Prostate cancer incidence and mortality rates and trends in the United States and Canada

OBJECTIVE: The purpose of this study was to compare prostate cancer incidence and mortality trends between the United States and Canada over a period of approximately 30 years. METHODS: Prostate cancer incident cases were chosen from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Program to estimate rates for the United States white males and from the Canadian Cancer Registry for Canadian men. National vital statistics data were used for prostate cancer mortality rates for both countries, and age-adjusted and age-specific incidence and mortality rates were calculated. Joinpoint analysis was used to identify significant changes in trends over time. RESULTS: Canada and the U.S. experienced 3.0% and 2.5% growth in age-adjusted incidence from 1969-90 and 1973-85, respectively. U.S. rates accelerated in the mid- to late 1980s. Similar patterns occurred in Canada with a one-year lag. Annual age-adjusted mortality rates in Canada were increasing 1.4% per year from 1977-93 then fell 2.7% per year from 1993-99. In the U.S., annual age-adjusted mortality rates for white males increased 0.7% from 1969-1987 and 3.0% from 1987-91, then decreased 1.2% and 4.5% during the 1991-94 and 1994-99 periods, respectively. CONCLUSIONS: Recent incidence patterns observed between the U.S. and Canada suggest a strong relationship to prostate-specific antigen (PSA) test use. Clinical trials are required to determine any effects of PSA test use on prostate cancer and overall mortality.     

Temporal trends and ethnic variations in amenable mortality in Singapore 1965-1994: the impact of health care in transition.

BACKGROUND: Amenable mortality is used to assess the effects of health care services on gains in mortality outcomes. Possibly differing patterns of trends in amenable mortality may be expected in economically less developed countries, which have undergone rapid epidemiological transition and recent reforms in health care systems, but such studies are scarce. This study was set up to examine the trends in amenable mortality in Singapore from 1965 to 1994; to estimate the relative impact of medical care and primary preventive policy measures in terms of gains in mortality outcomes; to examine ethnic differences in amenable mortality among Chinese, Malays and Indians. METHODS: Age-standardized mortality rates were calculated for 16 amenable causes of death in Singapore for six 5-year periods (1965-1969,..., 1990-1994), and for each of the three main ethnic groups for three periods (1989-1991, 1992-1994, 1995- 1997). Amenable mortality rates were divided into those which can be reduced by timely therapeutic care for 'treatable' conditions (e.g. asthma and appendicitis), or by primary preventive measures for 'preventable' conditions (e.g. lung cancer and motor vehicle injury). RESULTS: Amenable mortality was higher in males (age-standardized rate 109.7 per 100 000 population) than in females (age-standardized rate 60.7 per 100 000 population). Amenable mortality declined by 1.77% a year in males and 1.72% a year in females. By comparison, the average yearly decline in non-amenable mortality was 0.91% in males and 1.17% in females. The decline in amenable mortality was largely due to 'treatable' causes rather than a decline in mortality due to 'preventable' causes of death. Amenable mortality was lowest for Chinese and highest for Malays. Over the recent 9-year period from 1989 to 1997, amenable mortality declined more in Chinese than in Malays and Indians. However, Indian females showed by far the sharpest decline, whereas Indian males, by contrast, showed an increase in amenable mortality, due to both treatable and preventable causes. CONCLUSIONS: In line with findings from European countries, amenable mortality in Singapore declined more than non-amenable mortality. There were more significant gains in mortality outcomes from medical care interventions than from primary preventive policy measures. Gender and ethnic differences in amenable mortality were also observed, highlighting issues of socioeconomic equities to be addressed in the financing and delivery of health care.     

