Negri E, La Vecchia C, Levi F, Franceschi S, Serra-Majem L, Boyle P
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Eur J Cancer Prev. 1996 Aug;5(4):267-79. doi: 10.1097/00008469-199608000-00007.
The two main determinants of oral and oesophageal cancer in Europe are alcohol and tobacco, and the two cancer sites show several similarities in their descriptive epidemiology. This study compares mortality from cancers of the oral cavity and oesophagus in European countries to evaluate similarities and differences. From official death certification numbers and population estimates, we obtained age-standardized rates for all ages and truncated (35-64 years). In most countries, rates for men tended to increase between 1955-59 and 1990-92 for both sites, although the increases were more marked for oral cancer. In the UK and Ireland, however, oral cancer decreased and oesophageal cancer increased, while in Finland and Iceland mortality for both sites decreased. The most striking increases were in Hungary, where the truncated rate in most recent calendar periods reached the highest levels in Europe. In France, rates for both cancers were extremely high: oral cancer increased from 1955-59 to the early 1980s, but started to decline afterwards. Mortality rates were much lower for women than men, and the correlation between the two sites was less marked. An age, period and cohort model, applied to the rates for men in selected European countries, suggested strong cohort effects for both cancers, generally more marked for oral cancer, with substantial increases in the cohorts born after 1920. The mortality rates of cancers of the oral cavity and oesophagus show several analogies, as expected from their relation to tobacco and alcohol; but some discrepancies suggest that other, less well-identified, factors may also influence their rates and trends in Europe.
在欧洲，口腔癌和食管癌的两个主要决定因素是酒精和烟草，这两个癌症部位在描述性流行病学方面表现出若干相似之处。本研究比较了欧洲国家口腔癌和食管癌的死亡率，以评估其异同。根据官方死亡证明数字和人口估计数，我们得出了所有年龄段以及截断年龄（35 - 64岁）的年龄标准化率。在大多数国家，1955 - 1959年至1990 - 1992年期间，两个部位男性的发病率均呈上升趋势，不过口腔癌的上升更为明显。然而，在英国和爱尔兰，口腔癌发病率下降，食管癌发病率上升，而在芬兰和冰岛，两个部位的死亡率均下降。增幅最为显著的是匈牙利，在最近几个日历期，其截断年龄发病率达到了欧洲最高水平。在法国，两种癌症的发病率都极高：口腔癌从1955 - 1959年至20世纪80年代初呈上升趋势，但随后开始下降。女性的死亡率远低于男性，且两个部位之间的相关性不那么明显。应用于部分欧洲国家男性发病率的年龄、时期和队列模型表明，两种癌症都有很强的队列效应，一般口腔癌更为明显，1920年后出生的队列发病率大幅上升。口腔癌和食管癌的死亡率显示出若干相似之处，正如预期的那样，这与它们与烟草和酒精的关系有关；但一些差异表明，其他尚未明确的因素也可能影响欧洲的发病率及其趋势。
