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芬兰按教育和社会经济地位划分的结直肠癌发病率趋势。

Trends of colorectal cancer incidence by education and socioeconomic status in Finland.

机构信息

Finnish Cancer Registry, Helsinki, Finland.

Department of Public Health, University of Helsinki, Helsinki, Finland.

出版信息

Acta Oncol. 2019 Nov;58(11):1557-1563. doi: 10.1080/0284186X.2019.1652340. Epub 2019 Aug 22.

Abstract

The aim of this study was to investigate if the incidence of colorectal cancer (CRC) is associated with education and socioeconomic status (SES) in Finland, and if there are any changes in incidence differences between the groups over the period 1976-2014. CRC cases ( = 77,614) were retrieved from the Finnish Cancer Registry and linked with information on the education level and SES from Statistics Finland. We used Poisson regression model to quantify differences in incidence rates between the groups, and to assess changes over calendar time. Colon cancer incidence was higher among the highly educated, than in those with basic education. Similar differences were observed by SES in men. Incidence rates increased steeply over time among men with basic education (from 16.7/100,000 in 1976-1979 to 31.8 in 2010-2014), resulting in narrowed differences between the groups ( < .001). Incidence trends of proximal and distal colon and rectal cancer in men showed similar patterns. Heterogeneity across time periods by SES was observed only in colon cancer incidence in men ( = .009). No such large differences were detected in women. Steep increase in colon cancer incidence in men with basic education, and the respective persistent high incidence in the highly educated highlights the importance of focusing the preventive measures on modifiable lifestyle factors in order to reduce CRC incidence and to narrow the educational and socioeconomic health differences.

摘要

本研究旨在探讨在芬兰,结直肠癌(CRC)的发病率是否与教育和社会经济地位(SES)相关,以及在 1976-2014 年期间,这些组之间的发病率差异是否有任何变化。CRC 病例( = 77614)从芬兰癌症登记处检索,并与来自芬兰统计局的教育水平和 SES 信息相关联。我们使用泊松回归模型来量化组间发病率差异,并评估随时间的变化。与具有基本教育程度的人相比,高学历者的结肠癌发病率更高。在男性中,也观察到 SES 之间存在类似的差异。在具有基本教育程度的男性中,发病率随时间急剧上升(从 1976-1979 年的 16.7/100,000 上升到 2010-2014 年的 31.8),导致组间差异缩小( < .001)。男性近端结肠、远端结肠和直肠癌的发病率趋势表现出相似的模式。仅在男性结肠癌发病率中观察到 SES 随时间的异质性( = .009)。在女性中未发现这种较大差异。在具有基本教育程度的男性中,结肠癌发病率急剧上升,而在高学历者中,相应的发病率持续居高不下,这凸显了将预防措施重点放在可改变的生活方式因素上的重要性,以降低 CRC 的发病率,并缩小教育和社会经济健康差异。

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