Stroke surveillance: population-based estimates and projections for New Zealand

OBJECTIVE: To estimate the incidence, prevalence and mortality of stroke in New Zealand (NZ) in 2001, projected to 2011. METHODS: Multistate lifetable models were constructed using smoothed rates of first-ever stroke incidence and relative risks of mortality estimated from the most recent Auckland Regional Community Stroke (ARCOS) Study. Estimates of the burden of stroke in NZ were calculated by applying rates output by the model to the 2001 population. Stroke incidence, prevalence and mortality were then projected to 2011, assuming similar trends in stroke incidence and case fatality to those estimated between the 1991/92 and 2002/03 studies. RESULTS: A total of 5,200 first-ever strokes were estimated to have occurred in NZ in 2001. Rates of stroke rose exponentially with increasing age and were 20% higher among males than females at most ages. Nevertheless, the lifetable risk of stroke was lower for males (16%) than females (18%). On average, males survived a year longer than females after a first-ever stroke (9.0 vs. 8.2 years). The incidence rates of first-ever stroke declined by approximately 1% per year between 1991 and 2003. The lifetable risk of stroke remained stable for females but increased for males (from 14% to 16%) over this period. Stroke prevalence also increased by approximately 1% per year, whereas stroke-related mortality fell by 4% per year. If these trends continue, approximately 6,000 first-ever strokes (2% annual increase), 45,000 stroke survivors (2% annual increase) and 2,000 stroke-related deaths (1% annual decline) are expected in 2011. CONCLUSION: Stroke mortality is falling faster than stroke incidence. This, together with population growth and ageing, will lead to a rising burden of stroke-related disability over the next decade.     

Cutaneous malignant melanoma in New Zealand: trends by anatomical site, 1969-1993

BACKGROUND: Site-specific trend analysis is probably the most effective method available for assessing how the long-term trend in melanoma rates relates to changes in sun exposure and behaviour. New Zealand has very high incidence of and mortality from melanoma and the fraction of melanoma cases and deaths with a site specified has been comparatively high. METHODS: Trends in incidence and mortality from melanoma in New Zealand were analysed between 1969 and 1993, by sex and body site. A graphical representation of the trend by birth-cohort and age-period-cohort modelling were used. RESULTS: For all sites combined, the annual increase in incidence was 6.7% (95% CI : 6.3-7.1%) in men and 3.1% (95% CI : 2.3-3.7%) in women. The increase was significantly greater at each site for males. The largest increases occurred for the upper limbs in males (7.3% a year) and the trunk in females (3.8% a year). Incidence rates slowed appreciably in the later years (currently about 26/100 000 for each sex) and no further increase in lifetime risk of melanoma was observed among post World War II generations. Mortality trends paralleled those for incidence with a 25-year gap, with a more modest rate of increase (2-3% per annum for each sex), essentially due to the increased risk among generations born up to 1919 or 1924. Age-standardized death rates have now stabilized in New Zealand at about 5.5/100 000 (men) and 3.2/100 000 (women). Trends between cohorts were the most marked for sites with a likely intermittent pattern of exposure, and were consistent overall for the trunk and the limbs. CONCLUSIONS: Results support the hypothesis that changes in lifestyle factors resulted in a pattern of carcinogenic exposures that explains both the upsurge in melanoma in the last few decades and the current levelling off in incidence.     

Trends in cancer incidence in Allegheny County,Pennsylvania, 1937-71.

Cancer incidence rates by race, sex, and cancer site were obtained from the Third National Cancer Survey for the years 1969-71 for residents of Allegheny County, Pennsylvania. When the sex-site-specific rates for 1969-71, as well as incidence rates from surveys in the county in 1937, 1947, and 1957-58, were compared with U.S. rates for 1937, 1947, and 1969-71, a number of significant changes in incidence were observed. Male incidence of cancers of the lung, bronchus, and trachea increased steadily between 1937 and 1969-71 both in Allegheny County and the United States. In the county, female incidence rates for these cancers decreased in the period 1947 to 1957-58 but showed an average annual increased of 9.2 percent in the interval 1957-58 to 1969-71. Incidence rates for county males increased by an average of 4.4 percent per year from 1957-58 to 1969-71. For stomach cancer, incidence rates for both sexes have decreased sharply in the county and in the United States. In the county, stomach cancer rates for females declined by an annual average of 4 percent from 1957-58 to 1969-71, while those formales dropped 2.1 percent. There appears to have been a steady decline over time in cervical cancer in Allegheny County, although the average annual rate of decrease of 2.8 percent for the latest interval (1957-58 to 1969-71) is not as large as the decrease of 3.9 percent per year from 1947 to 1957-58. Breast cancer rates for the county appear to have been steadily, although slowly, increasing at an average rate of about 0.6 percent per year, in contrast to almost constant U.S. rates. The county''s breast cancer incidence rate for 1969-71 almost equals the U.S rate. There have been steady increases in prostate cancer incidence in both Allegheny County and the United States since 1937. For all sites combined, male cancer incidence rates increased, while those for females slowly decreased in both Allegheny County and the United States during the interval 1937 to 1969-71. In the county, male rates for the interval 1937 to 1969-71 increased an average of 1 percent per year, while female rates declined approximately 0.3 percent annually.     

