Davis D L, Hoel D, Percy C, Ahlbom A, Schwartz J
National Research Council, Washington D.C. 20418.
Ann N Y Acad Sci. 1990;609:191-204. doi: 10.1111/j.1749-6632.1990.tb32067.x.
This paper analyzes recent age-specific trends in brain and other central nervous system cancer mortality from 1968 to 1986-1987 in the United States, United Kingdom, Italy, France, and West Germany. It also examines changes in the use of diagnostic confirmation technology in the U.S. SEER program from 1973 to 1987 to estimate the influence of such factors on recent mortality trends. Other sources of error have not been evaluated in this paper. In the United States and Sweden, deaths due to brain and other central nervous system cancer, adjusted to the overall population, are unchanging. However, age-specific analyses of brain and other nervous system cancer in six major industrial countries show markedly different trends at different age groups, with drastic increases in brain tumor rates in the old: rates doubled in persons ages 75 to 84. In the United States, microscopic or radiographic confirmation occurred throughout this time period in 96% of all incident cases of brain and other central nervous system cancers diagnosed before death in the SEER program, with older persons receiving consistently more radiographic tests than younger persons. The use of diagnostic technology may change over time and across populations, but it is not known to what extent it accounts for these increasing trends, which require careful additional study.
本文分析了1968年至1986 - 1987年期间美国、英国、意大利、法国和西德脑癌及其他中枢神经系统癌症死亡率的近期年龄特异性趋势。它还研究了1973年至1987年美国监测、流行病学和最终结果(SEER)计划中诊断确认技术使用情况的变化,以估计这些因素对近期死亡率趋势的影响。本文未评估其他误差来源。在美国和瑞典,经总体人群调整后,脑癌及其他中枢神经系统癌症导致的死亡人数没有变化。然而,对六个主要工业国家脑癌及其他神经系统癌症的年龄特异性分析显示,不同年龄组呈现出明显不同的趋势,老年人群脑肿瘤发病率急剧上升:75至84岁人群的发病率翻了一番。在美国,在SEER计划中,在此期间96%的所有在死前诊断出的脑癌及其他中枢神经系统癌症的发病病例都进行了显微镜或影像学确认,老年人接受影像学检查的次数一直比年轻人多。诊断技术的使用可能会随时间和人群而变化,但尚不清楚其在多大程度上导致了这些上升趋势,这需要进一步仔细研究。