De Stefani E, Fierro L, Barrios E, Ronco A
National Cancer Registry, Instituto Nacional de Oncologia, Montevideo, Uruguay.
Int J Cancer. 1994 Mar 1;56(5):634-9. doi: 10.1002/ijc.2910560505.
Cancer mortality trends from 1953 to 1991 were assessed by means of data supplied by the Department of Vital Statistics of the Ministry of Public Health. The population at risk was obtained from the Bureau of Statistics and Censuses. Age-specific and age-adjusted mortality rates were calculated, using the world standard population, for a number of sites or groups of sites. In order to obtain relative risks of death for each period, Poisson regression models were fitted to the data using the GLIM program. The main model included age and period as explanatory variables. Among males, the principal increase was observed for lung cancer, followed by prostatic cancer. The rates were mainly stable in colon cancer and leukaemias, whereas gastric cancer showed a marked decline. Also, a recent decline was seen for oesophageal cancer. In females a steady decline in mortality was observed for all sites combined. Major decreases were seen for oesophageal, gastric, cervical and total uterine cancers. The only cancers showing significant increases were breast cancer, and lung cancer for the most recent period. Providing that there were no changes in death registration or in survival rates, changes in prevalence of risk factors might be responsible for the observed trends.
利用公共卫生部人口动态统计司提供的数据评估了1953年至1991年的癌症死亡率趋势。危险人群数据来自统计局和人口普查局。使用世界标准人口计算了多个部位或部位组的年龄别死亡率和年龄调整死亡率。为了获得每个时期的相对死亡风险,使用GLIM程序对数据拟合泊松回归模型。主要模型将年龄和时期作为解释变量。在男性中,主要观察到肺癌发病率上升,其次是前列腺癌。结肠癌和白血病发病率基本稳定,而胃癌发病率显著下降。此外,食管癌近期也出现下降。在女性中,所有部位综合死亡率呈稳步下降趋势。食管癌、胃癌、宫颈癌和子宫体癌死亡率大幅下降。仅乳腺癌和最近时期的肺癌呈显著上升趋势。假设死亡登记或生存率没有变化,风险因素患病率的变化可能是观察到的趋势的原因。