Zatonskí W, La Vecchia C, Levi F, Negri E, Lucchini F
Department of Cancer Control and Epidemiology, Maria Curie-Sklodowska Memorial Cancer Center, Warsaw, Poland.
J Cancer Res Clin Oncol. 1993;119(3):165-71. doi: 10.1007/BF01229532.
Trends in mortality from cancer of the gall-bladder and bile ducts over the period 1965-1989 were analysed for 25 European countries on the basis of official death certifications from the World Health Organization databank. A high-mortality area--i.e. with overall death certification rates, world standard, around or over 2/100,000 men and 4/100,000 women in 1985-1989--was identified in Germany and the surrounding central European countries (Austria, Czechoslovakia, Hungary and Poland). The highest rates were in Hungary (3.9/100,000 men and 7.4/100,000 women). During the two decades considered, rates increased in Czechoslovakia and Hungary, remained stable in Poland and declined in Austria and Germany. Intermediate-mortality areas included Scandinavian countries (except Norway) and Switzerland: their rates in the late 1980s were between 1.5 and 2.5/100,000 men and between 2.2 and 4.2/100,000 women. Mortality increased in Finland and Sweden, declined in the Netherlands and Switzerland, and did not change consistently in Denmark. Low-mortality countries (i.e. with rates in 1985-1989 below 2.0/100,000 men and 2.5/100,000 women) included Belgium, France, Britain, Ireland, Norway, Bulgaria and Mediterranean countries. Over the last two decades, certification rates declined in Bulgaria and Great Britain, but increased in all other countries. The ratio between the countries with the highest and lowest gall-bladder cancer mortality rates declined from 21 to 12 in women, although they remained stable around 10 for men. The pattern was similar when analysis was restricted to truncated rates from patients aged between 35 and 64 years. These trends, and particularly the exceedingly high rates in central Europe, the low rates in Mediterranean countries and the low and declining rates in Britain and Ireland are discussed in terms of known (cholelithiasis) or potential (dietary) factors in gall-bladder cancer aetiology, and of trends in cholecystectomy rates.
基于世界卫生组织数据库的官方死亡证明，对1965年至1989年期间25个欧洲国家胆囊癌和胆管癌的死亡率趋势进行了分析。在德国及周边中欧国家（奥地利、捷克斯洛伐克、匈牙利和波兰）确定了一个高死亡率地区，即1985 - 1989年期间，按世界标准计算，男性总体死亡证明率约为或超过2/10万，女性为4/10万。匈牙利的死亡率最高（男性为3.9/10万，女性为7.4/10万）。在考虑的二十年中，捷克斯洛伐克和匈牙利的死亡率上升，波兰保持稳定，奥地利和德国下降。中等死亡率地区包括斯堪的纳维亚国家（挪威除外）和瑞士：20世纪80年代末，其死亡率男性在1.5至2.5/10万之间，女性在2.2至4.2/10万之间。芬兰和瑞典的死亡率上升，荷兰和瑞士下降，丹麦则没有持续变化。低死亡率国家（即1985 - 1989年期间男性死亡率低于2.0/10万，女性低于2.5/10万）包括比利时、法国、英国、爱尔兰、挪威、保加利亚和地中海国家。在过去二十年中，保加利亚和英国的证明率下降，但所有其他国家上升。胆囊癌死亡率最高和最低的国家之间的比率，女性从21降至12，而男性则稳定在10左右。当分析仅限于35至64岁患者的截短率时，模式相似。根据胆囊癌病因中已知的（胆石症）或潜在的（饮食）因素以及胆囊切除术率的趋势，对这些趋势进行了讨论，特别是中欧的极高率、地中海国家的低率以及英国和爱尔兰的低且下降的率。
