Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Oral Oncol. 2020 Aug;107:104798. doi: 10.1016/j.oraloncology.2020.104798. Epub 2020 May 17.
Oral cancer is the fourth most common cancer among men in Taiwan. Betel nut consumption is a major risk factor for oral cancer, but the association between betel nut chewing and the long-term secular trend of oral cancer incidence is unclear.
We conducted an age-period-cohort analysis to examine the incidence rates of oral cancer among men in Taiwan from 1997 to 2016.
The oral cancer incidence rate among men doubled between 1997 and 2009, but the trend leveled off thereafter. Oral cancer incidence rates in the oldest age group (80-84y) were approximately 85 times those of the youngest group (25-29y). The period effect was weak, and the cohort effect exhibited a drastically increasing trend from 1917 (midyear for 1913-1921) to 1972 (1968-1976) birth cohorts and then a decreasing trend afterward. The Spearman rank correlation coefficient between the cohort effects on oral cancer incidence among men and the average consumption of betel nut with a lag time of 30 years had a significant and extremely high value of 0.993.
Our findings suggest that betel nut chewing is the main driver of the cohort effect for oral cancer incidence rates among men in Taiwan. In addition to reduced betel nut consumption, a decrease in smoking prevalence may also have contributed to the reduction in oral cancer incidence after the 1972 birth cohort; moreover, the increasing prevalence of alcohol consumption in Taiwan is unlikely to be the reason for the cohort effect for oral cancer.
口腔癌是台湾男性中第四大常见癌症。槟榔咀嚼是口腔癌的主要危险因素，但槟榔咀嚼与口腔癌发病率的长期长期趋势之间的关联尚不清楚。
我们进行了年龄-时期-队列分析，以检查 1997 年至 2016 年期间台湾男性口腔癌的发病率。
男性口腔癌发病率在 1997 年至 2009 年间翻了一番，但此后趋势趋于平稳。最年长组（80-84 岁）的口腔癌发病率约为最年轻组（25-29 岁）的 85 倍。时期效应较弱，队列效应从 1917 年（1913-1921 年中年）急剧增加到 1972 年（1968-1976 年）出生队列，然后呈下降趋势。男性口腔癌发病率的队列效应与槟榔咀嚼物平均消费量之间的 Spearman 秩相关系数具有显著的极高值 0.993，滞后时间为 30 年。
我们的研究结果表明，槟榔咀嚼是台湾男性口腔癌发病率队列效应的主要驱动因素。除了减少槟榔咀嚼量外，吸烟率的下降可能也是 1972 年出生队列后口腔癌发病率下降的原因之一；此外，台湾饮酒流行率的增加不太可能是口腔癌队列效应的原因。
