Dubrow R, Johansen C, Skov T, Holford T R
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034.
Int J Cancer. 1994 Aug 1;58(3):324-9. doi: 10.1002/ijc.2910580303.
In a previous investigation, statistical modelling was used to examine the relationship between large-bowel-cancer incidence and age, time period and birth cohort by anatomic sub-site and sex, using data from the Connecticut Tumor Registry (CTR) for the period 1950 to 1984. This analysis revealed differences in age-period-cohort patterns that suggested etiologic distinctions among sub-site groupings and between the sexes. To test the generalizability of the Connecticut findings, we have conducted a similar age-period-cohort analysis using data from the Danish Cancer Registry (DCR) for the period 1953 to 1987. Cancers of the large bowel were classified into 6 anatomic sub-sites: cecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. Data were fitted to log-linear age-period-cohort models. If we interpret differences in age-period-cohort patterns as reflecting etiologic distinctions, the Denmark analysis, in conjunction with the Connecticut findings, was consistent with there being etiologic distinctions between cancers of the colon vs. the rectum in both males and females, between cancers of the cecum and the ascending colon vs. the remainder of the colon in females and between males vs. females for cancers of the sigmoid colon and rectum. Cancers of the cecum and the ascending colon were the most similar between males and females. Due to the ambiguities of age-period-cohort modelling, these should be considered only tentative conclusions that can be tested by analytical epidemiologic studies.
在之前的一项调查中，利用1950年至1984年康涅狄格肿瘤登记处（CTR）的数据，通过解剖亚部位和性别，运用统计建模来研究大肠癌发病率与年龄、时间段和出生队列之间的关系。该分析揭示了年龄-时期-队列模式的差异，这表明亚部位分组之间以及性别之间存在病因学差异。为了检验康涅狄格研究结果的普遍性，我们使用丹麦癌症登记处（DCR）1953年至1987年的数据进行了类似的年龄-时期-队列分析。大肠癌症被分为6个解剖亚部位：盲肠、升结肠、横结肠、降结肠、乙状结肠和直肠。数据被拟合到对数线性年龄-时期-队列模型中。如果我们将年龄-时期-队列模式的差异解释为反映病因学差异，那么丹麦的分析与康涅狄格的研究结果相结合，表明男性和女性的结肠癌与直肠癌之间、女性盲肠和升结肠癌与结肠其余部分之间以及乙状结肠癌和直肠癌的男性与女性之间存在病因学差异。盲肠和升结肠癌在男性和女性之间最为相似。由于年龄-时期-队列建模的模糊性，这些应仅被视为可通过分析性流行病学研究进行检验的初步结论。
