Armstrong W, Borman B
Department of Community Health, University of Illinois at Urbana-Champaign, USA.
N Z Med J. 1996 Jun 28;109(1024):221-4.
To determine if incidence of cancer of the female breast in New Zealand is changing by age, ethnic group, and geographic region, and if there are differences in rates for stage of tumour by urban and rural residence.
Age-adjusted incidence rates for Maori and nonMaori were computed from all primary cancers of the breast registered in the National Cancer Registry, 1978-92. Analyses of time trends and geographic variations were conducted using standard statistical methods.
There were steady, but nonsignificant, increases in the Maori and nonMaori incidence rates between 1978-92 which represents important increases in case numbers. The age-specific rates increased sharply from age 20, levelled out at age 45 and slowly increased through 85 years and older. There was a significant trend over time for the rate of "not staged" cases which was due to an artifact. No statistically significant variations in the age-adjusted rates by area (14 area health board districts, 4 regional health authorities), or by stage of tumour in three urban-rural groups were found. Maori women showed less shift in incidence rates from regional to local stage of tumour than nonMaori. The proportion of tumours reported without stage increased in the period 1988-92. A large proportion of cases had nonspecific morphology codes.
There are small differences between rates of breast cancer in rural and urban residences in New Zealand, as compared to some other countries. The quality of the Cancer Registry as a basis for evaluating the planned breast cancer screening programme is adversely affected by the high proportion of cases found with no reported stage of tumour. The proportion of nonspecific morphologies in these data is also of concern. The recent passing of the Cancer Registry Act should ensure better reporting of morphologies.
确定新西兰女性乳腺癌的发病率在年龄、种族和地理区域方面是否发生变化，以及城乡居民在肿瘤分期的发病率上是否存在差异。
根据1978 - 1992年国家癌症登记处登记的所有原发性乳腺癌病例，计算毛利人和非毛利人的年龄调整发病率。使用标准统计方法对时间趋势和地理差异进行分析。
1978 - 1992年间，毛利人和非毛利人的发病率稳步上升，但不显著，这意味着病例数有重要增加。特定年龄发病率从20岁开始急剧上升，在45岁时趋于平稳，并在85岁及以上缓慢上升。“未分期”病例的发病率随时间有显著趋势，这是由一种人为因素导致的。未发现按地区（14个地区卫生委员会区、4个区域卫生当局）或三个城乡组的肿瘤分期调整后的发病率有统计学显著差异。与非毛利人相比，毛利女性肿瘤从区域分期向局部分期的发病率变化较小。1988 - 1992年期间，报告未分期的肿瘤比例有所增加。很大一部分病例有非特异性形态学编码。
与其他一些国家相比，新西兰城乡居民乳腺癌发病率存在微小差异。癌症登记处作为评估计划中的乳腺癌筛查项目基础的质量受到未报告肿瘤分期病例高比例的不利影响。这些数据中非特异性形态学的比例也令人担忧。最近通过的《癌症登记法》应确保更好地报告形态学情况。
