基于Joinpoint回归和年龄-时期-队列模型分析中国皮肤癌的长期发病趋势

目的  分析中国皮肤癌的发病趋势并分别估计其年龄、时期、队列效应。方法  从2019年全球疾病负担研究中估计中国皮肤癌发病率的变化趋势。采用Joinpoint回归分析模型分析年度变化百分比和平均年度变化百分比(average annual percentage change, AAPC);利用年龄-时期-队列模型评估年龄、时期和出生队列效应对皮肤癌发病率的影响。结果  1990―2019年中国皮肤癌男性和女性年龄标准化发病率均上升。Joinpoint回归分析模型分析显示皮肤恶性黑色素瘤男性AAPC为2.8%(95% CI: 2.6~3.0),女性AAPC为3.0%(95% CI: 2.8~3.2);基底细胞癌男性AAPC为4.2%(95% CI: 3.9~4.4),女性AAPC为4.0%(95% CI: 3.7~4.3);鳞状细胞癌男性AAPC为3.7%(95% CI: 3.5~3.9),女性AAPC为2.9%(95% CI: 2.7~3.0)。此外,年龄-时期-队列模型表明无论男女,皮肤癌的发病风险均随年龄增长和年份推移而增加,且较晚出生的队列的发病风险均低于之前出生的队列。结论  1990―2019年中国皮肤癌的发病率呈上升趋势,年龄越大、出生越早且生活在当代的人其发病风险更高。应重视皮肤癌的防治工作。     

中国2008年肿瘤发病和死亡隋况估计及预测

目的 估计2008年中国肿瘤发病和死亡的情况,并预测今后20年发病数和死亡数.方法 根据中国36个肿瘤登记点的数据以及全国第三次死因调查(2004-2005年)的结果,估计2008年恶性肿瘤的发病和死亡情况,预测2010、2015、2020、2025和2030年的发病数和死亡数.结果 中国按世界人口标化发病率排前10位的癌症是肺癌(33.5/10万)、胃癌、肝癌、乳腺癌、食管癌、结直肠癌、子宫体癌、子宫颈癌、白血病和脑瘤/神经肿瘤(4.4/10万);按世界人口标化死亡率排前10位的癌症依次为肺癌(28.7/10万)、肝癌、胃癌、食管癌、结直肠癌、乳腺癌、子宫颈癌、白血病、脑瘤/神经肿瘤和子宫体癌(2.4/10万).癌症高发人群为40岁以上人群,尤其是男性,40岁以后癌症的发病率和死亡率均超过女性.在今后20年,中国恶性肿瘤的发病数和死亡数均呈现上升趋势.结论 中国恶性肿瘤的发病和死亡情况越来越严重,以肺癌、乳腺癌和消化道肿瘤为主,重点防控对象为40岁以上男性中老年人群.     

Minimal and maximal incidence rates of skin cancer in Caucasians estimated by use of sigmoidal UV dose–incidence curves

BackgroundSigmoidal (S-shaped) dose–cancer incidence relationships are often observed in animal bioassays for carcinogenicity. Ultraviolet (UV) radiation is an established skin carcinogen. The aim of this study is to examine if S-shaped curves describe the relationship between solar UV doses and skin cancer incidences, and if such relationships can be used to estimate threshold levels of non-carcinogenic UV exposure, as well as maximal incidence rates.MethodsWe studied the incidence rate–annual erythema-effective UV dose relationship for squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and cutaneous melanoma (CM) among different Caucasian populations in Europe, Australia and New Zealand.ResultsOur analysis indicates that S-shaped associations describe the data well (P < 0.0001). The age-adjusted incidence rates for cases expected to be due to other causes than solar UV exposure (at zero UV dose) were found to be around 0.6, 9.7 and 4.0 per 100,000 for women in 1997–2007 for SCC, BCC and CM, respectively, and around 1.2, 14.3 and 2.6 per 100,000 for men. The analysis indicates that SCC, BCC and CM have maximal incidence of 361 ± 24, 1544 ± 49 and 36 ± 4 per 100,000 for women, and 592 ± 35, 2204 ± 109 and 50 ± 4 per 100,000 for men.ConclusionsBetween 89 and 95% of the annual CM cases, around 99.8% SCC and 99.4% BCC cases are caused by solar UV exposure. The analysis did not identify any “safe” UV dose below which the risk for skin cancer was absent. Avoidance of UV radiation has a potential to reduce the incidence of skin cancer in fair-skinned population.     

