Zheng T, Holford T R, Chen Y, Ma J Z, Mayne S T, Liu W, Flannery J, Boyle P
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA.
Int J Cancer. 1996 Oct 9;68(2):172-6. doi: 10.1002/(SICI)1097-0215(19961009)68:2<172::AID-IJC5>3.0.CO;2-V.
Earlier studies indicated that the incidence rates for bladder cancers rose rapidly in both the United States and Europe. Tobacco smoking is considered to be the major risk factor for urinary bladder cancer, and recent studies from Connecticut show that several smoking-related cancers have started leveling off or decreasing. The time trend for bladder cancer, however, is not clear in Connecticut. The current study examined the long-term trend of bladder cancer in Connecticut. Our results show that urinary bladder cancer has been increasing, with a marked increase among males. The rate of increase, however, has slowed since the early 1980s. Birth-cohort examination shows that the rates have leveled off for those born after about 1935 in both males and females. Age-period-cohort modeling results also show that the birth-cohort patterns of bladder cancer are somewhat similar to those observed for lung cancer in Connecticut, thus supporting the findings from analytical epidemiologic studies which indicate that cigarette smoking is one of the major risk factors for urinary bladder cancer. Our results also suggest that the difference in environmental and occupational exposures between males and females may be responsible for the large difference in the incidence rate of bladder cancer seen between the sexes.
早期研究表明，美国和欧洲的膀胱癌发病率均迅速上升。吸烟被认为是膀胱癌的主要危险因素，而康涅狄格州最近的研究表明，几种与吸烟相关的癌症已开始趋于平稳或下降。然而，康涅狄格州膀胱癌的时间趋势尚不清楚。当前研究调查了康涅狄格州膀胱癌的长期趋势。我们的结果显示，膀胱癌一直在增加，男性中的增幅尤为显著。然而，自20世纪80年代初以来，增长速度已经放缓。出生队列研究表明，1935年左右以后出生的男性和女性的发病率已趋于平稳。年龄-时期-队列模型结果还显示，膀胱癌的出生队列模式与康涅狄格州肺癌的模式有些相似，从而支持了分析性流行病学研究的结果，即吸烟是膀胱癌的主要危险因素之一。我们的结果还表明，男性和女性在环境和职业暴露方面的差异可能是两性膀胱癌发病率存在巨大差异的原因。
