Greig N H, Ries L G, Yancik R, Rapoport S I
Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892.
J Natl Cancer Inst. 1990 Oct 17;82(20):1621-4. doi: 10.1093/jnci/82.20.1621.
Between 1973 and 1985, total age-adjusted cancer incidence in the United States (all races, men and women) rose by 10.7%, with an average annual percentage change of +0.9%. Analysis of reported age-specific incidence of primary malignant brain tumors over the same years demonstrates that incidence rates increased dramatically between 1973/1974 and 1985. In 1985, incidence rates for persons aged 75-79, 80-84, and 85 years of age and over were 187%, 394%, and 501%, respectively, of rates in 1973/1974. Similar increases were found in both men and women, analyzed separately and combined. Average annual percentage changes in primary brain tumor incidence were +7.0%, +20.4%, and +23.4% in these age ranges, respectively. Reported incidence in younger persons varied little over the same period of time. The most common histologic type of primary brain tumor in the elderly was of glial origin, predominantly the glioblastoma multiforme and astrocytoma. These tumors are highly malignant and invariably fatal. Two possible causes may explain the increased incidence in the elderly: the introduction and extensive use of x-ray computed tomography since 1973 and/or a true increase in incidence occurring independently of diagnostic advances.
1973年至1985年间,美国(所有种族、男性和女性)经年龄调整后的癌症总发病率上升了10.7%,年均变化率为+0.9%。对同期报告的原发性恶性脑肿瘤特定年龄发病率的分析表明,1973/1974年至1985年间发病率急剧上升。1985年,75 - 79岁、80 - 84岁以及85岁及以上人群的发病率分别是1973/1974年发病率的187%、394%和501%。单独分析和综合分析男性和女性的数据时,均发现了类似的增长情况。在这些年龄范围内,原发性脑肿瘤发病率的年均变化率分别为+7.0%、+20.4%和+23.4%。同期,较年轻人群的报告发病率变化不大。老年人原发性脑肿瘤最常见的组织学类型起源于神经胶质,主要是多形性胶质母细胞瘤和星形细胞瘤。这些肿瘤具有高度恶性,无一例外都是致命的。老年人发病率增加可能有两个原因:自1973年以来X线计算机断层扫描的引入和广泛应用,以及/或者发病率的真正增加独立于诊断技术的进步而发生。