Department of Clinical Sciences and Community Health, Universitá degli Studi di Milano, 20133 Milan, Italy.
Department of Biomedical and Clinical Sciences, Universitá degli Studi di Milano, 20157 Milan, Italy.
Int J Environ Res Public Health. 2020 Jul 23;17(15):5311. doi: 10.3390/ijerph17155311.
To illustrate trends in sex ratios in epithelial cancer mortality in the EU, USA, and Japan, with a focus on age-specific and cohort patterns.
We obtained certified deaths and resident populations from the World Health Organisation for the period of 1970-2014 for the USA, Japan, and the EU for 12 epithelial cancer sites. From these, we calculated both the age-specific and age-standardised male-to-female mortality sex ratios. We applied an age-period-cohort model to the sex ratios in order to disentangle the effects of age, period of death, and birth cohort.
Age-standardised mortality sex ratios were found to be unfavourable to males, apart from thyroid cancer. The highest standardised rates were in laryngeal cancer: 7·7 in the 1970s in the USA, 17·4 in the 1980s in the EU, and 16·8 in the 2000s in Japan. Cohort patterns likely to be due to excess smoking (1890 cohort) and drinking (1940 cohort) in men were identified in the USA, and were present but less defined in the EU and Japan for the oral cavity, oesophagus, liver, pancreas, larynx, lung, bladder, and kidney.
Mortality sex ratio patterns are partly explained by the differences in exposure to known and avoidable risk factors. These are mostly tobacco, alcohol, and obesity/overweight, as well as other lifestyle-related factors.
展示欧盟、美国和日本上皮性癌死亡率性别比的趋势，重点关注年龄别和队列模式。
我们从世界卫生组织获得了 1970 年至 2014 年期间美国、日本和欧盟 12 个上皮性癌部位的认证死亡人数和居民人口。在此基础上，我们计算了年龄别和年龄标准化的男性与女性死亡率性别比。我们应用年龄-时期-队列模型来分析性别比，以区分年龄、死亡时期和出生队列的影响。
除甲状腺癌外，年龄标准化死亡率性别比对男性不利。喉癌的标准化率最高：美国 20 世纪 70 年代为 7.7，欧盟 80 年代为 17.4，日本 2000 年代为 16.8。在美国，由于男性吸烟（1890 队列）和饮酒（1940 队列）过多，可能导致了队列模式，而在欧盟和日本，口腔、食管、肝脏、胰腺、喉、肺、膀胱和肾脏也存在但不太明确的队列模式。
死亡率性别比模式部分可以用已知和可避免的风险因素暴露差异来解释。这些因素主要是烟草、酒精和肥胖/超重，以及其他与生活方式相关的因素。
