Departments of Clinical Sciences and Community Health, Universitá degli Studi di Milano, Milan, Italy.
Departments of Biomedical and Clinical Sciences, Universitá degli Studi di Milano, Milan, Italy.
Ann Oncol. 2019 Aug 1;30(8):1344-1355. doi: 10.1093/annonc/mdz178.
Population ageing results in an increasing cancer burden in the elderly. We aimed to evaluate time-trends in cancer mortality for adults aged 65 and over for 17 major cancer types and all cancers combined in 11 countries worldwide over the period 1970-2015.
We obtained cancer death certification and population figures from the WHO and PAHO databases. We computed age-standardised (world standard population) rates for individuals aged 65 and over, and applied joinpoint regression models.
Age-standardised mortality rates for all cancers combined showed a heterogeneous, but widespread decline. Lung cancer mortality rates have been decreasing among men, and increasing among women. Pancreatic cancer had unfavourable trends in all countries for both sexes. Despite variability across countries, other tobacco-related cancers (except kidney) showed overall favourable trends, except in Poland and Russia. Age-standardised mortality rates from stomach cancer have been declining in all countries for both sexes. Colorectal mortality has been declining, except in Poland and Russia. Liver cancer mortality increased in all countries, except in Japan, France and Italy, which had the highest rates in the past. Breast cancer mortality decreased for most countries, except for Japan, Poland and Russia. Trends for age-standardised uterine cancer rates in the USA, Canada and the UK were increasing over the last decade. Ovarian cancer rates showed declines in most countries. With the exception of Russia, prostate cancer rates showed overall declines. Lymphoid neoplasms rates have been declining in both sexes, except in Poland and Russia.
Over the last decades, age-standardised cancer mortality in the elderly has been decreasing in major countries worldwide and for major cancer sites, with the major exception of lung and uterine cancer in women and liver, pancreatic and kidney cancers in both sexes. Cancer mortality for the elderly in central and eastern Europe remains comparatively high.
人口老龄化导致老年人癌症负担增加。我们旨在评估 1970 年至 2015 年间全球 11 个国家 17 种主要癌症类型和所有癌症类型中 65 岁及以上成年人的癌症死亡率的时间趋势。
我们从世卫组织和泛美卫生组织数据库获得癌症死亡证明和人口数据。我们计算了 65 岁及以上人群的年龄标准化（世界标准人口）率，并应用了联合点回归模型。
所有癌症合并的年龄标准化死亡率显示出不均匀但广泛的下降趋势。男性肺癌死亡率下降，女性肺癌死亡率上升。在所有国家，男性和女性的胰腺癌死亡率都呈不利趋势。尽管各国情况不同，但除了肾脏外，其他与烟草相关的癌症（除外）总体呈有利趋势。在所有国家，男女的胃癌年龄标准化死亡率均呈下降趋势。结直肠癌死亡率下降，除了波兰和俄罗斯。除了日本、法国和意大利外，所有国家的肝癌死亡率都在增加，这些国家过去的肝癌死亡率最高。除了日本、波兰和俄罗斯，大多数国家的乳腺癌死亡率都在下降。过去十年，美国、加拿大和英国的子宫癌年龄标准化率呈上升趋势。大多数国家的卵巢癌死亡率下降。除了俄罗斯，前列腺癌的发病率总体呈下降趋势。男女的淋巴样肿瘤发病率均呈下降趋势，除了波兰和俄罗斯。
在过去几十年中，全球主要国家 65 岁及以上老年人的癌症标准化死亡率呈下降趋势，主要癌症部位的死亡率呈下降趋势，除了女性的肺癌和子宫癌以及男女的肝癌、胰腺癌和肾癌外。中欧和东欧老年人的癌症死亡率仍然相对较高。
