中国肺癌流行病学

近50年来,世界上很多国家的肺癌发病率和死亡率呈急剧上升趋势。2002年全世界的肺癌新病例大约为135万,死亡118万,居恶性肿瘤第1位。根据我国居民死因调查的结果,肺癌死亡率从20世纪70年代中期至90年代初期的20年增加近1．5倍,是增长最快的恶性肿瘤。     

肺癌流行病学

肺癌是世界范围内发病率及死亡率最高，治疗效果相对较差的癌症，研究肺癌流特征，相关的危险因素对提高肺癌的三级预防水平有积极意义。综述了肺癌流行特征以及病因学方面的研究进展。     

辽宁省七城市肺癌病因流行病学研究

前言吸烟作为肺癌病因早已肯定,国外认为它占病因之80-85％。但国内文献报导它对肺癌相对危险性不及国外高,而普遍关注室内煤烟的危害。除此而外,职业毒害、被动吸烟、既往疾病、厨房炊烟、妇女特殊病因、戒烟的有效性等等均未最后阐明。我们组织省内七个不同大小城市,进行病例一对照调查(共703对)。对上述各方面共230余变量进行多因素分析,找到北方城市肺癌发病主要原因有吸烟、室内煤烟污染、三种职业毒害、三种既往疾病。分析了它们在病因中所占比重。肯定了戒烟和改烧煤气在降低发病中的作、用。     

我国肺癌分子流行病学研究概况

癌的分子流行病学是分子生物学与传统流行病学相结合的一门新兴学科[1 ] 。癌的分子流行病学研究内容广泛 ,如个体对致癌物的有效接触剂量 ,致癌物引起的早期生物效应 ,个体对致癌物的敏感差异或遗传倾向性等。癌的分子流行病学研究在发现和监测高危人群 ,早期发现癌患者 ,预防癌的新途径等方面可能带来重大突破。我国肺癌分子流行病学的研究可追溯到 2 0世纪 80年代 ,研究内容大多结合我国肺癌病因实际 ,以肺癌高发区为现场 ,进行了许多有意义的工作。近年来 ,在跟踪国际研究前沿方面 ,取得一定进展 ,显示出我国肺癌流行病学的进步和肺癌防…     

我国肺癌流行病学研究及病因研究概况

本文叙述了我国肺癌的流行病学及病因研究的现状及成果。我国肺癌在近16年中以每年11.9%递增,城市发病率与死亡率均高于农村。现肺癌的发病率已居恶性肿瘤首位。肺癌的发病原因研究结果认为吸烟不论主动还是被动都可提高发病率,大气污染与肺癌密切相关,室内微小环境受污染是另一重要因素,职业危害很明显提高了肺癌发病率,既往肺部疾病及女性激素与生育史、个人营养状况,体内微量元素硒水平均有关。     

福州市区1988年—1993年肺癌流行趋势分析

近年来有不少报道，表明肺癌的发病率、死亡率均呈上升趋势，尤其是女性肺癌，已引起了人们的关注。本文对福州市区1988年一1993年间的肺癌发病及死亡资料进行整理、核实和汇总，现报道如下：一、材料和方法福州市从1988年起实行恶性肿瘤新病例登记报告制度。每年对各级医院进行两次态性肿瘤登记报告工作的检查。检查中发现个别医院存在门诊病例漏报情况，由福建省肿用防治办公室协同医院方面共同时漏报病例进行了补报，因而系统全面地收集了全市各省级、市级、区级医疗部门住院部和门诊部的恶性肿瘤的新发病例很p新确诊的病例，确诊后原病…     

肺癌流行现状及未来趋势

在整个20世纪中人类癌症呈现逐年上升的总趋势，尤以肺癌流行趋势变化最为明显。肺癌流行的现况和预测未来发展趋势倍受各国政府和有关学者关注。根据大量的流行病学研究资料，可将肺癌流行的现况及特征归纳如下几点：一、肺癌发病率上升最为迅速本世纪各类恶性肿瘤中，发病率、死亡率增长最迅速的癌症首属肺癌。追溯肺癌流行病学史料，20世纪初，除少数矿山报道有肺癌发生外，肺癌在世界范围内是一种少见疾病，第一次世界大战后，肺癌的死亡率逐渐升高，进入30年代后，伴随现代工业发展所引起环境中大气的污染，职业性致癌因素的增加，烟草…     