Increasing incidence of thyroid cancer in Great Britain, 1976–2005: age-period-cohort analysis

Increases in the incidence of thyroid cancer have been previously reported. The purpose of the present study was to examine temporal trends in the incidence of primary thyroid cancer diagnosed in 0-49?year olds in parts of Great Britain during 1976-2005. Data on 4,337 cases of thyroid cancer were obtained from regional cancer registries. Age-standardized incidence rates (ASRs) were calculated. Negative binomial regression was used to examine effects of age, sex, drift (linear trend), non-linear period and non-linear cohort. The best fitting negative binomial regression model included age (P?相似文献   

河北省磁县近三十年食管癌发病死亡趋势分析

目的分析河北省磁县1974-2002年食管癌发病、死亡趋势.方法食管癌发病资料取自磁县肿瘤登记处,全部资料录入计算机,采用SPSS 11.5软件进行统计分析.结果磁县19742002年食管癌新发病例18 471例,年平均发病率为118.2/10万,其中男性11 068例,女性7403例.男女性年平均发病率分别为140.13/10万和95.66/10万.29年来食管癌发病率总体有下降的趋势.从25岁组开始,各年龄组发病率均随时间推移有所降低,低年龄组发病下降较为明显,发病年龄逐渐后移.1974-2002年山区共发生食管癌2511例,年平均发病率为104.57/10万.经过近30年的防治,山区食管癌发病率明显下降.丘陵地区共发生5934例,年平均发病率114.17/10万,丘陵地区食管癌发病率也有下降.平原地区共发生食管癌10 026例,年平均发病率124.73/10万,平原地区食管癌发病率基本稳定,近年来略有上升趋势.磁县1969-2002年,全县34年共死亡食管癌患者18 736例,年平均死亡率106.00/10万,其中男性11 598例,女性7138例,年平均死亡率分别为129.91/10万、81.61/10万.2002年较1969年食管癌死亡率下降53.48/10万,下降了37.96%.各年代食管癌死亡占恶性肿瘤总死亡的百分比明显下降.结论1974-2002年磁县食管癌发病呈现下降趋势,发病年龄逐渐后移.山区下降尤为显著,丘陵地区下降幅度较小,平原地区发病基本稳定,近年来略有上升趋势.1969-2002年磁县食管癌死亡有明显的下降.     

Time Trends in Liver Cancer Mortality, Incidence, and Risk Factors by Unemployment Level and Race/Ethnicity, United States, 1969–2011

This study examined unemployment and racial/ethnic disparities in liver cancer mortality, incidence, survival, and risk factors in the United States between 1969 and 2011. Census-based unemployment rates were linked to 1969–2009 county-level mortality and incidence data, whereas 2006–2011 National Health Interview Surveys were used to examine variations in hepatitis infection and alcohol consumption. Age-adjusted mortality rates, risk-ratios, and rate-differences were calculated by year, sex, race, and county-unemployment level. Log-linear, Poisson, and logistic regression and disparity indices were used to model trends and differentials. Although liver-cancer mortality rose markedly for all groups during 1969–2011, higher unemployment levels were associated with increased mortality and incidence rates in each time period. Both absolute and relative inequalities in liver cancer mortality according to unemployment level increased over time for both males and females and for those aged 25–64 years. Compared to the lowest-unemployment group, those aged 25–64 in the highest-unemployment group had 56 and 115 % higher liver-cancer mortality in 1969–1971 and 2005–2009, respectively. Regardless of unemployment levels, Asian/Pacific Islanders and Hispanics had the highest mortality and incidence rates. The adjusted odds of hepatitis infection and heavy drinking were 38–39 % higher among the unemployed than employed. Liver-cancer mortality and incidence have risen steadily among all racial/ethnic, sex, and socioeconomic groups. Faster increases in mortality among the highest-unemployment group have led to a widening gap in mortality over time. Disparities in mortality and incidence are consistent with similar inequalities in hepatitis infection and alcohol consumption.     

