Institute of Social and Preventive Medicine, University of Bern, Switzerland.
Swiss Med Wkly. 2012 Aug 14;142:w13607. doi: 10.4414/smw.2012.13607. eCollection 2012.
Cancer is disease of aging that disproportionately affects older adults and often results in considerable public health consequences. This study evaluated gender-age-specific cancer mortality risk factors in older adults in Switzerland with attention to the most common types of cancer.
The population included all individuals ≥65 years old based on 1990/2000 censuses linked to mortality records through end of 2008. Cancer mortality relative risk was assessed by gender-age-specific all-cancer and cancer-specific mortality hazard ratios (HR) with 95% confidence intervals (CI) from adjusted Cox proportional hazards regression models.
The risk profile of dying from cancer was similar in older men and women across most socio-demographic characteristics: higher cancer mortality risk with lower educational attainment (all-cancer men HR = 0.84 [95%CI 0.82, 0.85] tertiary, HR = 1.09 [95%CI 1.07, 1.10] compulsory, women all-cancer HR = 0.95 [95%CI 0.92, 0.98] tertiary, HR = 1.03 [95%CI 1.02, 1.05] compulsory) and unmarried marital status. Cancer mortality risk factors varied less than hypothesised across older age-groups. However, for outcomes and characteristics with age-specific variation the oldest (≥85 years) generally showed the lower cancer mortality relative risk (except for non-Swiss lung cancer risk).
These comprehensive epidemiological results indicate that in Switzerland (like other developed countries) age alone is not the only important cancer risk factor and risk is not necessarily the same across older age-groups; providing additional needed information about the aging-cancer nexus. However, additional studies especially with consideration of stage of disease, treatments received and comorbidity are needed.
癌症是一种衰老疾病，它在老年人中不成比例地发生，并且经常导致相当大的公共卫生后果。本研究评估了瑞士老年人中性别-年龄特异性癌症死亡风险因素，特别关注最常见的癌症类型。
该人群包括基于 1990/2000 年人口普查的所有≥65 岁个体，通过与 2008 年底的死亡率记录相关联来链接人口。通过性别-年龄特异性全癌和癌症特异性死亡率风险比（HR），从调整后的 Cox 比例风险回归模型评估癌症死亡率的相对风险，置信区间（CI）为 95%。
在大多数社会人口统计学特征方面，男性和女性老年人的癌症死亡风险特征相似：较低的教育程度与较高的癌症死亡率风险相关（全癌男性 HR = 0.84 [95%CI 0.82, 0.85] 高等教育，HR = 1.09 [95%CI 1.07, 1.10] 义务教育，女性全癌 HR = 0.95 [95%CI 0.92, 0.98] 高等教育，HR = 1.03 [95%CI 1.02, 1.05] 义务教育）和未婚婚姻状况。癌症死亡风险因素在不同老年组之间的变化小于假设。然而，对于具有年龄特异性变化的结果和特征，最年长的（≥85 岁）组通常显示出较低的癌症死亡率相对风险（瑞士以外的肺癌风险除外）。
这些综合的流行病学结果表明，在瑞士（与其他发达国家一样），年龄本身并不是唯一重要的癌症风险因素，并且风险在不同的老年组之间不一定相同；为老龄化与癌症之间的关系提供了额外的必要信息。然而，需要进行更多的研究，特别是考虑疾病的阶段、接受的治疗和合并症。