肺癌是可以控制的

近50年来我国肺癌的发病率和死亡率呈现持续上升的趋势。许多地区特别在城市，肺癌已成为第1位死亡原因。因此，对肺癌的流行病学及其预防对策的研究具有十分重要的意义。     

海宁市区大气污染与肺癌发病率关系的研究

[目的]探讨海宁市区大气污染与肺癌发病率关系。[方法]将大气中二氧化硫(SO2)、氮氧化物(NOx)、总悬浮微粒(TSP)含量浓度与肺癌发病率作相关分析 ,将大气污染物吨/平方公里·年排放量与乡镇进行比较。[结果]市区肺癌发病率明显高于全市平均水平 ,标准化发病比(SIR)为1.59(P<0.01) ;1991年～1998年空气质量基本保持在Ⅱ级水平以上 ;SO2、NOx、TSP与肺癌发病率相关不显著(P>0.05);而大气污染物SO2、工业粉尘、烟尘 (吨/平方公里·年 )排放量市区远远高于乡镇(P<0.01)。[结论]海宁市区肺癌发病率增高可能与大气污染物排放量及空气净化能力等因素有关。     

Characteristics of Patients With Second Primary Lung Cancer Following Breast Cancer: A Retrospective Descriptive Study

BackgroundBreast cancer (BC) is the most common noncutaneous malignancy in women and survivors are at an increased risk for secondary malignancy with lung cancer (LC) being the most common. There are few studies that have explored the clinicopathological specifics of LC in BC survivors.MethodsIn this single-institution, retrospective study, we identified BC survivors who subsequently developed LC, examined their breast and LC clinical and pathological characteristics and compared them to the general BC and LC population as published in the literature.ResultsIn our study, we found the following associations that could be meaningful: an association between receiving radiation (RT) and LC (including a statistically significant P = .03 chance of ipsilateral LC after BC treatment with RT), a higher incidence and amount of smoking and LC, high BRCA positivity (78.9%) in the few patients who had germline testing, and a higher incidence of EGFR mutations in NSCLC after BC (60.9%) as well as an earlier stage of NSCLC disease.ConclusionTreatments such as RT, genetic factors such as BRCA mutations, and tobacco use may increase the risk of developing LC amongst BC survivors. Exploring this further can potentially lead to better risk stratification through modified low-dose CT chest screening protocols to catch LCs earlier and ultimately improve outcomes. Past studies have shown that BC survivors who are subsequently diagnosed with NSCLC may have improved OS compared with primary NSCLC and our study showed a high incidence of EGFR mutated NSCLC, which also suggest both improved prognosis and a different molecular profile of NSCLC, which warrants further investigation. Lastly, BC survivors who subsequently are diagnosed with NSCLC had earlier stage disease in our study, perhaps a result of surveillance, highlighting the importance of close monitoring of BC survivors.     

结直肠癌流行病学趋势

结直肠癌已严重威胁人类的健康, 2012年全世界约有136万结直肠癌新发病例,是世界第3高发恶性肿瘤,在世界男性发病排第3位,女性排第2位;死亡约69万例, 居恶性肿瘤第4位。2010年我国结直肠癌新发病例数已超过27万,死亡病例13万以上。世界结直肠癌发病死亡比例均随时间而增加,且整体趋势为男性高于女性,发达地区高于欠发达地区,城市高于农村。在发达国家,90％以上患者年龄在50岁以上,但在发展中国家,患者发病年龄较小。本文以最新数据就世界结直肠癌流行病学现状作一综述,以期为今后结直肠癌的防治策略提供病因依据和理论支持。     

女性乳腺癌流行病学趋势及危险因素研究进展

乳腺癌是全球女性最常见的癌症,也是女性癌症死亡的主要原因.2018年全球新确诊女性乳腺癌病例约209万,死亡人数约63万.世界各地区乳腺癌发病率各不相同,但均呈上升趋势.虽然中国女性乳腺癌发病率(36.1/105)和死亡率(8.8/105)在世界范围内相对较低,但是中国女性乳腺癌发病人数及死亡人数均居世界首位,而且近年...     

Epidemiological and Clinicopathological Characteristics of Lung Cancer in a Teaching Hospital in Iran

