Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China.
J Thorac Oncol. 2021 Jun;16(6):933-944. doi: 10.1016/j.jtho.2021.01.1626. Epub 2021 Feb 16.
Lung cancer (LC) has been the most common cancer worldwide for several decades. This study comprehensively examines recent geographic patterns and temporal trends in LC incidence from 1978 to 2012 in 43 countries and evaluates the effects of birth cohort and period on temporal trends.
Data were retrieved from the Cancer Incidence in Five Continents database. Joinpoint regression and age-period-cohort models were applied.
The age-standardized rate was highest in Turkey (69.3 per 100,000 person-years) for men and in Denmark (36.7) for women in the period 2008 to 2012. Sex disparities were noted in most countries. From 1978 to 2012, a total of 19 countries had significantly declining trends among men, whereas 26 countries had significantly increasing trends among women (all p < 0.05). Quasi-reversed V-shaped and U-shaped incidence rate ratio trends indicating birth cohort effects were detected in 26 countries for men, with the highest risks mainly occurring in the 1930 to 1950 birth cohorts. However, the risks among recent generations have moderately increased in the People's Republic of China and Japan for men and sharply increased in Lithuania, Belarus, and Republic of Korea for women. Incidence rate ratio increases were steep among earlier birth cohorts and gradual among the post-1930s cohorts in 15 countries for women. Period effects were more evident than birth cohort effects in five countries for both sexes.
Disparities in LC incidence and carcinogenic risk persist worldwide. Our findings identified high-risk target populations for primary prevention to reduce the LC incidence and highlighted the urgent need for etiologic studies to identify the reasons for pronounced cohort-specific risk increases in certain countries.
几十年来，肺癌（LC）一直是全球最常见的癌症。本研究全面考察了 1978 年至 2012 年 43 个国家 LC 发病率的近期地理模式和时间趋势，并评估了出生队列和时期对时间趋势的影响。
数据来自《五大洲癌症发病率》数据库。采用 Joinpoint 回归和年龄-时期-队列模型进行分析。
2008 年至 2012 年期间，男性发病率最高的是土耳其（69.3/10 万人口年），女性发病率最高的是丹麦（36.7）。大多数国家都存在性别差异。1978 年至 2012 年期间，共有 19 个国家男性发病率呈显著下降趋势，26 个国家女性发病率呈显著上升趋势（均 p<0.05）。在 26 个国家的男性中，发现了具有出生队列效应的准反向 V 形和 U 形发病率比趋势，最高风险主要发生在 1930 年至 1950 年出生队列。然而，在中国和日本，男性最近几代人的风险适度增加，而在立陶宛、白俄罗斯和韩国，女性的风险急剧增加。在 15 个国家的女性中，较早出生队列的发病率比增加较为陡峭，而 1930 年后出生队列的发病率比增加则较为平缓。五个国家的两性中，时期效应比出生队列效应更为明显。
全球范围内，LC 发病率和致癌风险的差异仍然存在。我们的研究结果确定了高危目标人群，以进行初级预防，降低 LC 发病率，并强调迫切需要开展病因学研究，以确定某些国家特定队列风险显著增加的原因。
