9/11 前后纽约市和纽约州头颈部癌症的发病率。
Incidence of Head and Neck Cancers before and after 9/11 in New York City and New York State.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA,
出版信息
ORL J Otorhinolaryngol Relat Spec. 2022;84(4):324-335. doi: 10.1159/000519840. Epub 2021 Dec 27.
INTRODUCTION
The incidence of cancers in New York State (NYS) before and after 9/11 including lung, colorectal, and renal cancers has been previously described. To date, the incidence of head and neck cancers (HNCs) before and after 9/11 has not been described.
METHODS
Cancers involving the oral cavity and oropharynx; the nose, nasal cavity, nasopharynx, and middle ear; larynx; and thyroid were identified using the New York State Cancer Registry (NYSCR). Age-adjusted incidence and rates per 100,000 residents from 1987 to 2015 were analyzed using joinpoint regression. Trends in incidence using annual percent changes are presented.
RESULTS
The overall rate of HNC increased slightly by 0.7% (p < 0.001) from 1987 to 2003 in NYS. From 2003 to 2008, the rate increased by 5.73% (p < 0.001), and from 2008 to 2015, the rate increased by 1.68% (p < 0.001). The rate of thyroid cancer increased by 6.79% (p < 0.001) from 1987 to 2003, by 9.99% (p < 0.001) from 2003 to 2009, and by 2.41% (p = 0.001) from 2009 to 2015. The rate of thyroid cancer was higher in women at all time points. In a subset analysis of HNCs excluding thyroid cancer, the rate decreased by 2.02% (p < 0.001) from 1991 to 2001, followed by a nonsignificant increase of 0.1% (p = 0.515) from 2001 to 2015. The rate of oropharyngeal (OP) cancer significantly increased from 1999 to 2015 (2.65%; p < 0.001). The rate of oral cavity cancer significantly decreased from 1987 to 2003 (1.97%; p < 0.001), with no significant change after 2003. The rate of laryngeal cancer decreased significantly by 2.43% (p < 0.001) from 1987 to 2015, as did the rate of nasal cavity/nasopharyngeal cancer (0.33%; p = 0.03).
CONCLUSIONS
In NYS, OP cancer and thyroid cancer rates increased significantly during the study period. The rate of thyroid cancer was higher in women. The rate of combined HNC increased significantly after 9/11 compared to before 9/11; however, in a subset analysis of all HNC patients excluding thyroid cancer, the rate decreased significantly prior to 9/11 and then nonsignificantly increased afterward. This suggests that the increase in thyroid cancer accounts for the increase in combined HNC in NYS. The impact of 9/11 on rates of HNC requires further research.
简介
之前已经描述过纽约州（NYS）在 9/11 前后肺癌、结直肠癌和肾癌的发病率。迄今为止，9/11 前后头颈部癌症（HNC）的发病率尚未描述。
方法
使用纽约州癌症登记处（NYSCR）确定涉及口腔和口咽；鼻腔、鼻腔、鼻咽和中耳；喉；和甲状腺的癌症。使用 joinpoint 回归分析 1987 年至 2015 年的年龄调整发病率和每 100,000 居民的发病率。以每年百分比变化的形式呈现发病率趋势。
结果
1987 年至 2003 年，NYS 的 HNC 总体发病率略有上升 0.7%（p<0.001）。2003 年至 2008 年，发病率上升 5.73%（p<0.001），2008 年至 2015 年，发病率上升 1.68%（p<0.001）。甲状腺癌的发病率从 1987 年到 2003 年上升了 6.79%（p<0.001），从 2003 年到 2009 年上升了 9.99%（p<0.001），从 2009 年到 2015 年上升了 2.41%（p=0.001）。在所有时间点，女性的甲状腺癌发病率均较高。在排除甲状腺癌的 HNC 亚组分析中，1991 年至 2001 年发病率下降 2.02%（p<0.001），随后 2001 年至 2015 年发病率无显著变化 0.1%（p=0.515）。口咽癌（OP）的发病率从 1999 年到 2015 年显著增加（2.65%；p<0.001）。口腔癌的发病率从 1987 年到 2003 年显著下降（1.97%；p<0.001），2003 年之后没有明显变化。喉癌的发病率从 1987 年到 2015 年显著下降 2.43%（p<0.001），鼻腔/鼻咽癌症的发病率也下降了 0.33%（p=0.03）。
结论
在纽约州，OP 癌和甲状腺癌的发病率在研究期间显著增加。女性的甲状腺癌发病率更高。9/11 后，HNC 的综合发病率与 9/11 前相比显著增加；然而，在排除甲状腺癌的所有 HNC 患者的亚组分析中，9/11 前发病率显著下降，随后无显著增加。这表明甲状腺癌的增加导致了纽约州 HNC 发病率的增加。9/11 对 HNC 发病率的影响需要进一步研究。
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