Decarli A, La Vecchia C, Negri E, Cislaghi C
Institute of Medical Statistics, University of Milan, Italy.
J Cancer Res Clin Oncol. 1990;116(2):215-9. doi: 10.1007/BF01612680.
Although cancer mortality in young adults accounts for only a small proportion of all cancer deaths, it is important since it provides useful indications of the most likely future trends, and relevant information on the role of exposure to specific, or newer, carcinogens. We, therefore, analysed trends in cancer mortality between 1955 and 1985 among Italian men and women aged 20-44 years. In those three decades, overall cancer mortality declined steadily, by 27% in young women (from 33.8 to 24.7/100,000, world standard) but only by 3% (from 27.3 to 26.4/100,000) among men. The decline for men, however, was 16% from the peak rate of 31.5 reached in 1970-1974. The major underlying component causing the different trends in the two sexes was lung and other tobacco-related neoplasms, which had been considerably on the increase in young men up to the early 1970s, and levelled-off thereafter, while showing no appreciable change in women. The falls were about 50% for stomach cancer in both sexes, and over 80% for cervical cancer. A clear impact of improved treatment was reflected in the substantial declines in Hodgkin's disease, of testicular cancer in the last decade and, possibly, in the favourable trends in cancers of the breast, bone, brain and leukemias over the most recent calendar periods. Only two sites showed appreciable and persisting upward trends: oral cavity in men and skin melanoma in both sexes. They therefore constitute priorities for intervention in the near future.
尽管年轻成年人的癌症死亡率在所有癌症死亡中仅占一小部分,但它很重要,因为它能为未来最可能出现的趋势提供有用的指示,以及关于接触特定或新型致癌物作用的相关信息。因此,我们分析了1955年至1985年期间意大利20至44岁男性和女性的癌症死亡率趋势。在这三十年中,总体癌症死亡率稳步下降,年轻女性下降了27%(从33.8降至24.7/10万,世界标准),而男性仅下降了3%(从27.3降至26.4/10万)。然而,男性的死亡率从1970 - 1974年达到的峰值31.5下降了16%。导致两性出现不同趋势的主要潜在因素是肺癌和其他与烟草相关的肿瘤,在20世纪70年代初之前,年轻男性中的这类肿瘤大幅增加,此后趋于平稳,而女性则没有明显变化。两性的胃癌死亡率下降了约50%,宫颈癌下降了80%以上。治疗改善的明显影响体现在霍奇金病的大幅下降、过去十年睾丸癌的下降,以及最近几年乳腺癌、骨癌、脑癌和白血病的良好趋势中。只有两个部位呈现出明显且持续的上升趋势:男性的口腔癌和两性的皮肤黑色素瘤。因此,它们是近期干预的重点。