Background: Lung cancer is one of the most commonly diagnosed cancers and the most frequent cause ofcancer-related death worldwide. In Iran, it ranks second and third as the cancer-causing death in men and women,respectively. We carried out this study to find out the demographic, clinical, and histological characteristics andrisk factors of lung cancer in a referral tertiary center in Iran. Materials and Methods: A retrospective study wasconducted on cases of primary lung cancer based on the results of registered cancer reports of cytological andpathological specimens between March 2001 and March 2012. Demographic variables, clinical manifestations,histology and location of tumors were determined based on the data found in the medical records of eachpatient. Definite or probable etiologic factors were identified. Data analysis was performed with SPSS version16 and a p-value ≤0.05 was considered as significant. Results: A total of 203 patients, with a mean age of 65.7years (SD=11.2), with primary lung cancer were identified, 81.3% being men. Of the total, 110 cases (54.2%)were living in urban areas. In 53.2% of cases, the site of tumor was on the right side and in 72.9% of cases thelesion was centrally located. The histological types of lung cancer were squamous cell carcinoma (SCC) in 107cases (52.7%), adenocarcinoma (AC) in 30 cases (14.8%), and small cell carcinoma (SC) in 27 cases (13.3%).Significant correlations between the gender and residence, smoking, and the histological type and location(central or peripheral) of tumor were found. The percentage of smokers was 75.2% in men and 15.8% in women.Conclusions: Smoking was the most important risk factor and squamous cell carcinoma the most commonhistological type of lung cancer in our study. Male sex and being a smoker was associated with histological typesof SCC while being nonsmoker had relationship with adenocarcinoma.     

广州市2005～2013年肺癌发病趋势分析

目的分析广州市2005~2013年肺癌发病趋势,为广州市肺癌防治措施的制定提供依据。方法根据广州市2005~2013年肿瘤登记处收集的发病资料以及相应的人口数据,分别计算肺癌的性别、年龄别发病率、年龄调整发病率（世标率）、年度变化百分比（APC%）,同时描述2005~2013年期间各年度肺癌的发病变化趋势。结果广州市2005-2013年肺癌发病共34873例,肺癌粗发病率和世标率分别为49.27/10万（其中男性65.44/10万,女性32.55/10万）和34.94/10万（其中男性49.68/10万,女性21.53/10万）。肺癌发病率随年龄增高而增长,在40岁开始迅速上升,80~84岁年龄组达到发病高峰为380.46/10万,85岁以上年龄组回落到307.08/10万。广州市2005~2013年肺癌粗发病率呈平稳增长态势,年度变化百分比为1.21%（95%CI:0.30%~2.10%）,粗发病率变化趋势有统计学差异（P<0.05）。世标率呈平稳下降态势,年度变化百分比为-1.16%（95%CI:-1.90%~-0.40%）,世标率变化趋势有统计学差异（P<0.05）。结论广州市2005-2013年肺癌粗发病率发病呈平稳增长趋势,主要原因是人口老龄化造成的,应积极加强有效的防治措施。     

Descriptive Epidemiology of Female Breast Cancer in Delhi,India

Background: Breast cancer is the most frequently diagnosed cancer in females worldwide. The Population Based Cancer Registry data of Delhi were here used to describe the epidemiology and trends in breast cancer incidence in Delhi. Methods: Crude rate, age-standardized incidence rates (ASR) and age-specific incidence rates were calculated using the data collected by Delhi PBCR for the year 2012. The time trend of breast cancer incidence was evaluated by joinpoint regression using the PBCR data from 1988-2012. Results: A total of 19,746 cancer cases were registered in 2012, 10,148 in males and 9,598 in females. Breast cancer was the leading site of cancer in females accounting for 2,744 (28.6%) of cases with a median age of 50 years. The crude and age standardized incidence rates for breast cancer were 34.8 and 41.0 per 100,000 females, respectively. Age specific incidence rates increased with age and attained a peak in the 70-74 years age group..A statistically significant increase in ASR with an annual percentage change (APC) of 1.44% was observed. Conclusions: The breast, which was the second most common cancer site in Delhi in 1988, has now surpassed cancer of cervix to become the leading site over the years. A similar trend has also been noted for other metropolitan cities viz. Bangalore, Bhopal and Chennai. Though the ASRs in these are comparable, they are still low compared to Western countries. Changing life styles in metropolitan cities like delayed marriage, late age at first child birth, lower parity and higher socio-economic status, may be some of the probable primary cause for higher incidences of breast cancer in urban as opposed to rural areas.     

