rate was 22%. This decrease was steeper over the 2000-2005 period in both men and women. Alcohol-related cancer incidence and mortality continued to decrease in men. The increasing trend of lung cancer incidence and mortality among women continued; this cancer was the second cause of cancer death among women. Breast cancer incidence increased regularly, whereas mortality has decreased slowly since the end of the 1990s.

CONCLUSION

This study confirmed the divergence of cancer incidence and mortality trends in France over the 1980-2005 period. This divergence can be explained by the combined effects of a decrease in the incidence of the most aggressive cancers and an increase in the incidence of less aggressive cancers, partly due to changes in medical practices leading to earlier diagnoses.

摘要

背景

本研究的目的是提供1980 - 2005年法国癌症发病率和死亡率的全国趋势最新估计。

方法

分析了25个癌症部位。1975 - 2003年期间的发病率数据收集自17个部门级别的登记处，覆盖法国16%的人口。1975 - 2004年的死亡率数据由法国国家健康与医学研究院提供。全国发病率估计基于将死亡率作为发病率的关联指标，死亡率在部门和国家层面均可获取。使用年龄队列方法对观察到的发病率和死亡率数据进行建模，包括一个交互项。该模型的短期预测给出了2005年法国新癌症病例和癌症死亡人数的估计。

结果

2005年新癌症病例数约为320,000例。自1980年以来，这一数字增长了89%。人口结构变化几乎占了这一增长的一半。其余部分主要由男性前列腺癌发病率和女性乳腺癌发病率的上升所解释。全球年龄标准化发病率的相对增幅为39%。癌症死亡人数从130,000人增加到146,000人。这13%的增幅远低于基于人口结构变化预期的37%。年龄标准化死亡率的相对降幅为22%。在2000 - 2005年期间，男性和女性的这一降幅更为明显。男性中与酒精相关的癌症发病率和死亡率持续下降。女性肺癌发病率和死亡率的上升趋势仍在继续；这种癌症是女性癌症死亡的第二大原因。乳腺癌发病率持续上升，而自20世纪90年代末以来死亡率缓慢下降。