National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
Int J Cancer. 2022 Nov 1;151(9):1447-1461. doi: 10.1002/ijc.34158. Epub 2022 Jun 22.
A male predominance was observed in esophageal and gastric cancers, though present limited data has revealed variations by age. We aim to investigate the global age-specific sex differences in esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric cardia cancer (GCC) and gastric noncardia cancer (GNCC). Data on esophageal and gastric cancers incidence by diagnosis year, sex, histology, subsite and age group were extracted from 171 registries in 54 countries included in the last two volumes (X and XI, 2003-2012) of Cancer Incidence in Five Continents, which contributing to over 80% of the global burdens of these cancers. Age-standardized incidence rates (ASIRs) and male-to-female ASIRs ratios were estimated for esophageal and gastric cancers, by histological subtype and subsite, globally and by country. We consistently observed a male predominance in esophageal and gastric cancers across the world from 2003 to 2012, with male-to-female ASIRs ratios of 6.7:1 for EAC, 3.3:1 for ESCC, 4.0:1 for GCC and 2.1:1 for GNCC. The sex differences were consistent across time periods but varied significantly by age across the life span. Across the four cancer types, the male-to-female incidence rate ratios increased from young ages, approaching a peak at ages 60-64, but sharply declined thereafter. Similar "low-high-low" trends of age-specific sex ratio were observed in other digestive cancers including liver, pancreas, colon and rectum with peak ages ranging from 50 to 65. Age-dependent risk factors warrant further investigation to aid our understanding of the underlying etiologies of esophageal and gastric cancers by histological subtype and subsite.
在食管癌和胃癌中观察到男性居多，但目前有限的数据表明，其存在年龄差异。我们旨在研究食管鳞状细胞癌（ESCC）、食管腺癌（EAC）、胃贲门癌（GCC）和胃非贲门癌（GNCC）在全球范围内按年龄划分的性别差异。从包含在《五大洲癌症发病率》（Cancer Incidence in Five Continents）最后两卷（X 和 XI，2003-2012 年）中的 54 个国家的 171 个登记处提取了按诊断年份、性别、组织学、部位和年龄组分类的食管癌和胃癌发病率数据，这些登记处占这些癌症全球负担的 80%以上。估计了全球和各国按组织学亚型和部位分类的食管癌和胃癌的年龄标准化发病率（ASIR）和男女 ASIR 比值。我们一致观察到 2003 年至 2012 年期间，全球范围内食管癌和胃癌均存在男性居多的现象，EAC 的男女 ASIR 比值为 6.7:1，ESCC 为 3.3:1，GCC 为 4.0:1，GNCC 为 2.1:1。这些性别差异在不同时间段内是一致的，但在整个生命周期中按年龄变化显著。在这四种癌症类型中，男女发病率比从年轻时增加，在 60-64 岁时达到峰值，但此后急剧下降。在其他消化系统癌症（包括肝癌、胰腺癌、结肠癌和直肠癌）中也观察到了类似的“低-高-低”年龄别性别比趋势，其峰值年龄在 50-65 岁之间。需要进一步研究年龄相关的危险因素，以帮助我们了解不同组织学亚型和部位的食管癌和胃癌的潜在病因。
