Pollán M, López-Abente G, Ruiz-Tovar M, Martínez de Aragón M V
Cancer Epidemiology Unit, National Centre of Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Eur J Cancer. 1995 Oct;31A(11):1811-21. doi: 10.1016/0959-8049(95)00427-k.
Using log-linear Poisson modelling, trends in childhood cancer mortality among the population under 20 years of age in Spain are described over the 35-year period from 1956 to 1990. Overall cancer mortality and seven specific sites were considered: all leukaemias, Hodgkin's disease, non-Hodgkin's lymphomas, malignant brain tumours, kidney cancer, malignant bone neoplasms, and a broad category of ill-defined tumours. An age-period-cohort model was used to analyse the influence of age, period of death and birth cohort. Recent trends were estimated by restricting analysis to the last three 5-year periods. In general, mortality began to decline at the beginning of the 1970s, with reductions of 36% in males and 45% in females being registered between 1966-1970 and 1986-1990. The use of age-period-cohort models revealed an initially rising period effect attributable to diagnostic advances. The decline in mortality in post-1965 generations and the final downturn in the period effect are both most certainly a consequence of the remarkable progress achieved in the treatment of such tumours. During the final 15 years, there was a relative decline in mortality of approximately 20% every 5 years. However, in the case of malignant renal tumours in males and malignant bone tumours and non-Hodgkin's lymphomas in both sexes the situation remained stable.
运用对数线性泊松模型，描述了1956年至1990年这35年间西班牙20岁以下人群儿童癌症死亡率的趋势。研究考虑了总体癌症死亡率以及七个特定部位：所有白血病、霍奇金病、非霍奇金淋巴瘤、恶性脑肿瘤、肾癌、恶性骨肿瘤以及一大类定义不明的肿瘤。采用年龄-时期-队列模型分析年龄、死亡时期和出生队列的影响。通过将分析限制在最后三个5年期间来估计近期趋势。总体而言，死亡率在20世纪70年代初开始下降，1966 - 1970年至1986 - 1990年间，男性死亡率下降了36%，女性下降了45%。年龄-时期-队列模型的应用显示，由于诊断技术的进步，最初存在一个上升的时期效应。1965年后出生队列的死亡率下降以及时期效应的最终下降，无疑都是此类肿瘤治疗取得显著进展的结果。在最后15年中，死亡率每5年相对下降约20%。然而，男性恶性肾肿瘤以及男女两性的恶性骨肿瘤和非霍奇金淋巴瘤的情况保持稳定。
