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1943 - 1984年丹麦儿童癌症发病率。

Incidence of childhood cancer in Denmark 1943-1984.

作者信息

de Nully Brown P, Hertz H, Olsen J H, Yssing M, Scheibel E, Jensen O M

机构信息

Danish Cancer Registry, Institute of Cancer Epidemiology, Copenhagen.

出版信息

Int J Epidemiol. 1989 Sep;18(3):546-55. doi: 10.1093/ije/18.3.546.

Abstract

A population-based study was carried out on 5790 tumours in children (aged 0-14 years) diagnosed in the period 1943-1984 in Denmark. Cases were identified from the files of the high-quality National Cancer Registry in which codes for tumours were based solely on topography until the end of 1977. To achieve a uniform data set following the outlines of the International Classification of Diseases for Oncology (ICD-O) coding system used by the Cancer Registry today, all cases of childhood cancer diagnosed prior to 1978 were re-evaluated, and an ICD-O code was applied. Tumours were aggregated into diagnostic groups suitable for analysis and presentation using an internationally agreed scheme, which was designed by the Manchester Children's Tumour Registry and modified recently by the International Agency for Research on Cancer. The average incidence rates for all histological types of childhood cancer combined were 137 per million boys and 111 per million girls, which are close to those reported from the USA but higher than most of the overall figures reported from Europe. The proportions of specific tumours were similar to those observed in other industrialized countries. The well known excess of cancer cases among boys compared to girls was due mainly to the occurrence of 90% more lymphomas, 30% more leukaemias and 15% more tumours of the central nervous system (CNS) among boys. Although significant increases were seen in the subgroups of CNS neoplasms and neuroblastomas (both sexes) and of lymphomas (boys only), no overall increase in childhood cancer was observed during the 42-year period of registration. While the increase in the incidence of CNS tumours was explained at least partly by better cancer surveillance, no interpretation can be offered for the increases seen for neuroblastomas and lymphomas. Our descriptive data suggest that environmental exposures do not play any significant role in the aetiology of the majority of childhood cancers.

摘要

对1943年至1984年期间在丹麦诊断出的5790例0至14岁儿童肿瘤进行了一项基于人群的研究。病例来自高质量的国家癌症登记处档案,在1977年底之前,肿瘤编码仅基于肿瘤形态学。为了按照当今癌症登记处使用的国际肿瘤疾病分类(ICD-O)编码系统的大纲获得统一的数据集,对1978年之前诊断出的所有儿童癌症病例进行了重新评估,并应用了ICD-O编码。肿瘤按照一个国际商定的方案汇总为适合分析和展示的诊断组,该方案由曼彻斯特儿童肿瘤登记处设计,最近由国际癌症研究机构进行了修改。所有组织学类型的儿童癌症合并后的平均发病率为每百万男孩137例,每百万女孩111例,这与美国报告的发病率相近,但高于欧洲报告的大多数总体数字。特定肿瘤的比例与其他工业化国家观察到的比例相似。众所周知,男孩中的癌症病例比女孩多,主要是因为男孩中的淋巴瘤发病率高90%,白血病发病率高30%,中枢神经系统(CNS)肿瘤发病率高15%。尽管在中枢神经系统肿瘤和神经母细胞瘤亚组(男女均有)以及淋巴瘤亚组(仅男孩)中出现了显著增加,但在42年的登记期间未观察到儿童癌症总体增加。虽然中枢神经系统肿瘤发病率的增加至少部分可以通过更好的癌症监测来解释,但对于神经母细胞瘤和淋巴瘤的增加无法给出解释。我们的描述性数据表明,环境暴露在大多数儿童癌症的病因中没有起到任何显著作用。

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