翁布里亚癌症负担的估计。

Stracci Fabrizio, Petrucci Maria Saba, Ciampichini Roberta, Tavilla Andrea, Foschi Roberto

Tumori. 2013 May-Jun;99(3):342-50. doi: 10.1177/030089161309900309.

AIMS AND BACKGROUND

Model-based estimates and projections of epidemiological indicators related to cancer are important tools to support public health policies and planning. The aim of the present study is to produce projections of cancer incidence, mortality and prevalence for the Umbria region (900,000 inhabitants) in central Italy.

METHODS

The estimations were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Published data from the Italian cancer registries were modeled in order to estimate regional cancer survival. Estimated incidence rates were validated with observed incidence rates obtained from the Umbria regional cancer registry.

RESULTS

The most frequent cancer sites estimated were colon-rectum, prostate and breast in women, with 970, 615 and 729 new diagnoses, respectively, in 2012. The incidence rates were increasing for female lung cancer, male colorectal cancer, and melanoma. By contrast, the rates have been declining for cervix and stomach cancer. For lung cancer and prostate cancer in men and colorectal cancer in women the rates increased, reaching a peak in different periods, and then decreased. The incidence rates of breast cancer rose, reaching a plateau in the mid 2010s. Favorable mortality trends were predicted for all cancers except skin melanoma and lung cancer in women. The prevalence of cancer was increasing with the only exception of cervical cancer in women and lung cancer in men in the most recent estimation period.

CONCLUSION

The scenario found for cancer incidence and prevalence was largely influenced by screening activities, so that increasing or stable incidence rates may reflect active preventive efforts. Aging, screening, and more complex and costly treatments pose a problem of sustainability and selection of interventions to the regional oncology system. Evaluation of effectiveness of intervention and cost-benefit analyses will be important to ensure cancer control in the future.

目的与背景

基于模型的癌症相关流行病学指标估计和预测是支持公共卫生政策与规划的重要工具。本研究的目的是对意大利中部翁布里亚地区（90万居民）的癌症发病率、死亡率和患病率进行预测。

方法

通过应用MIAMOD方法进行估计，这是一种从死亡率和相对生存数据推导发病率和患病率数据的统计反向计算方法。对意大利癌症登记处发布的数据进行建模，以估计该地区的癌症生存率。用从翁布里亚地区癌症登记处获得的观察发病率对估计的发病率进行验证。

结果

估计的最常见癌症部位，女性为结肠直肠癌、前列腺癌和乳腺癌，2012年分别有970例、615例和729例新诊断病例。女性肺癌、男性结肠直肠癌和黑色素瘤的发病率呈上升趋势。相比之下，子宫颈癌和胃癌的发病率呈下降趋势。男性肺癌和前列腺癌以及女性结肠直肠癌的发病率上升，在不同时期达到峰值，然后下降。乳腺癌的发病率上升，在2010年代中期达到平稳状态。预计除皮肤黑色素瘤和女性肺癌外，所有癌症的死亡率都呈有利趋势。在最近的估计期内，癌症患病率呈上升趋势，但女性宫颈癌和男性肺癌除外。