da Costa Wilson L, Oluyomi Abiodun O, Thrift Aaron P
Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA.
Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.
JNCI Cancer Spectr. 2020 May 9;4(4):pkaa033. doi: 10.1093/jncics/pkaa033. eCollection 2020 Aug.
Pancreatic ductal adenocarcinoma is a major contributor to cancer-related mortality in the United States. We aimed to investigate trends in incidence rates from all 50 states from 2001 to 2016, overall and by race, sex, and state and using age-period-cohort analyses.
Age-adjusted incidence rates and trends in adults aged 35 years and older were calculated using data from the US Cancer Statistics registry. We used joinpoint regression to compute annual percent changes (APC) and average annual percent changes. We also analyzed incidence trends by age groups and birth cohorts through age-period-cohort modeling.
Age-standardized incidence rates increased by 1.23% (95% confidence interval [CI] = 0.92% to 1.54%) annually between 2001 and 2008 but were stable between 2008 and 2016 (APC = 0.11%, 95% CI = -0.13% to 0.35%). APCs and inflection points were no different for men and women. Rates increased statistically significantly among non-Hispanic whites (NHW) and non-Hispanic blacks between 2001 and 2007 and between 2001 and 2008, respectively, but, in later years, rates increased slowly among NHWs (APC = 0.36%, 95% CI = 0.12% to 0.60%), and were stable among non-Hispanic blacks (APC = -0.40%, 95% CI = -0.89% to 0.10%). The number of states with age-standardized incidence rates no less than 20.4 per 100 000 increased from 16 in 2001-2003 to 40 by 2015-2016. We found a strong birth cohort effect in both men and women and increasing rates among successive birth cohorts of NHWs.
The incidence of pancreatic ductal adenocarcinoma has consistently increased in the United States, albeit at slower rates recently. We observed notable increases among NHWs and in some states in the central and southern part of the country.
胰腺导管腺癌是美国癌症相关死亡的主要原因之一。我们旨在调查2001年至2016年美国50个州的发病率趋势，包括总体趋势以及按种族、性别、州别划分的趋势，并采用年龄-时期-队列分析方法。
利用美国癌症统计登记处的数据，计算35岁及以上成年人的年龄调整发病率及趋势。我们使用连接点回归来计算年度百分比变化（APC）和平均年度百分比变化。我们还通过年龄-时期-队列模型分析了不同年龄组和出生队列的发病趋势。
2001年至2008年期间，年龄标准化发病率每年增长1.23%（95%置信区间[CI]=0.92%至1.54%），但在2008年至2016年期间保持稳定（APC=0.11%，95%CI=-0.13%至0.35%）。男性和女性的APC及转折点无差异。2001年至2007年期间非西班牙裔白人（NHW）以及2001年至2008年期间非西班牙裔黑人的发病率分别有统计学显著上升，但在随后几年，NHW的发病率上升缓慢（APC=0.36%，95%CI=0.12%至0.60%），而非西班牙裔黑人的发病率保持稳定（APC=-0.40%，95%CI=-0.89%至0.10%）。年龄标准化发病率每10万人不少于20.4的州的数量从2001 - 2003年的16个增加到2015 - 2016年的40个。我们发现男性和女性均存在强烈的出生队列效应，且NHW的连续出生队列发病率呈上升趋势。
在美国，胰腺导管腺癌的发病率持续上升，尽管最近增速有所放缓。我们观察到NHW以及美国中部和南部部分州的发病率显著上升。