Cost of skin cancer in England

This paper estimates the financial cost of skin cancer in England. National Health Service (NHS) costs were calculated by combining published data on health service use by patients with skin cancer with published data on the unit cost of services. Indirect costs arising from individuals’ inability to function in their usual role as a result of skin cancer were estimated from incapacity benefit claims and numbers of registered deaths due to skin cancer. The total costs of skin cancer were around ￡240 million. Costs to the NHS represented 42% of the total.      

中山市1970～1999年皮肤恶性肿瘤发病动态分析

目的 探讨1970～1999年中山市皮肤恶性肿瘤发病状况及趋势，为中山市皮肤恶性肿瘤防治提供科学依据。方法 对中山市1970～1999年肿瘤登记资料中的皮肤恶性肿瘤发病资料进行发病粗率、中国与世界标化发病率、发病趋势等指标的分析。结果 1970～1999年中山市皮肤恶性肿瘤新发病例共600例，总发病粗率为1．85／10万，中国与世界标化发病率分别为1．51／10万、2．02／10万；1970～1999年男、女世界标化年发病率分别为0．73／10万～4．22／10万、0．49／10万～4．17／10万之间；病理类型以基底细胞癌最常见(占42．3％)，其次为鳞状细胞癌(占30．5％)。结论 中山市皮肤恶性肿瘤总的发病率相对稳定，但仍应加强皮肤癌的防治。     

An ecologic study of skin cancer and environmental arsenic exposure

Summary We conducted an epidemiologic study of skin cancer incidence rates for four counties in Montana. The two counties considered to be exposed to arensic were Deer Lodge, containing the former Anaconda copper smelter, and Silver Bow, containing an open pit copper mine. Residents in these counties had potential exposure to arsenic and other heavy metals. Gallatin and Park counties served as controls. All histologically proven skin cancer cases during the period January 1980 through June 1986 were collected from pathology services and dermatologists in these four counties. In addition, all skin cancer cases from four dermatologists practicing in urban referral areas outside the counties were reviewed. Results were analzyed by individual as well as by two different definitions of anatomically distinct lesions: the National Cancer Institute (NCI) definition and the study definition. There were 1616 individuals with skin cancer in the four counties during the period under consideration, yielding 2252 (NCI definition) and 2451 (study definition) cases. The clinical features of the skin cancers in the exposed counties were not similar to those described for arsenicrelated skin cancer. The age-adjusted annual skin cancer rates were higher for the two control counties as compared to either the county with the former smelter, Deer Lodge, or the county with the mine, Silver Bow. Our results cannot be explained by differences in ascertainment, latitude, or altitude. They can be partially explained by differences in both outdoor employment and medical practice. The overall skin cancer incidence rates for the exposed counties were well within the range of skin cancer rates observed for other locations in the United States.     

中国城乡11市县常见恶性肿瘤发病趋势分析

目的 探讨中国恶性肿瘤发病特点及时间趋势.方法 采用中国城乡11个市县肿瘤登记处的1988-2002年资料进行统计与分析,描述恶性肿瘤发病现状,研究其时间趋势与发病特点.结果 11个市县肿瘤登记处覆盖地区15年内新发恶性肿瘤695 050例,粗发病率为215.50/10万,世界标准人口调整发病率为170.97/10万.主要恶性肿瘤发病率排序依次为肺癌、胃癌、肝癌、食管癌、乳腺癌、结肠癌、直肠癌、胰腺癌、膀胱癌、白血病.16种主要恶性肿瘤占全部的85.56%.1988-2002年恶性肿瘤合并的粗发病率呈较快上升趋势.按部位分析,增幅最大的是前列腺癌(185.48%),其次为胆囊癌、乳腺癌、结肠癌等.发病率下降幅度最大的是宫颈癌(17.00%),其次为食管癌、胃癌、鼻咽癌.结论 中国11个市县1988-2002年恶性肿瘤总的粗发病率呈上升趋势,调整年龄因素后变化不明显.胰腺癌、膀胱癌、白血病已进入前10位,成为常见恶性肿瘤.前列腺癌和胆囊癌发病率虽然较低,但是增长幅度最大.     

