Cayuela Lucía, Gaeta Anna Michela, Lopez-Campos José Luis, Cayuela Aurelio
Department of Internal Medicine, Hospital Universitario Severo Ochoa, Leganés, Spain.
Pulmonology Department, Hospital Universitario Severo Ochoa, Leganés, Spain.
Clin Transl Oncol. 2025 Jan;27(1):189-195. doi: 10.1007/s12094-024-03555-9. Epub 2024 Jun 19.
This study examines lung cancer incidence in Spain (1990-2019) through age-period-cohort (A-P-C) analysis and Global Burden of Diseases (GBD) data, unravelling the complex interplay of age, period, and birth cohort in shaping these trends.
Utilizing GBD and Spanish population data, the study calculates age-standardized incidence rates (ASIRs) and employs Joinpoint analysis to identify significant trends. A-P-C analysis dissects the individual effects of age, calendar period, and birth cohort on incidence patterns.
Between 1990 and 2019, almost 738,000 cases of lung cancer were diagnosed in Spain, with an average annual increase of 1.7%. The ASIR of lung cancer in Spain from 1990 to 2019 showed a sustained upward trend in women (Average Annual Per cent Change: 2.5%, P < 0.05), reaching 23.3 cases per 100,000 in 2019, whilst men experienced a significant decrease in incidence rates (AAPC: -0.6%, P < 0.05), falling to 108.9 in 2019. The male-to-female incidence ratio decreased from 12.2 in 1992 to 4.9 in 2019. Joinpoint analysis identified distinct periods for both sexes, with men showing stability, decline and then a significant decrease, whereas women showed an initial increase followed by a decrease. The longitudinal age curves showed a consistently higher incidence risk in men, peaking in the 80-84 age group. Male cohorts since the 1920s showed a decreasing relative risk, whereas women showed fluctuations in risk over time.
Lung cancer rates are falling in Spain, especially amongst men, due to lower smoking rates. The gender gap is closing, but prevention targeted at women is needed. Tighter tobacco control and research into other risk factors are essential. Understanding the long-term effects of smoking and early exposure is key to better prevention and treatment in Spain.
本研究通过年龄-时期-队列（A-P-C）分析和全球疾病负担（GBD）数据，研究西班牙（1990 - 2019年）的肺癌发病率，揭示年龄、时期和出生队列在塑造这些趋势中的复杂相互作用。
利用GBD和西班牙人口数据，该研究计算年龄标准化发病率（ASIRs），并采用Joinpoint分析来确定显著趋势。A-P-C分析剖析年龄、日历时期和出生队列对发病模式的个体影响。
1990年至2019年期间，西班牙诊断出近73.8万例肺癌病例，年均增长1.7%。1990年至2019年西班牙肺癌的ASIR在女性中呈持续上升趋势（年均变化百分比：2.5%，P < 0.05），2019年达到每10万人23.3例，而男性发病率显著下降（AAPC：-0.6%，P < 0.05），2019年降至108.9例。男女发病率之比从1992年的12.2降至2019年的4.9。Joinpoint分析确定了男女不同的时期，男性表现为稳定、下降然后显著下降，而女性则先上升后下降。纵向年龄曲线显示男性的发病风险始终较高，在80 - 84岁年龄组达到峰值。自20世纪20年代以来，男性队列的相对风险呈下降趋势，而女性的风险随时间波动。
由于吸烟率降低，西班牙的肺癌发病率正在下降，尤其是男性。性别差距正在缩小，但仍需要针对女性的预防措施。加强烟草控制和对其他风险因素的研究至关重要。了解吸烟的长期影响和早期暴露是西班牙更好地预防和治疗肺癌的关键。