滇东产(燃)煤区农民肺癌流行病学调查

背景与目的云南省宣威市位于滇东黔西晚二叠纪聚煤区,当地肺癌死亡率居全国首位,研究显示宣威农民肺癌高发与室内烟煤燃烧产生的多环芳烃等污染物有关。近年来宣威周边产煤地区环境污染和肺癌高发问题引起国内外关注,滇东其它地区居民肺癌流行水平与发病原因是否与宣威相似未见报道。本研究旨在探索滇东产(燃)煤地区农民肺癌流行状况和发病原因。方法采用多阶段、分层、整群、概率抽样方法随机抽取滇东产(燃)煤382个调查小区,对其中30岁-79岁常住居民进行X线胸片肺癌筛查和相关因素调查,筛查阳性疑似肺癌进行CT复查,诊断为肺癌的病例进行痰癌细胞检查和随访。采用世界肿瘤研究中心标化率比对不同地区肺癌筛查阳性率进行显著性检验分析、调整合并为A区、B区、C区、D区等4层,并进行肺癌相关因素分析。结果共筛查和问卷调查52,833名农村居民,X线胸片筛查疑似肺癌阳性604例,541例经过CT复查,诊断为肺癌363例(其中组织学确诊109例),CT复查校正筛查阳性率763.08/10万,世界人口标化率426.28/10万(95%CI:381.51/10万-471.05/10万),男性482.78/10万,女性387.98/10万,男女比值1.24。各层肺癌流行强度差别较大,从A区→B区→C区→D区,肺癌筛查世标率逐渐减少,男女比值逐渐增大。筛查世标率最高的A区是最低D区的6.97倍。肺癌筛查阳性率与煤炭资源分布有关,调查对象肺癌筛查阳性率与烟煤使用率和使用量成正比,而与无烟煤使用率和使用量无明显关联。调查地区居民早期火塘使用率80%以上,其下无进气口,上无烟囱,煤炭燃烧不完全,加重煤烟废气污染。家族成员肺癌死亡率与肺癌筛查阳性率的分布一致,肺癌筛查阳性率随家族成员肺癌死亡率增加而增加。男性吸烟率85.08%,平均吸烟量16.12支/天;约50%从事过采煤、炼焦等工作。女性吸烟率1.37%,主要从事农业生产和做饭、喂养生猪等室内家务工作,吸烟、职业危害不是女性肺癌的主要发病因素,但可能是男性肺癌发病比女性严重的影响因素。结论肺癌高发与室内外烟煤污染、家族易感性有关联,吸烟、采煤、炼焦不是女性肺癌的主要因素。     

我国云南曲靖肺癌高发区环境流行病学调查研究

背景与目的我国云南省东北部的曲靖是全世界肺癌高发地区之一,当地居民长期暴露在燃煤烟气中,本研究旨在全面了解我国云南曲靖肺癌高发区的环境背景和污染情况,为肺癌病因学研究提供科学依据,同时也为改善环境状况提供数据支持。方法采用多阶段、分层、整群、概率抽样方法随机抽取280个自然村,了解当地自然村使用燃料的种类、附近有无炼焦厂、铁锌厂、化工厂等环境背景和污染情况,并采用二项Logistic回归分析方法对调查因素进行分析。结果高发区78.1%的自然村使用烟煤和焦煤,低发区78.8%的自然村使用无烟煤和木柴。二项Logistic回归分析方法显示,上述因素中仅有燃料种类进入方程(P<0.05),烟煤和焦煤的使用与肺癌高发具有正关联作用,而使用木柴、无烟煤不会对肺癌的高发产生影响。结论当地居民使用燃料类型是影响肺癌高发的重要因素,其中烟煤和焦煤对当地肺癌高发有促进作用,而无烟煤或者木柴作用不大或有抑制作用。     

Lung Cancer Incidence Rate for Male Ex-smokers According to Age at Cessation of Smoking

Lung cancer incidence rate after the cessation of smoking was assessed for male ex-smokers according to the age at cessation, using the results from a case-control study for ex-smoker versus continuing smoker, and the lung cancer incidence rate function for continuing smoker estimated from Japan Vital Statistics and the “Six-prefectural Cohort Study” in Japan. This hospital-based case-control study consisted of 776 lung cancer cases (553 current smokers and 223 ex-smokers) and 772 controls (490 current smokers and 282 ex-smokers) who started smoking at ages 18–22. The odds ratio of developing lung cancer for ex-smokers compared to continuing smokers according to years since the cessation of smoking was estimated for four age groups (55–64, 60–69, 65–74 and 70–79). Given that the number of years since cessation of smoking is the same, reduction of the odds ratio appeared to be greater for the younger age group than for the older age group, reflecting the shorter period of exposure for the younger age group. Lung cancer incidence rate (per 100,000) was assumed to be expressed by the following function; 1.7 × 10^?5× (age – 24.3)^4,5 for continuing smokers and 0.15 × 10^?5× (age)⁴ for nonsmokers. Lung cancer incidence rate among ex-smokers according to years since cessation was then estimated to be the above function multiplied by the odds ratio from the case-control study for each age group. In contrast to the greater reduction of the odds ratio among younger ex-smokers, reduction of the incidence rate, in terms of rate difference, was considerably greater for older ex-smokers due to a high incidence rate of lung cancer for older continuing smokers. This indicates that the absolute magnitude of reduction of the lung cancer incidence rate after cessation of smoking is greater for older ex-smokers, although the relative magnitude of reduction is greater for younger ex-smokers.