Water traffic accidents, drowning and alcohol in Finland, 1969-1995

OBJECTIVE: To examine age- and sex-specific mortality rates and trends in water traffic accidents (WTA), and their association with alcohol, in Finland. MATERIALS AND METHODS: National mortality and population data from Finland, 1969-1995, are used to analyse rates and trends. The mortality rates are calculated on the basis of population, per 100000 inhabitants in each age group (<1, 1-4, 5-14, 15-24, 25-44, 45-64, > or = 65), and analysed by sex and age. The Poisson regression model and chi2 test for trend (EGRET and StatXact softwares) are used to analyse time trends. RESULTS: From 1969 through 1995 there were 3473 (2.7/100000/year; M:F= 20.4:1) WTA-related deaths among Finns of all ages. In 94.7% of the cases the cause of death was drowning. Alcohol intoxication was a contributing cause of death in 63.0% of the fatalities. During the study period the overall WTA mortality rates declined significantly (-4% per year; P < 0.001). This decline was observed in all age groups except > or = 65 year olds. The overall mortality rates in WTA associated with alcohol intoxication (1987-1995) also declined significantly (-6%; P = 0.01). CONCLUSIONS: In Finland, mortality rates in WTA are exceptionally high. Despite a marked decline in most age groups, the high mortality in WTA nevertheless remains a preventable cause of death. Preventive countermeasures targeted specifically to adult males, to the reduction of alcohol consumption in aquatic settings and to the use of personal safety devices should receive priority.     

2005—2013年中国肿瘤登记地区鼻咽癌发病和死亡分析

目的 根据2005—2013年《中国肿瘤登记年报》登记的鼻咽癌资料,分析中国鼻咽癌的发病和死亡情况,为制定中国鼻咽癌防控策略提供科学依据。 方法 整理收集2005—2013年中国鼻咽癌发病和死亡数据,利用Joinpoint回归模型分析鼻咽癌标化发病和死亡率的时间变化趋势,以及年龄别趋势。 结果 鼻咽癌发病率整体来说呈下降趋势,在2009—2010年出现明显转折,其中城市在2009年前呈上升趋势(APC=2.97%, P=0.30),2009年后呈下降趋势(APC=-5.75%, P＜0.05);而农村在2009年前鼻咽癌发病率呈快速下降趋势(APC=-17.64%, P=0.20),2009年后呈缓慢上升趋势(APC=4.24%, P=0.60),城乡差距逐渐缩小;中国男性鼻咽癌标化发病率一直高于女性,为女性的2.30~2.45倍,随时间发展男女性发病率整体呈下降趋势(APC＜0, P＜0.05);0~25岁人群鼻咽癌年龄别发病率趋势较平缓且较低,25~60岁人群随着年龄递增发病率逐渐升高,且各年份鼻咽癌发病率峰值均出现在50~60岁年龄组。鼻咽癌死亡率在2009—2010年出现明显转折,其中城市在2009年前呈上升趋势(APC=3.09%, P=0.20),2009年后呈下降趋势(APC=-7.27%, P＜0.05);2009年前农村鼻咽癌死亡率呈快速下降趋势(APC=-22.81%, P=0.10),2009年后呈缓慢上升趋势(APC=3.60%, P=0.60),城乡差距逐渐缩小;中国男性鼻咽癌标化死亡率一直高于女性,为女性的2.54~3.09倍,随时间发展男女性死亡率整体呈下降趋势(APC＜0, P＜0.05);整体而言,0~25岁人群鼻咽癌年龄别死亡率趋势较平缓且较低,25岁以后各年份随年龄增长呈上升趋势。 结论 2005—2013年间中国鼻咽癌发病和死亡率整体呈下降趋势,无论是发病或死亡均存在明显的年龄、性别差异,城市农村差距逐渐缩小,25岁以后呈现增长趋势且保持较高的发病率和死亡率水平,需重点关注25岁以上男性的鼻咽癌防治情况。     

Mortality trends and the epidemiological transition in Nauru

This article aims to examine the epidemiological transition in Nauru through analysis of available mortality data. Mortality data from death certificates and published material were used to construct life tables and calculate age-standardized mortality rates (from 1960) with 95% confidence intervals. Proportional mortality was calculated from 1947. Female life expectancy (LE) varied from 57 to 61 years with no significant trend. Age-standardized mortality for males (15-64 years) doubled from 1960-1970 to 1976-1981 and then decreased to 1986-1992, with LE fluctuating since then from 49 to 54 years. Proportional mortality from cardiovascular disease and diabetes increased substantially, reaching more than 30%. Nauru demonstrates a very long period of stagnation in life expectancy in both males and females as a consequence of the epidemiological transition, with major chronic disease mortality in adults showing no sustained downward trends over 40 years. Potential overinterpretation of trends from previous data due to lack of confidence intervals was highlighted.     

