School of Population Health, University of Queensland, Australia.
Aust N Z J Public Health. 2011 Jun;35(3):212-9. doi: 10.1111/j.1753-6405.2011.00700.x.
OBJECTIVE: The relationship of long-term population-level trends in oral, pharyngeal and oesophageal cancer mortality with major risk factors such as tobacco consumption have not been statistically analysed in Australia. We have demonstrated the long-term implications using historical data. METHODS: Estimated age and sex-specific tobacco consumption back-extrapolated to 1887 were used together with alcohol and fruit and vegetable consumption data to examine their association with trends in oral, pharyngeal and oesophageal cancer mortality. Log-linear Poisson regression models were applied to specify the relationship with oesophageal and pharyngeal mortality data. RESULTS: Oral cancer mortality for males decreased sharply in the first half of the 20th Century in contrast to steadily rising tobacco consumption. Female oral and pharyngeal cancer remained steady at low levels. Post-World War II male and female oesophageal and male pharyngeal cancer mortality rose, then either fell or stabilised, without a clear relationship with risk factors. CONCLUSIONS: Tobacco and alcohol consumption have influenced post-World War II trends in oral, pharyngeal and oesophageal cancer mortality. However, the challenges in using historical population level data prevent precise interpretation of findings. IMPLICATIONS: There is increased exposure to risk factors for these cancers in many low- and middle-income countries. In particular, smoking cessation programs are needed to prevent increases in mortality from these cancers in such countries.
目的:在澳大利亚,尚未对长期的人口水平口腔癌、咽癌和食管癌死亡率趋势与烟草消费等主要危险因素之间的关系进行统计学分析。我们使用历史数据证明了长期影响。
方法:我们将回溯至 1887 年的年龄和性别特异性估计烟草消费与酒精和水果与蔬菜消费数据相结合,以检验它们与口腔癌、咽癌和食管癌死亡率趋势之间的关联。对数线性泊松回归模型被应用于食管和咽癌死亡率数据,以指定关系。
结果:与持续上升的烟草消费形成鲜明对比的是,20 世纪上半叶男性口腔癌死亡率急剧下降。女性口腔癌和咽癌的死亡率一直保持在低水平。二战后,男性和女性的食管癌和男性的咽癌死亡率上升,然后要么下降或稳定,与危险因素没有明显关系。
结论:烟草和酒精消费影响了二战后口腔癌、咽癌和食管癌死亡率的趋势。然而,使用历史人口水平数据存在挑战,无法对研究结果进行精确解释。
意义:在许多低收入和中等收入国家,人们面临着更高的这些癌症的危险因素。特别是,需要戒烟计划来预防这些国家的癌症死亡率上升。
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