Prevalence and correlates of skin cancer risk behaviors in Madrid (Spain)

Objective

To estimate the prevalence and correlates of skin cancer-related behaviors in a representative sample of the population of the region of Madrid (Spain).

Methods

We performed a cross-sectional study based on a telephone survey. A total of 2,007 participants aged 18-64 years completed a questionnaire that included items on knowledge about the risk of skin cancer, sun exposure, the use of ultraviolet (UV) lamps and sunburn during the previous year. Logistic regression models were constructed, adjusted for gender, age, educational level and employment status.

Results

Sun exposure as a risk factor for skin cancer was identified by 92.3% of participants and artificial tanning by 73.6%. Knowledge of risk factors was greater among university graduates and women (P<.001). A total of 14.6% were usually exposed to the sun in the summer during the hours of maximum UV radiation, while 4.3% had used UV lamps during the previous year; the use of these lamps was more frequent among women (P<.001) and young people (P<.05). The prevalence of sunburn was 13.2% and was lower among women: odds ratio (OR) 0.68 (95% CI: 0.51-0.90); this prevalence declined with greater age (p linear trend <0.001) and was higher among students: OR 1.60 (95% CI: 1.07-2.40).

Conclusions

Numerous sociodemographic factors are related to UV radiation exposure and sunburn, with young people at highest risk. UV exposure is more frequent among women, whereas sunburn is more common among men.     

Time trends in incidence of cervical cancer in Lithuania from 1983 to 1997

This report examines time trends in both age-specific and age-standardized cervical cancer (ICD9-180) incidence rates among Lithuanian women. The study covers the period from 1983 to 1997. In case of the age-specific rates Poisson regression revealed the controversial results for the different age groups. The incidence rates increased ( > 0) for the women below 50 years and decreased ( < 0) for the women above 50 years. The average annual percentage changes were estimated using the age-drift model. In the age groups from 30 to 49 years old the incidence rate increased by 3.3% per year with the 95% confidence interval (CI) being 2.2–4.4. In the age groups from 50 to 69 years old the incidence rate decreased by 2.9% (95% CI: 1.9–3.8). In case of the age-standardized rates during the last few years some increase was observed, although no strict conclusions could be drawn. This observation together with the results of the age-specific rate studies predicts that in the near future the age-standardized rate will start growing.     

上海市区胃癌发病的时间趋势和特点分析

目的分析1973-2004年上海市区胃癌发病的时间趋势，探讨近年来上海市区胃癌发病的新特点。方法全部资料来源于上海市恶性肿瘤登记报告系统。分别按粗率和标准化率逐年统计1973-2004年市区男性和女性户籍居民的胃癌发病率，用对数线性回归法计算其年度变化百分比（APC），对上海市区近32年的胃癌发病趋势进行估计。对已全部计算机化的2002-2004年上海市区胃癌发病资料，从性别、年龄、诊断分期、病理类型、发病部位等角度进行独立或联合分析，以探讨近年来上海市区胃癌发病的新特点。上海市区的人口资料来自上海市公安局。率的标准化采用世界标准人口。构成比的比较采用χ^2检验。统计分析采用SPSS 10．0软件包。结果1973-2004年上海市区男性和女性居民的胃癌标化发病率均呈现显著而持续的下降趋势，其中男性下降了54．4％，女性下降了37．6％。2002-2004年上海市区共登记报告新发胃癌7630例，男性和女性胃癌的标化发病率分别为27．4／10万和14．0／10万。40岁以下人群的胃癌发病率较低，男女性无明显差异。40岁以上人群的胃癌发病率明显上升且男性逐渐高于女性。在诊断分期上，46．1％的病例具有详细的诊断分期记录，其中Ⅳ期胃癌比例最多，Ⅰ期最少。74．1％的病例为病理诊断，71．7％的病例具有详细的病理类型记录，其中腺癌占76．8％，印戒细咆癌占9．4％。男性腺癌和管状腺癌的比例高于女性，而女性印戒细胞癌的比例高于男性。肠型胃癌仍占主导地位且男性多于女性，而女性弥漫型胃癌的比例高于男性。发病部位以胃窦癌最为常见且女性比例高于男性，而贲门癌男性明显高于女性。远端胃癌中女性的比例高于男性，而近端胃癌中男性明显高于女性。结论上海市区胃癌发病率在1973-2004年间呈现显著而持续的下降趋势，且近年来在性别、年龄、诊断分期、病理类型、发病部位等方面表现出一些有意义的发病特点。     

