胰腺癌发病趋势：来自监测、流行病学和最终结果（SEER）人群为基础数据的证据。
Pancreatic cancer incidence trends: evidence from the Surveillance, Epidemiology and End Results (SEER) population-based data.
机构信息
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20850, USA.
The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
出版信息
Int J Epidemiol. 2018 Apr 1;47(2):427-439. doi: 10.1093/ije/dyx232.
BACKGROUND
Annual pancreatic cancer incidence rates have been increasing. We examine pancreatic cancer incidence trends by demographics and histologic type.
METHODS
Data from the Surveillance, Epidemiology and End Results (SEER) registries were available to assess temporal trends and pancreatic cancer rates from 1974 to 2013.
RESULTS
Pancreatic cancer incidence rates declined between the 1970s and 1990s but increased from 1994 to 2013 among White males. Among non-Hispanic White and Hispanic males, the annual percent change (APC) in incidence between 1992 and 2013 was 0.84% and 0.73%, respectively. Rates also rose among White non-Hispanic, Hispanic and Asian females (APC = 0.81%, 0.56% and 1.23%, respectively) and even more rapidly among females aged 25-34 years (APC > 2.5%). Rates among Black males and females remained unchanged, but higher compared with the other racial/ethnic groups. By histologic type, the increases were greatest for non-secretory endocrine cancers ( > 6%), followed by ductal adenocarcinomas (∼5%) and adenocarcinoma, NOS (∼1.4%)-the largest histologic subgroup of pancreatic cancer. Rates for mucinous adenocarcinomas and poorly specified pancreatic cancer decreased. Overall, incidence rates during 2000-13 were higher among males than females [MF incidence rate ratio (IRR) = 1.28]. The IRR was >1.00 at all ages ≥ 35, but rates among females were higher at younger ages (IRRs 15-24: 0.66, 25-34: 0.81). The MF IRRs for most of the histologic types were elevated among males apart from solid pseudopapillary adenocarcinoma and cystic carcinomas (IRR = 0.22, confidence interval: 0.14-0.34 and 0.52, 0.41-0.65, respectively).
CONCLUSION
Pancreatic cancer has been increasing overall, but patterns differ by demographic group and histologic type. Many of the trends parallel changing prevalence of lifestyle risk factors such as smoking, overweight and obesity, and diabetes in the USA, particularly for pancreatic adenocarcinoma, and improved diagnosis methods during the past 40 years.
背景
每年胰腺癌的发病率一直在上升。我们通过人口统计学和组织学类型来研究胰腺癌发病趋势。
方法
利用监测、流行病学和最终结果（SEER）登记处的数据，评估了 1974 年至 2013 年的时间趋势和胰腺癌发病率。
结果
胰腺癌发病率在 20 世纪 70 年代至 90 年代期间有所下降，但在 1994 年至 2013 年期间，白人男性的发病率却有所上升。在非西班牙裔白人男性和西班牙裔男性中，1992 年至 2013 年的发病率年变化百分比（APC）分别为 0.84%和 0.73%。在白人非西班牙裔、西班牙裔和亚裔女性中，发病率也有所上升（APC 分别为 0.81%、0.56%和 1.23%），在 25-34 岁的女性中，发病率上升速度甚至更快（APC>2.5%）。黑人男性和女性的发病率保持不变，但与其他种族/族裔群体相比，黑人的发病率更高。按组织学类型，非分泌性内分泌癌（>6%）、导管腺癌（5%）和腺鳞癌（1.4%）的发病率增幅最大，这是胰腺癌最大的组织学亚组。黏液性腺癌和未明确的胰腺癌的发病率下降。总体而言，2000 年至 2013 年期间，男性的发病率高于女性（男性与女性的发病率比为 1.28）。所有年龄≥35 岁的人群中，IRR 均大于 1.00，但女性在年龄较小的人群中的发病率更高（IRR 为 15-24 岁：0.66；25-34 岁：0.81）。除实性假乳头状腺癌和囊性癌外（IRR 分别为 0.22、0.14-0.34 和 0.52、0.41-0.65），大多数组织学类型的男性发病率比女性高。
结论
总体而言，胰腺癌的发病率一直在上升，但不同的人群和组织学类型有不同的发病模式。在美国，许多趋势与吸烟、超重和肥胖以及糖尿病等生活方式危险因素的流行变化有关，特别是与胰腺腺癌有关，这与过去 40 年中诊断方法的改进有关。
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