Suicide mortality in the European Union

BACKGROUND: There are an estimated one million completed suicides per year worldwide. As a response to increasing concern about suicide within Europe, the EUROSAVE (European Review of Suicide and Violence Epidemiology) study was undertaken to examine recent trends in the epidemiology of suicide and self-inflicted injury mortality in the European Union (EU). METHODS: Suicide and self-inflicted injury mortality data for the 15 EU countries for the years 1984-1998 were obtained from the World Health Organisation (WHO), the European Statistical Office of the European Commission (EUROSTAT) and national statistical agencies. Data were also obtained for a second group of deaths classified as 'undetermined' or 'other violence'. Age-standardized mortality rates were calculated and examined for trends over time. RESULTS: Finland had the highest suicide rate, while Greece had the lowest for the latest available year (1997). Age-standardized suicide rates tended to be lowest in the Mediterranean countries. Significant downward linear time trends in suicide mortality were observed in most countries, although rates varied markedly between countries. Both Ireland and Spain displayed significant upward linear trends in suicide mortality. Portugal had the highest rate of undetermined deaths both in 1984 and 1998 while Greece had the lowest in both 1984 and 1997. Five countries (including Ireland and Spain) showed significant downward trends in deaths due to undetermined causes whereas Belgium and Germany showed borderline significant upward linear trends in deaths due to undetermined causes. CONCLUSIONS: Although suicide rates in most countries seem to be decreasing, the validity of the data is uncertain. Misclassification may contribute to the geographical and temporal variation in suicide rates in some EU countries but it does not explain the phenomenon. More detailed research comparing suicide-recording procedures and practices across the EU is required. In the absence of adequate EU wide data on suicide epidemiology, effective prevention of this distressing phenomenon is likely to remain elusive.     

2006-2013年江苏省昆山市食管癌发病 与死亡趋势分析

摘要:目的　探究2006-2013年昆山市食管癌发病与死亡趋势。方法　食管癌发病病例来源于昆山市恶性肿瘤登记报告系统,死亡病例来源于死因登记;计算食管癌粗发病（死亡）率与年龄标化发病（死亡）率;使用Join-point 回归计算发病率与死亡率平均年度变化百分比（Annual Percentage Change,APC）。结果　2006-2013年间,食管癌年龄标化发病率呈现下降趋势（APC＝-8.6%,95%CI:-11.1～-6.2）;男性中也呈现了显著的下降趋势（APC＝-9.0%,95%CI:-11.8～-6.2）;而女性下降趋势未能发现统计学显著性差异（APC＝-6.3%,95%CI:-13.2～0.6）。食管癌年龄标化死亡率在两者（APC＝-10.6%,95%CI:-14.5～-6.7）、男性（APC＝-8.3%,95%CI:-12.3～-4.3）及女性（APC＝-15.6%,95%CI:-22.5～-8.7）中均有显著下降趋势。结论　虽然当前食管癌年龄标化死亡率与发病率呈现下降态势,但是女性发病率下降趋势不明显,仍需加强预防措施从根本上遏制食管癌的发生。     

上海市区鼻咽癌发病率趋势分析

目的 分析上海市区1973-2005年鼻咽癌发病率变化趋势.方法 利用上海市肿瘤登记资料,计算鼻咽癌的粗发病率(粗率)、世界标准人口调整后发病率(世调率)、截缩率和累积发病率.采用线性同归模型计算发病率的估计年度变化百分比(APC).结果 33年间上海市区共登记鼻咽癌新发病例7889例,其中男5555例、女2334例.男性鼻咽癌33年间发病趋势保持不变呈平稳状态,粗率和标化率分别由1973-1976年的4.56/10万和4.12/10万变化到2001-2005年的6.18/10万和3.96/10万,APC为-0.250%,差异无统计学意义(P=0.340).而女性鼻咽癌发病率有下降的趋势,粗率和标化率分别由1973-1976年的2.60/10万和2.18/10万变化到2001-2005年的2.41/10万和1.42/10万,APC为-1.577%,差异有统计学意义(P<0.001).结论 1973-2005年上海市区男性鼻咽癌发病水平呈平稳趋势,而女性鼻咽癌发病率有下降的趋势.提示应进一步开展分析流行病学调查,研究其病因和防治对策.     