2016年中国归因于人乳头瘤病毒感染的肿瘤发病与死亡分析

目的:分析2016年我国归因于人乳头瘤病毒（HPV）感染的肿瘤发病和死亡情况。方法:结合肿瘤发病率、死亡率、全国人口数及人群归因分值（ PAF）计算2016年全国不同地区、不同年龄及男性和女性人群归因于HPV感染的肿瘤发病数和死亡数。使用Segi's人口计算年龄标化发病率和年龄标化死亡率。 结果:...     

Neck trouble in machine operating, dynamic physical work and sedentary work:. A prospective study on occupational and individual risk factors

A prospective study on the effects of occupational and individual factors on neck trouble was carried out among 1832 men representing static work with whole-body vibration (machine operators), dynamic physical work (construction carpenters) and sedentary work (office workers). Neck trouble and occupational and individual factors were inquired about via postal questionnaires in 1984 and 1987. Machine operating was associated with an increased risk to contract severe neck trouble, and machine operating and dynamic physical work were associated with persistently severe neck trouble. Other predictors for contracting severe neck trouble were age and current smoking. Physical exercise decreased the risk of persistently severe neck trouble. The results of our prospective study confirm the role of physical factors in neck trouble.     

Inequalities in cancer incidence and mortality across income groups and policy implications in South Korea

OBJECTIVE: To investigate inequalities in cancer incidence and mortality across income groups in South Korea. STUDY DESIGN: After reviewing 2001 data from the Korean National Cancer Registry, and National Health Insurance and National Medical Aid data, 49,277 cancer cases were classified into six income groups. The incidence and 3-year mortality rates of major cancers were calculated separately and as a total. METHODS: Two composite indices (slope index of inequality and relative index of inequality) were calculated to analyse the relative differences in cancer incidence. The 3-year mortality rate ratios for major cancers were calculated, with Class 1 as the reference, using a Cox regression model to adjust for age. RESULTS: The relative risk of cancer incidence (total) in the lowest income group was 1.65 and 1.43 times higher than that in the highest income group for males and females, respectively. For cancer mortality, all other income groups showed significantly higher 3-year mortality rate ratios than the highest income group for males and females. CONCLUSIONS: This study identified inequalities in cancer incidence and 3-year mortality across income groups in South Korea, most of which were unfavourable to lower income groups. It is suggested that lower income groups should receive financial assistance for cancer screening and inpatient medical services.     

Circulating 25-hydroxyvitamin D serum concentration and total cancer incidence and mortality: A systematic review and meta-analysis

Objective

To conduct a systematic review and meta-analysis of longitudinal studies on the association of 25(OH)D with total cancer incidence and mortality.

Method

Relevant longitudinal observational studies were identified by systematically searching Ovid Medline, EMBASE, and ISI Web of Knowledge databases. Due to the heterogeneity across studies in categorizing 25(OH)D concentration, all results were recalculated for an increase of 25(OH)D by 50 nmol/L.

