Taylor R, Bell J, Coates M, Churches T, Wain G
Department of Public Health and Community Medicine, University of Sydney.
Aust N Z J Public Health. 1996 Aug;20(4):413-20. doi: 10.1111/j.1467-842x.1996.tb01055.x.
We analysed five-year relative survival of 6992 cases of cervical cancer incident between 1972 and 1991 in New South Wales (NSW) women, using data from the population-based state Cancer Registry. Follow-up was to 1992. Survival was determined by record linkage to death certificates. Relative survival was derived from absolute survival of cases with expected survival of age- and period-matched NSW women. Proportional hazard regression analysis was used for multivariate analysis. Relative survival at five years improved from 64 per cent in 1972-1976 to 72 per cent in 1987-1991, although the only significant increase occurred between 1972-1976 and 1977-1981 (64 to 70 per cent). Survival was better for the age groups 0-39 years (RR 0.51) and 40-49 years (RR 0.63) and worse for the elderly (> or = 65 years) (RR 1.47) than for the referent group (50-64 years). Excess mortality was much less for those with localised disease (referent group), than for those with regional spread (RR 3.47) or metastatic cancer (RR 10.5) at diagnosis. For the most recent period (1987-1991), relative five-year survival for localised disease was 82 per cent, for regional spread at diagnosis it was 49 per cent, and for metastatic cancer 21 per cent. When adjusted for confounding, excess mortality was significantly higher for adenocarcinoma (RR 1.16) than for squamous cell carcinoma. Five-year relative survival for cervical cancer in NSW women for the most recent period is similar to that in South Australia, and both compare favourably with international statistics. The lack of improvement of five-year survival for cervical cancer over 15 years since 1977-1981 reinforces the importance of prevention through regular screening by cytology.
我们利用基于人群的新南威尔士州癌症登记处的数据，分析了1972年至1991年间新南威尔士州6992例宫颈癌发病病例的五年相对生存率。随访至1992年。通过与死亡证明进行记录链接来确定生存率。相对生存率来自年龄和时期匹配的新南威尔士州女性预期生存病例的绝对生存率。采用比例风险回归分析进行多变量分析。五年相对生存率从1972 - 1976年的64%提高到1987 - 1991年的72%，不过唯一显著的增长发生在1972 - 1976年和1977 - 1981年之间（从64%提高到70%）。0 - 39岁年龄组（风险比0.51）和40 - 49岁年龄组（风险比0.63）的生存率高于参照组（50 - 64岁），而老年人（≥65岁）（风险比1.47）的生存率低于参照组。诊断时局限性疾病患者（参照组）的超额死亡率远低于区域扩散患者（风险比3.47）或转移性癌症患者（风险比10.5）。在最近时期（1987 - 1991年），局限性疾病的五年相对生存率为82%，诊断时区域扩散的为49%，转移性癌症的为21%。在对混杂因素进行调整后，腺癌的超额死亡率（风险比1.16）显著高于鳞状细胞癌。新南威尔士州女性宫颈癌最近时期的五年相对生存率与南澳大利亚州相似，且两者均优于国际统计数据。自1977 - 1981年以来的15年里宫颈癌五年生存率缺乏改善，这凸显了通过定期细胞学筛查进行预防的重要性。
