Xie Li, Qian Ying, Liu Yishan, Li Yixuan, Jia Sinong, Yu Herbert, Wang Chunfang, Qian Biyun, Bao Pingping
Hongqiao International Institute of Medicine, Shanghai Tong Ren Hospital and Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Cancer Med. 2020 Apr;9(8):2930-2939. doi: 10.1002/cam4.2917. Epub 2020 Feb 19.
Many previous studies reported secular trend of lung cancer incidence and mortality, but little is known about the possible reasons for these trends.
Data were obtained from Shanghai Cancer Registry. Age-standardized rates were calculated and average annual percent changes (AAPCs) were evaluated by Joinpoint regression. Age, period, and birth cohort effects were assessed by age-period-cohort models.
From 1973 to 2010, compared with long-time slowly increasing trend in women, male lung cancer incidence had significantly decreased between 2001 and 2009. After that lung cancer incidence rising sharply in women (AAPC = 14.13%, 95%CI: 2.68%-26.86%, P = .016) and similar rising trends without statistical significance in men (AAPC = 2.96, 95%CI: -2.47%-8.69%, P = .281) between 2010 and 2014. Age-period cohort model showed the different patterns of period effects for lung cancer incidence between men and women. The period effects for lung cancer incidence showed rising effect for women, whereas there was decline effect for lung cancer incidence for men. On the other hand, the model showed a significant period effect in both genders with a similar fashion in mortality, yielding steady falling trends during the entire study period.
The distinctive patterns of lung cancer incidence between men and women may be attributable to significant period effects, which reflected the changes in public health policies or diagnostic practices and highlighted the urgent of continued monitoring of gender-specific risk factors for lung cancer incidence.
此前许多研究报告了肺癌发病率和死亡率的长期趋势，但对于这些趋势的可能原因知之甚少。
数据来自上海癌症登记处。计算年龄标准化率，并通过Joinpoint回归评估平均年度百分比变化（AAPC）。通过年龄-时期-队列模型评估年龄、时期和出生队列效应。
1973年至2010年，与女性长期缓慢上升的趋势相比，男性肺癌发病率在2001年至2009年期间显著下降。此后，2010年至2014年期间，女性肺癌发病率急剧上升（AAPC = 14.13%，95%CI：2.68%-26.86%，P = 0.016），男性有类似的上升趋势但无统计学意义（AAPC = 2.96，95%CI：-2.47%-8.69%，P = 0.281）。年龄-时期-队列模型显示男性和女性肺癌发病率的时期效应模式不同。女性肺癌发病率的时期效应呈上升趋势，而男性肺癌发病率呈下降趋势。另一方面，该模型显示男女在死亡率方面都有显著的时期效应，且模式相似，在整个研究期间呈稳定下降趋势。
男性和女性肺癌发病率的独特模式可能归因于显著的时期效应，这反映了公共卫生政策或诊断实践的变化，并突出了持续监测肺癌发病率特定性别风险因素的紧迫性。
