Luke Colin, Price Timothy, Karapetis Christos, Singhal Nimit, Roder David
Epidemiology Branch, South Australian Department of Health, Adelaide, South Australia.
Asian Pac J Cancer Prev. 2009 Jul-Sep;10(3):369-74.
South Australian registry data were used to explore age-standardised incidence and mortality rates and case survivals for pancreatic cancer during 1977 to 2006. Disease-specific survivals were investigated using Kaplan-Meier estimates and Cox proportional hazards regression. While annual incidence and mortality rates were relatively stable among males during 1983-2006, they were 14% and 17% lower respectively than for the 1977-82 baseline. A converse non-significant secular trend was suggested in females, in that incidence in 1989-2006 was 10% higher than in 1977-88, with a corresponding 9% increase in mortality. As a result, male to female incidence rate ratios decreased from 1.73:1 in 1977-82 to about 1.34:1 in 2001-06. One-year survival was 18.0% but this figure decreased to 3.6% at five years. Higher survivals were evident for more recent diagnostic periods, with one-year survival increasing from 14.3% in 1977-88 to 23.9% in 2001-06. Multivariable proportional hazards regression indicated that case fatality was higher in the older age groups and lower for neuroendocrine than other histology types, patients from high and mid-high than lower socio-economic areas, and for more recent diagnostic periods. The differences by diagnostic period, socio-economic status and histology type applied both to the age range less than 60 years and between 60 and 79 years, but were not evident in older patients. The divergent secular trends in incidence and mortality in males and females and associated decreases in male to female rate ratio are consistent with trends in the USA and likely reflect differences in historic tobacco smoking trends by sex. While survival at five years from diagnosis is still only about 5%, patients are living longer with more surviving one year or more, probably due to gains in treatment and potentially in diagnostic technology.
利用南澳大利亚登记处的数据，探究了1977年至2006年期间胰腺癌的年龄标准化发病率、死亡率和病例生存率。使用Kaplan-Meier估计值和Cox比例风险回归研究特定疾病的生存率。1983 - 2006年期间，男性的年发病率和死亡率相对稳定，但分别比1977 - 1982年基线低14%和17%。女性呈现出相反的无显著长期趋势，即1989 - 2006年的发病率比1977 - 1988年高10%，死亡率相应增加9%。因此，男女发病率之比从1977 - 1982年的1.73:1降至2001 - 2006年的约1.34:1。一年生存率为18.0%，但五年生存率降至3.6%。在更近的诊断时期，生存率更高，一年生存率从1977 - 1988年的14.3%增至2001 - 2006年的23.9%。多变量比例风险回归表明，老年组的病死率较高，神经内分泌型的病死率低于其他组织学类型，社会经济地位高和中高的患者低于低社会经济地区的患者，且更近诊断时期的病死率较高。诊断时期、社会经济地位和组织学类型的差异在60岁以下和60至79岁年龄组均适用，但在老年患者中不明显。男性和女性发病率和死亡率的不同长期趋势以及男女发病率比的相关下降与美国的趋势一致，可能反映了按性别划分的历史吸烟趋势差异。虽然诊断后五年生存率仍仅约为5%，但患者存活时间更长，更多患者存活一年或更长时间，这可能归因于治疗方面的进展以及潜在的诊断技术进步。
