Pou Sonia Alejandra, Osella Alberto Rubén, Eynard Aldo Renato, Diaz Maria del Pilar
Consejo Nacional de Investigaciones Cientificas y Tecnicas, Facultad de Matematica, Astronomia y Fisica, Universidad Nacional de Córdoba, Argentina.
Tumori. 2010 Mar-Apr;96(2):202-12. doi: 10.1177/030089161009600204.
Cancer is the second main cause of death in Argentina, surpassed only by cardiovascular disease. However, analytical approaches isolating some of the known effects, such as age at death, period of death and birth cohort, have never been performed in cancer mortality studies in Argentina. The aim of this study was to analyze cancer mortality trends in a representative region of the country, the Córdoba province (1986-2006).
Overall age-standardized (world population) mortality rates for cancer (all sites) were computed by a direct method. Joinpoint regression was fitted to the age-standardized mortality rates for both sexes to provide estimated and 95% confidence intervals of the annual percentage changes. The effects of age (15 age groups), period of death (1986-90, 1991-95, 1996-00 or 2001-06), and birth cohort (18 overlapping 10-year birth cohorts) covariates on mortality rates were estimated using a sequentially fitted Poisson regression model.
During the study period, 102,737 people died of cancer in Córdoba, with the age-standardized mortality rates decreasing from 139.3 to 118.7/100,000 person-years. Although this reduction was more noticeable in men, the joinpoint regression model showed a significant change of the age-standardized mortality rates after 1996 in both sexes. Age-period-cohort analysis suggested that the cancer mortality trends may be linked with a strong age effect and a moderate or mild period and cohort effect, related to sex and place of residence.
Based on the observed cohort effect, it may be argued that there has been a lower exposure level to some risk factors, such as diet and other environmental factors, in Cordoba over the last decades.
癌症是阿根廷第二大主要死因，仅次于心血管疾病。然而，在阿根廷的癌症死亡率研究中，从未采用过分离某些已知影响因素（如死亡年龄、死亡时期和出生队列）的分析方法。本研究的目的是分析该国一个代表性地区科尔多瓦省（1986 - 2006年）的癌症死亡率趋势。
采用直接法计算所有部位癌症的总体年龄标准化（世界人口）死亡率。对男女的年龄标准化死亡率进行连接点回归分析，以提供年度百分比变化的估计值和95%置信区间。使用逐步拟合的泊松回归模型估计年龄（15个年龄组）、死亡时期（1986 - 90年、1991 - 95年、1996 - 00年或2001 - 06年）和出生队列（18个重叠的10年出生队列）协变量对死亡率的影响。
在研究期间，科尔多瓦省有102,737人死于癌症，年龄标准化死亡率从139.3降至118.7/100,000人年。尽管这种下降在男性中更为明显，但连接点回归模型显示，1996年后男女的年龄标准化死亡率均有显著变化。年龄 - 时期 - 队列分析表明，癌症死亡率趋势可能与强烈的年龄效应以及与性别和居住地点相关的中度或轻度时期和队列效应有关。
基于观察到的队列效应，可以认为在过去几十年中，科尔多瓦省居民对某些风险因素（如饮食和其他环境因素）的暴露水平较低。
