Barchuk Anton, Bespalov Alexander, Huhtala Heini, Chimed Tuvshinjargal, Laricheva Irina, Belyaev Alexey, Bray Freddie, Anttila Ahti, Auvinen Anssi
University of Tampere, Faculty of Social Sciences, Epidemiology Group, Arvo, Arvo Ylpön katu 34, 33520 Tampere, Finland; Petrov National Research Medical Center of Oncology, Leningradskaya 68, Pesochny, Saint-Petersburg, 197758, Russia.
Petrov National Research Medical Center of Oncology, Leningradskaya 68, Pesochny, Saint-Petersburg, 197758, Russia.
Cancer Epidemiol. 2018 Aug;55:73-80. doi: 10.1016/j.canep.2018.05.008. Epub 2018 May 26.
Breast and cervical cancer are among the leading causes of preventable cancer deaths in women in Russia. The aim of this study is to analyze changes in breast and cervical cancer incidence and mortality trends using data from the Russian State Cancer Registry.
The age-standardized rates of cervical cancer incidence (1993-2013) and mortality (1980-2013) were analyzed using piecewise linear regression. Age-period-cohort models were used to estimate the temporal effects and provide future predictions.
Breast and cervical cancer incidence rates uniformly increased over two decades from 33.0 to 47.0 per 100,000 and from 10.6 to 14.2 per 100,000, respectively. Breast cancer mortality rates however declined from 17.6 to 15.7 in 2013, while cervical cancer mortality increased steadily from 5.6 to 6.7. Breakpoints in the risk occurred in cohorts born 1937-1953, indicating a recent generational decrease in breast cancer mortality, but a concomitant increase in cervical cancer. Cervical cancer has already surpassed breast cancer in terms of years of life lost (YLL) (23.4 per death vs 18.5 in 2009-2013), while future projections suggest that the annual YLL could reach 1.2 million for cervical cancer and (decline to) 1.8 million for breast cancer by the year 2030.
The temporal patterns of breast cancer incidence and mortality in Russia are in line with other countries in Europe, although cervical cancer rates and the risk of occurrence in recent generations is rapidly increasing; these trends underscore the need to place immediate priority in national cervical vaccination and screening programs.
乳腺癌和宫颈癌是俄罗斯女性可预防癌症死亡的主要原因之一。本研究的目的是利用俄罗斯国家癌症登记处的数据，分析乳腺癌和宫颈癌发病率及死亡率趋势的变化。
采用分段线性回归分析宫颈癌发病率（1993 - 2013年）和死亡率（1980 - 2013年）的年龄标准化率。使用年龄 - 时期 - 队列模型来估计时间效应并进行未来预测。
在二十年中，乳腺癌和宫颈癌的发病率均呈上升趋势，分别从每10万人33.0例增至47.0例，以及从每10万人10.6例增至14.2例。然而，乳腺癌死亡率在2013年从17.6降至15.7，而宫颈癌死亡率则从5.6稳步上升至6.7。风险转折点出现在1937 - 1953年出生的队列中，表明近期一代乳腺癌死亡率下降，但宫颈癌死亡率随之上升。就生命损失年数（YLL）而言，宫颈癌已经超过乳腺癌（2009 - 2013年每例死亡的YLL为23.4年，而乳腺癌为18.5年），而未来预测表明，到2030年，宫颈癌的年度YLL可能达到120万，乳腺癌则（降至）180万。
俄罗斯乳腺癌发病率和死亡率的时间模式与欧洲其他国家一致，尽管宫颈癌发病率及近几代人的发病风险正在迅速上升；这些趋势凸显了在国家宫颈癌疫苗接种和筛查计划中立即优先安排的必要性。
