Feller Anita, Mark Michael Thomas, Steiner Annik, Clough-Gorr Kerri M
National Institute for Cancer Epidemiology and Registration (NICER), Zürich, Switzerland; Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland.
Kantonsspital Graubünden, Chur, Switzerland.
Swiss Med Wkly. 2015 Oct 2;145:w14184. doi: 10.4414/smw.2015.14184. eCollection 2015.
What are the trends in avoidable cancer mortality in Switzerland and neighbouring countries?
Mortality data and population estimates 1996-2010 were obtained from the Swiss Federal Statistical Office for Switzerland and the World Health Organization Mortality Database (http://www.who.int/healthinfo/mortality_data/en/) for Austria, Germany, France and Italy. Age standardised mortality rates (ASMRs, European standard) per 100 000 person-years were calculated for the population <75 years old by sex for the following groups of cancer deaths: (1) avoidable through primary prevention; (2) avoidable through early detection and treatment; (3) avoidable through improved treatment and medical care; and (4) remaining cancer deaths. To assess time trends in ASMRs, estimated annual percentage changes (EAPCs) with 95% confidence intervals (95% CIs) were calculated.
In Switzerland and neighbouring countries cancer mortality in persons <75 years old continuously decreased 1996-2010. Avoidable cancer mortality decreased in all groups of avoidable cancer deaths in both sexes, with one exception. ASMRs for causes avoidable through primary prevention increased in females in all countries (in Switzerland from 16.2 to 20.3 per 100 000 person years, EAPC 2.0 [95% CI 1.4 to 2.6]). Compared with its neighbouring countries, Switzerland showed the lowest rates for all groups of avoidable cancer mortality in males 2008-2010.
Overall avoidable cancer mortality decreased, indicating achievements in cancer care and related health policies. However, increasing trends in avoidable cancer mortality through primary prevention for females suggest there is a need in Switzerland and its European neighbouring countries to improve primary prevention.
瑞士及周边国家可避免的癌症死亡率趋势如何?
1996 - 2010年的死亡率数据和人口估计数分别从瑞士联邦统计局获取瑞士的相关数据,从世界卫生组织死亡率数据库(http://www.who.int/healthinfo/mortality_data/en/)获取奥地利、德国、法国和意大利的相关数据。按性别计算了75岁以下人群每10万人年的年龄标准化死亡率(ASMRs,欧洲标准),用于以下几组癌症死亡情况:(1)通过一级预防可避免的;(2)通过早期检测和治疗可避免的;(3)通过改善治疗和医疗护理可避免的;以及(4)其余癌症死亡情况。为评估ASMRs的时间趋势,计算了估计年度百分比变化(EAPCs)及其95%置信区间(95% CIs)。
在瑞士及周边国家,1996 - 2010年75岁以下人群的癌症死亡率持续下降。两性中所有可避免癌症死亡组的可避免癌症死亡率均下降,但有一个例外。所有国家女性中通过一级预防可避免的病因的ASMRs均有所上升(在瑞士从每10万人年16.2上升至每10万人年20.3,EAPC为2.0 [95% CI 1.4至2.6])。与周边国家相比,2008 - 2010年瑞士男性所有可避免癌症死亡率组的死亡率最低。
总体可避免癌症死亡率下降,表明在癌症护理及相关卫生政策方面取得了成效。然而,女性通过一级预防导致的可避免癌症死亡率呈上升趋势,这表明瑞士及其欧洲邻国需要改进一级预防。