Department of Forensic Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Int J Public Health. 2021 Mar 17;66:603810. doi: 10.3389/ijph.2021.603810. eCollection 2021.
This study aimed to estimate the long-term trends of breast cancer incidence in Shanghai, Hong Kong, and Los Angeles (LA) Data were obtained from Cancer Incidence in Five Continents () database. The average annual percent change (AAPC) was conducted by joinpoint regression analysis, and the age, period and cohort effects were estimated by age-period-cohort (APC) analysis. The age-standardized incidence rates (ASIRs) in LA were higher than Shanghai and Hong Kong. During 1988-2012, the ASIRs significantly decreased in white women in LA (AAPC = -0.6%, 95% CI: -0.9% to -0.4%) while increased in Shanghai (2.5%: 2.1%-2.9%) and Hong Kong (2.2%: 2.0%-2.5%). The APC analysis revealed significantly increased effects of age and period, and decreased effect of birth cohort. Although age and cohort effects were relatively strong, the period effect may be the key factor affecting trends of incidence, which may be caused by increasing exposures to carcinogens and risk factors. Therefore, more effective measures should be carried out promptly to protect high-risk populations such as elder women, to avoid exposures to risk factors of breast cancer.
本研究旨在估计上海、香港和洛杉矶（LA）的乳腺癌发病率的长期趋势。数据来自《五大洲癌症发病率》（Cancer Incidence in Five Continents）数据库。通过 Joinpoint 回归分析计算平均年度百分比变化（AAPC），通过年龄-时期-队列（APC）分析估计年龄、时期和队列效应。LA 的年龄标准化发病率（ASIR）高于上海和香港。1988 年至 2012 年期间，LA 白人女性的 ASIR 显著下降（AAPC=-0.6%，95%CI：-0.9%至-0.4%），而上海（2.5%：2.1%-2.9%）和香港（2.2%：2.0%-2.5%）则呈上升趋势。APC 分析显示，年龄和时期的影响显著增加，而出生队列的影响则降低。尽管年龄和队列效应较强，但时期效应可能是影响发病率趋势的关键因素，这可能是由于接触致癌物质和危险因素的增加所致。因此，应迅速采取更有效的措施，保护高危人群，如老年妇女，避免接触乳腺癌的危险因素。
