Cuzick J, Velez R, Doll R
Int J Cancer. 1983 Jul 15;32(1):13-9. doi: 10.1002/ijc.2910320104.
Mortality statistics for multiple myeloma over the period 1960-1975 have been analysed for 23 countries. Attention has been focused on international variations, secular trends, and the male to female mortality ratio. The greatest percentage increases have been found in countries with low overall rates. The male:female ratio was generally higher in countries with high rates, and the national rates correlated more strongly with GNP per caput than with an index of medical care (hospital beds/10,000). Further analyses have been carried out over the period 1955-79 in Sweden, a country with high but relatively stable rates, and Japan, where the rates are very low but are increasing rapidly. An age, period, and cohort analysis of the trends in these countries is presented and criticized. The contributions made by increased diagnostic capability and by an increase in the true incidence of the disease are discussed.
对1960年至1975年期间23个国家的多发性骨髓瘤死亡率统计数据进行了分析。重点关注了国际差异、长期趋势以及男女死亡率之比。总体发病率较低的国家出现了最大百分比的增长。发病率较高的国家，男女比例通常也较高，而且各国发病率与人均国民生产总值的相关性，要比与医疗保健指数（每万名居民的医院病床数）的相关性更强。对瑞典（该国发病率较高但相对稳定）和日本（该国发病率很低但增长迅速）1955年至1979年期间的数据进行了进一步分析。本文呈现并批评了对这些国家趋势的年龄、时期和队列分析。讨论了诊断能力提高和疾病实际发病率增加所起的作用。
