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瑞典国家住院登记册和死因登记册中脑肿瘤发病率的上升。

Increasing rates of brain tumours in the Swedish national inpatient register and the causes of death register.

作者信息

Hardell Lennart, Carlberg Michael

机构信息

Department of Oncology, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden.

出版信息

Int J Environ Res Public Health. 2015 Apr 3;12(4):3793-813. doi: 10.3390/ijerph120403793.

Abstract

Radiofrequency emissions in the frequency range 30 kHz-300 GHz were evaluated to be Group 2B, i.e., "possibly", carcinogenic to humans by the International Agency for Research on Cancer (IARC) at WHO in May 2011. The Swedish Cancer Register has not shown increasing incidence of brain tumours in recent years and has been used to dismiss epidemiological evidence on a risk. In this study we used the Swedish National Inpatient Register (IPR) and Causes of Death Register (CDR) to further study the incidence comparing with the Cancer Register data for the time period 1998-2013 using joinpoint regression analysis. In the IPR we found a joinpoint in 2007 with Annual Percentage Change (APC) +4.25%, 95% CI +1.98, +6.57% during 2007-2013 for tumours of unknown type in the brain or CNS. In the CDR joinpoint regression found one joinpoint in 2008 with APC during 2008-2013 +22.60%, 95% CI +9.68, +37.03%. These tumour diagnoses would be based on clinical examination, mainly CT and/or MRI, but without histopathology or cytology. No statistically significant increasing incidence was found in the Swedish Cancer Register during these years. We postulate that a large part of brain tumours of unknown type are never reported to the Cancer Register. Furthermore, the frequency of diagnosis based on autopsy has declined substantially due to a general decline of autopsies in Sweden adding further to missing cases. We conclude that the Swedish Cancer Register is not reliable to be used to dismiss results in epidemiological studies on the use of wireless phones and brain tumour risk.

摘要

2011年5月,世界卫生组织(WHO)下属的国际癌症研究机构(IARC)评估认为,频率范围在30千赫至300吉赫的射频辐射属于2B组,即“可能”对人类致癌。瑞典癌症登记处并未显示近年来脑肿瘤发病率上升,且一直被用来否定有关风险的流行病学证据。在本研究中,我们使用瑞典国家住院患者登记处(IPR)和死亡原因登记处(CDR),通过连接点回归分析,进一步研究1998 - 2013年期间与癌症登记处数据相比的发病率。在IPR中,我们发现2007年出现一个连接点,2007 - 2013年期间脑或中枢神经系统未知类型肿瘤的年变化百分比(APC)为 +4.25%,95%置信区间为 +1.98,+6.57%。在CDR中,连接点回归发现在2008年出现一个连接点,2008 - 2013年期间的APC为 +22.60%,95%置信区间为 +9.68,+37.03%。这些肿瘤诊断将基于临床检查,主要是CT和/或MRI,但没有组织病理学或细胞学检查。这些年瑞典癌症登记处未发现有统计学意义的发病率上升。我们推测,很大一部分未知类型的脑肿瘤从未报告给癌症登记处。此外由于瑞典尸检总体减少,基于尸检的诊断频率大幅下降,这进一步增加了漏报病例。我们得出结论,瑞典癌症登记处用于否定关于使用无线电话与脑肿瘤风险的流行病学研究结果是不可靠的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a7c/4410216/ca6be263d857/ijerph-12-03793-g001.jpg

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