Vatanasapt V, Martin N, Sriplung H, Chindavijak K, Sontipong S, Sriamporn H, Parkin D M, Ferlay J
Faculty of Medicine, Khon Kaen University, Srinagarind Hospital, Thailand.
Cancer Epidemiol Biomarkers Prev. 1995 Jul-Aug;4(5):475-83.
Results from three cancer registries (Chiang Mai, Khon Kaen, and Songkhla) in different regions of Thailand and from a cancer survey in the population of Bangkok during the years 1988-1991 are presented, together with an estimate of the incidence of cancer for the country as a whole. Overall, liver cancer is the most frequent malignancy, but there are large regional differences in incidence and in histological type, with very high rates of cholangiocarcinoma in the northeast (associated with endemic opisthorchiasis) but a more even distribution of hepatocellular carcinoma. Lung cancer is second in frequency, with the highest rates in northern Thailand, where the incidence in women (Age Standardized Rate, 37.4 per 100,000) is among the highest in the world. A link with tobacco smoking is suggested by similarly raised rates, especially in women, for cancers of the larynx and pancreas. Cervical cancer is the most common malignancy in women, with relatively little regional variation in risk, while the incidence of breast cancer is low. Other cancer sites showing moderately increased rates include the lip and oral cavity, particularly in females from the north and northeast, where the chewing of betel nut remains common among older generations, nasopharyngeal cancer, carcinoma of the esophagus in the southern region, and penile cancer, especially in the north and northeast. Previous studies which have investigated the etiological factors underlying these patterns are reviewed, and the implications for future research and for national cancer control policies are discussed.
本文呈现了泰国不同地区三个癌症登记处（清迈、孔敬和宋卡）的结果以及1988 - 1991年间曼谷人群癌症调查的结果，并对泰国全国的癌症发病率进行了估计。总体而言，肝癌是最常见的恶性肿瘤，但发病率和组织学类型存在较大的地区差异，东北部胆管癌发病率极高（与地方性华支睾吸虫病有关），而肝细胞癌分布更为均匀。肺癌发病率排第二，在泰国北部最高，那里女性的发病率（年龄标准化率为每10万人口37.4例）位居世界前列。喉癌和胰腺癌发病率同样升高，尤其在女性中，这表明与吸烟有关。宫颈癌是女性中最常见的恶性肿瘤，风险在地区间相对差异较小，而乳腺癌发病率较低。其他发病率适度上升的癌症部位包括唇和口腔，特别是北部和东北部的女性，那里嚼槟榔在老一辈人中仍然很普遍，还有鼻咽癌、南部地区的食管癌以及阴茎癌，尤其是北部和东北部。本文回顾了此前调查这些模式背后病因的研究，并讨论了对未来研究和国家癌症控制政策的影响。
