La Vecchia C, Negri E, Decarli A, Fasoli M, Cislaghi C
Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
Tumori. 1990 Apr 30;76(2):87-166. doi: 10.1177/030089169007600202.
Number of certified deaths, age-specific and age-standardised rates and percentages of all cancer deaths from 30 cancers or groups of cancers (plus total cancer mortality) for each five-year calendar period between 1955 and 1984 in Italy are presented in tabular form. From these data, three graphs are derived, including trends in age-standardised rates, age-specific rates centered on birth cohorts and maps plotted in different shades of grey to represent the surfaces defined by the matrix of various age-specific rates. These analyses quantified the rises in overall cancer mortality in males (from 137 to 192/100,000 world standard), chiefly due to increases in lung and other tobacco-related neoplasms. Overall cancer mortality was stable in females (around 100/100,000). Appreciable cohort effects were evident for tobacco related neoplasms, but also for other major cancer sites, such as intestines or breast, whose rates, after earlier rises, are now stable in earlier middle age. Since the early 1970's, cancer mortality rates have been declining in all age groups below 40 in males and below 55 in females. These declines reflect improvements in therapy for leukemias, lymphomas and germ cell tumors, and general improvements in food availability and storage, hygiene and early diagnosis, which have led to the declines in stomach and cervical cancer. Although moderate in absolute terms and smaller than in other western countries where tobacco-related neoplasms have also been falling in more recent cohorts, these declines are encouraging for the indication they provide on the most likely patterns over the next decades in the same and subsequent generations.
表格形式呈现了1955年至1984年期间意大利每五年的30种癌症或癌症组（加上癌症总死亡率）的认证死亡人数、年龄别和年龄标准化率及所有癌症死亡的百分比。根据这些数据得出了三个图表，包括年龄标准化率趋势、以出生队列中心的年龄别率，以及用不同灰度绘制的地图，以表示由各种年龄别率矩阵定义的表面。这些分析量化了男性总体癌症死亡率的上升（从137/10万上升至192/10万世界标准），主要归因于肺癌和其他与烟草相关肿瘤的增加。女性总体癌症死亡率稳定（约100/10万）。与烟草相关的肿瘤以及肠道或乳腺等其他主要癌症部位都有明显的队列效应，这些部位的发病率在早期上升后，现在在中年早期趋于稳定。自20世纪70年代初以来，40岁以下男性和55岁以下女性的所有年龄组癌症死亡率一直在下降。这些下降反映了白血病、淋巴瘤和生殖细胞肿瘤治疗的改善，以及食物供应和储存、卫生和早期诊断的普遍改善，这些改善导致了胃癌和宫颈癌的下降。尽管绝对降幅适中且小于其他西方国家（在这些国家，与烟草相关的肿瘤在最近几代人中也在下降），但这些下降令人鼓舞，因为它们为同一代人和后代未来几十年最可能的模式提供了指示。
