Dubrow R, Bernstein J, Holford T R
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510.
Int J Cancer. 1993 Apr 1;53(6):907-13. doi: 10.1002/ijc.2910530607.
In order to investigate etiologic distinctions among the anatomic sub-sites of the large bowel by sex, the relationship between large-bowel-cancer incidence and age at diagnosis, time period at diagnosis, and birth cohort was analyzed by anatomic sub-site and by sex, using data from the Connecticut Tumor Registry. Included in the study were all incident large-bowel-cancer cases occurring between 1950 and 1984 among Connecticut residents aged 40 to 79. Cancers of the large bowel were classified into 5 anatomic sub-sites: ascending colon (including cecum), transverse colon (including flexures), descending colon, sigmoid colon, and rectum (including rectosigmoid junction, anal canal, and anus). The data were fitted to log-linear age-period-cohort models. For each of the sub-sites, the age-period-cohort patterns for males and females differed. Within each sex, sub-site groupings with common patterns were indicated. Among males, the age-period-cohort patterns for the colon sub-sites were fairly similar; but the pattern for the rectum differed markedly from that for the colon sub-sites. There were secondary differences among the colon sub-sites that pointed to a secondary distinction between the right and the left colons. Among females, the age-period-cohort patterns for the left colon sub-sites and the rectum were fairly similar. The pattern for the transverse colon differed moderately from that of the left colon, and differed substantially from that of the rectum and the ascending colon. The ascending colon differed markedly from each of the other sub-sites. It is possible that these differences in age-period-cohort patterns reflect etiologic distinctions among sub-site groupings and between the sexes.
为按性别研究大肠各解剖亚部位之间的病因差异，利用康涅狄格肿瘤登记处的数据，按解剖亚部位和性别分析了大肠癌发病率与诊断年龄、诊断时间段及出生队列之间的关系。该研究纳入了1950年至1984年间康涅狄格州40至79岁居民中所有新发的大肠癌病例。大肠癌被分为5个解剖亚部位：升结肠（包括盲肠）、横结肠（包括弯曲部）、降结肠、乙状结肠和直肠（包括直肠乙状结肠交界处、肛管和肛门）。数据拟合至对数线性年龄-时期-队列模型。对于每个亚部位，男性和女性的年龄-时期-队列模式不同。在每种性别中，指出了具有共同模式的亚部位分组。在男性中，结肠亚部位的年龄-时期-队列模式相当相似；但直肠的模式与结肠亚部位明显不同。结肠亚部位之间存在次要差异，这表明右半结肠和左半结肠之间存在次要区别。在女性中，左半结肠亚部位和直肠的年龄-时期-队列模式相当相似。横结肠的模式与左半结肠略有不同，与直肠和升结肠有很大不同。升结肠与其他每个亚部位都明显不同。这些年龄-时期-队列模式的差异可能反映了亚部位分组之间以及性别之间的病因差异。