Results

In meta-analyses with random effects models, the summary risk ratios and confidence intervals (RRs (95% CI)) for the association of an increase of 25(OH)D by 50 nmol/L with total cancer incidence (5 studies) and mortality (13 studies) were 0.89 (0.81, 0.97) and 0.83 (0.71, 0.96), respectively. In sex-specific analyses no significant association with total cancer incidence was observed among men or women. A clear inverse association with total cancer mortality was observed among women (0.76 (0.60, 0.98)) but not among men (0.92 (0.65, 1.32)). Large heterogeneity was observed for studies on total cancer mortality (P < 0.01) but not for studies on cancer incidence (P = 0.41). No publication bias was found.

Conclusion

The meta-analysis suggests a moderate inverse association of 25(OH)D concentration with total cancer incidence and mortality.     

武汉市东西湖区巨大胎儿发生率及其危险因素的病例对照研究

目的:了解武汉市东西湖区巨大胎儿发生率及影响因素。方法:以2006年在武汉市东西湖区妇幼保健院建册的761例孕妇及分娩的活产儿为研究对象,新生巨大儿为病例组,正常出生体重新生儿为对照组,进行病例对照研究。结果:男女出生性别比为1.13∶1。巨大儿发生率为6.31%(男女新生儿的发生率分别为7.00%和5.64%);单因素分析显示,巨大儿组产妇的身高、分娩前BMI、产前检查次数均高于对照组(P<0.05),多因素非条件Logistic回归分析结果显示,孕期BMI≥28是巨大胎儿的独立预测因子(OR95%CI=1.102～1.38,P<0.05)。结论:孕妇身高、孕期肥胖与巨大胎儿的发生有关。应加强孕期保健,避免孕期体重过度增长,以预防巨大儿发生。     

浙江省嘉善县1990-2014年恶性肿瘤发病和死亡的性别差异分析

目的 描述和分析浙江省嘉善县居民恶性肿瘤发病和死亡的性别差异。方法 1990－2014年嘉善县恶性肿瘤发病和死亡资料源自当地肿瘤登记报告系统。以2010年全国人口为标准人口,计算标准化发病率和标准化死亡率,并计算相应性别发病率比值、死亡率比值及其95% CI。结果 1990－2014年嘉善县所有恶性肿瘤的标准化发病率为226.13/10万,其中男性为266.04/10万,女性为187.22/10万,男、女性发病率比值为1.42（95% CI：1.39～1.46）,发病差异有统计学意义（P<0.05）。所有恶性肿瘤的标准化死亡率为155.39/10万,其中男性为206.55/10万,女性为104.98/10万,性别死亡率比值为1.97（95% CI：1.91～2.03）,男、女性死亡差异同源有统计学意义（P<0.05）。分析恶性肿瘤类型发现,除胆囊癌及甲状腺癌以外,其他恶性肿瘤的发病率和死亡率均为男性高于女性。结论 浙江省嘉善县居民恶性肿瘤的发病和死亡均为男性高于女性,且存在显著性别差异。     

2010 - 2015年新疆生产建设兵团第八师恶性肿瘤发病和死亡情况分析

目的 根据2010 - 2015年新疆生产建设兵团八师肿瘤登记处收集的肿瘤资料,估计八师2010 - 2015恶性肿瘤的发病死亡情况。方法 按照全国肿瘤登记中心制定的评价标准审核肿瘤登记数据。从年龄、性别等角度分析恶性肿瘤发病、死亡情况。结果 2010 - 2015年八师新发恶性肿瘤病例8 893例,死亡4 498例。发病率为257.5/10万,死亡率为130.2/10万。从2010到2015年,男、女性以及≥60、＜60岁年龄组恶性肿瘤发病及死亡率均呈上升趋势（P＜0.05）。肺癌、乳腺癌、结直肠癌是八师恶性肿瘤发病前3位,肺癌、胃癌、肝癌是死亡前3位。结论 八师2010 - 2015年恶性肿瘤发病与死亡水平不断上升,且性别、年龄及不同肿瘤间均有差异,应根据实际情况有重点地开展防治工作。