一生中罹患癌症的风险是多少？：调整多重原发性癌症的影响。
What is the lifetime risk of developing cancer?: the effect of adjusting for multiple primaries.
机构信息
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Bart's and The London School of Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
出版信息
Br J Cancer. 2011 Jul 26;105(3):460-5. doi: 10.1038/bjc.2011.250. Epub 2011 Jul 19.
BACKGROUND
The 'lifetime risk' of cancer is generally estimated by combining current incidence rates with current all-cause mortality ('current probability' method) rather than by describing the experience of a birth cohort. As individuals may get more than one type of cancer, what is generally estimated is the average (mean) number of cancers over a lifetime. This is not the same as the probability of getting cancer.
METHODS
We describe a method for estimating lifetime risk that corrects for the inclusion of multiple primary cancers in the incidence rates routinely published by cancer registries. The new method applies cancer incidence rates to the estimated probability of being alive without a previous cancer. The new method is illustrated using data from the Scottish Cancer Registry and is compared with 'gold-standard' estimates that use (unpublished) data on first primaries.
RESULTS
The effect of this correction is to make the estimated 'lifetime risk' smaller. The new estimates are extremely similar to those obtained using incidence based on first primaries. The usual 'current probability' method considerably overestimates the lifetime risk of all cancers combined, although the correction for any single cancer site is minimal.
CONCLUSION
Estimation of the lifetime risk of cancer should either be based on first primaries or should use the new method.
背景
癌症的“终身风险”通常是通过将当前的发病率与全因死亡率相结合来估计的（“当前概率”方法），而不是通过描述一个出生队列的经历来估计。由于个体可能患上不止一种癌症，因此通常估计的是一生中平均（均值）患癌数量。这与患癌的概率不同。
方法
我们描述了一种估计终身风险的方法，该方法纠正了癌症登记处常规发布的发病率中包含多种原发性癌症的问题。新方法将癌症发病率应用于没有先前癌症的个体存活概率的估计值。使用苏格兰癌症登记处的数据说明了新方法，并与使用（未公布）关于第一原发癌的数据的“黄金标准”估计值进行了比较。
结果
这种校正的影响是使估计的“终身风险”变小。新的估计值与使用基于第一原发癌的发病率获得的估计值非常相似。常用的“当前概率”方法会大大高估所有癌症的终身风险，尽管对任何单一癌症部位的校正都很小。
结论
癌症终身风险的估计应该基于第一原发癌，或者应该使用新方法。
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