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淋巴瘤发病率和死亡率的性别差异:基于人群的研究。

Sex differences in lymphoma incidence and mortality by subtype: A population-based study.

机构信息

Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.

Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Am J Hematol. 2023 Jan;98(1):23-30. doi: 10.1002/ajh.26744. Epub 2022 Oct 10.

Abstract

It is well established that the male sex is associated with increased risk for, as well as poorer survival of, most cancers. A similar pattern has been described in lymphomas but has not yet been comprehensively assessed. In this nationwide population-based cohort study, we used the Swedish Lymphoma Register to investigate sex differences in lymphoma subtype incidence and excess mortality in adults (age 18-99) diagnosed in 2000-2019. Male-to-female incidence rate ratios (IRRs) and excess mortality ratios (EMRs) adjusted for age and calendar year were predicted using Poisson regression. We identified 36 795 lymphoma cases, 20 738 (56.4%) in men and 16 057 (43.6%) in women. Men were at significantly higher risk of 14 out of 16 lymphoma subtypes with IRRs ranging from 1.15 (95% confidence interval [CI] 1.09-1.22) in follicular lymphoma to 5.95 (95% CI 4.89-7.24) in hairy cell leukemia. EMRs >1 were seen in 13 out of 16 lymphoma subtypes indicating higher mortality in men, although only statistically significant for classical Hodgkin lymphoma 1.26 (95% CI 1.04-1.54), aggressive lymphoma not otherwise specified 1.29 (95% CI 1.08-1.55), and small lymphocytic lymphoma 1.52 (95% CI 1.11-2.07). A corresponding analysis using data from the Danish Lymphoma Register was performed with comparable results. In conclusion, we demonstrate a significantly higher incidence and trend toward higher mortality in men for most lymphoma subtypes. Future studies with large patient material that include detailed clinicopathological prognostic factors are warranted to further delineate and explain sex differences in lymphoma survival to enable optimal management of lymphoma patients regardless of sex.

摘要

众所周知,男性患大多数癌症的风险更高,且生存预后更差。这种模式在淋巴瘤中也有类似的描述,但尚未得到全面评估。在这项全国性基于人群的队列研究中,我们使用瑞典淋巴瘤登记处调查了 2000 年至 2019 年间诊断的成年(18-99 岁)淋巴瘤亚型发病率和超额死亡率的性别差异。使用泊松回归预测调整年龄和日历年后的男性与女性发病率比值(IRR)和超额死亡率比值(EMR)。我们确定了 36795 例淋巴瘤病例,其中 20738 例(56.4%)为男性,16057 例(43.6%)为女性。男性患 16 种淋巴瘤亚型中的 14 种的风险显著更高,IRR 范围从滤泡性淋巴瘤的 1.15(95%置信区间 [CI] 1.09-1.22)到毛细胞白血病的 5.95(95% CI 4.89-7.24)。16 种淋巴瘤亚型中有 13 种的 EMRs>1,表明男性死亡率更高,尽管仅在经典霍奇金淋巴瘤 1.26(95% CI 1.04-1.54)、非特指侵袭性淋巴瘤 1.29(95% CI 1.08-1.55)和小淋巴细胞性淋巴瘤 1.52(95% CI 1.11-2.07)中具有统计学意义。使用丹麦淋巴瘤登记处的数据进行了相应的分析,结果相似。总之,我们证明了男性大多数淋巴瘤亚型的发病率显著更高,且死亡率呈上升趋势。未来需要进行包含详细临床病理预后因素的大型患者资料研究,以进一步阐明和解释淋巴瘤生存中的性别差异,从而实现无论性别如何,都能对淋巴瘤患者进行最佳管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61e0/10092431/0c43068cad6d/AJH-98-23-g002.jpg

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