Westerling R
Department of Social Medicine, Akademiska sjukhuset, Uppsala, Sweden.
Int J Epidemiol. 1995 Dec;24(6):1086-93. doi: 10.1093/ije/24.6.1086.
Cancer mortality has been stated to be the best single measure of progress in combatting cancer. The variation in total and cause-specific cancer mortality among health administrative areas in Sweden was analysed in order to find out if the mortality outcome has been equally distributed.
Data on underlying causes of death for ages 0-74 years were analyzed for the 26 health administrative areas in Sweden, 1975-1990. Analyses of systematic (non-random) variance were performed and measures chosen in order to make comparisons possible between different malignant neoplasms and different periods of time.
The systematic variance for all malignant neoplasms was reduced by about 40% during the study period. The largest systematic variations in mortality were found for cancer of the oesophagus and lung, although the systematic variation for these neoplasms was lower in the 1980s than in the 1970s. Large systematic variation was also found for cancer of the cervix uteri and of the bladder. For these causes the variation remained constant throughout the period.
Generally speaking, the outcome of cancer has become more equally distributed across the country. Preventive measures should be possible for the malignant neoplasms with the largest regional variation.
癌症死亡率被认为是衡量抗癌进展的最佳单一指标。分析了瑞典各卫生行政区全因癌症死亡率及特定病因癌症死亡率的差异，以了解死亡率结果是否得到了均衡分布。
分析了瑞典26个卫生行政区1975 - 1990年0至74岁人群的潜在死因数据。进行了系统（非随机）方差分析，并选择了相应指标，以便能够对不同恶性肿瘤和不同时间段进行比较。
在研究期间，所有恶性肿瘤的系统方差降低了约40%。食管癌和肺癌的死亡率存在最大的系统差异，尽管这些肿瘤在20世纪80年代的系统差异低于70年代。子宫颈癌和膀胱癌也存在较大的系统差异。在整个时期，这些病因的差异保持不变。
总体而言，癌症的结果在全国范围内分布得更加均衡。对于区域差异最大的恶性肿瘤，应采取预防措施。