Convergence of immigrant suicide rates to those in the destination country

Factors influencing the 1969-1973 suicide rate in 25 immigrant groups in Canada were investigated. Standardized mortality ratios (SMRs) were calculated for each group relative to the suicide rates in the origin country populations. Compared with their origin countries, immigrant females exhibited a significant increase in suicide rates (SMR = 1.11, p less than 0.01), whereas immigrant males did not (SMR = 0.98). Another set of standardized mortality ratios were then calculated for both origin and immigrant populations using the Canadian native-born rates as the standard. For the majority of immigrant groups, the standardized mortality ratios were significantly different from the ratios of their corresponding origin country populations, with 60% of the female immigrant groups and 41% of the male immigrant groups exhibiting higher ratios. Considerable variation was observed in the immigrant standardized mortality ratios, with a significant proportion of this variability being associated with the suicide rates in the origin countries (males r = 0.60, p less than 0.01; females r = 0.47, p less than 0.05). Using the standardized mortality ratios based on the Canadian native-born rates, the degree of "convergence" of immigrant suicide rates to the Canadian native-born rates was examined. Overall, significant convergence occurred for both sexes (p less than 0.01), with the immigrant suicide rates converging 40% of the initial difference between the standardized mortality ratios for the origin country and the Canadian native-born.     

Ethnic differences in the occurrence of oropharyngeal cancer in Taiwan

OBJECTIVE: The purpose of this study was to examine the oropharyngeal cancer pattern among different ethnic groups in Taiwan. METHODS: The sample population was divided into three ethnic groups: the Fukkien, Hakka, and aboriginal communities. Age-standardized mortality rates (SMRs) and age-standardized incidence rates (SIRs) were estimated among these ethnic groups for the period 1979-1996/1997. RESULTS: Our study found that the higher oropharyngeal cancer mortality and incidence rates in females of aboriginal groups are statistically significant, and higher than reference groups for both genders (SMR=3.76, SIR=2.18). However, in the lower areca quid chewing aboriginal groups, the higher pattern was not seen in females, and the lower pattern was even found in males. The incidence and mortality rate of oropharyngeal cancer in Hakkas was significantly lower than in the reference group. CONCLUSIONS: The pattern of oropharyngeal cancer in Taiwan showed ethnic differences. The differences may be due to variation in exposure to different risk factors; however, in our study, we found that genetic differences might also be considered when explaining the different oropharyngeal cancer patterns among ethnic groups.     

深圳市居民2017—2020年伤害死亡特征及减寿分析

  目的  分析2017—2020年深圳市居民的主要伤害死亡特征及减寿情况, 为制定伤害预防控制策略和措施提供科学依据。  方法  使用构成比、死亡率、标化死亡率、潜在减寿年数(potential years of life lost, PYLL)、减寿率(potential years of life lost rate, PYLLR)、平均减寿年数(average years of life lost, AYLL)等指标评估伤害死亡特征及减寿情况。同时应用Joinpoint回归对主要伤害死因的年龄别死亡率进行分析比较。  结果  2017—2020年深圳市居民的伤害死亡例数为7 199, 年均粗死亡率为12.73/10万, 年均标化死亡率为20.70/10万, 男性高于女性。伤害死因及伤害所致PYLL前三位均为自杀、交通事故和意外跌落。全人群全部伤害死因年龄别死亡率的整体变化为平均每岁上升4.9%(t=5.2, P < 0.001), 自杀死亡率为平均每岁上升3.1%(t=3.8, P < 0.001), 交通事故死亡率为平均每岁上升2.7%(t=2.8, P=0.005), 意外跌落死亡率为平均每岁上升6.1%(t=6.8, P < 0.001), 男、女死亡率转折点不同, 且死亡率曲线不平行, 变化趋势不一样。4年间伤害所造成的PYLL合计为269 093.5人年, AYLL为37.38年/人, PYLLR为4.76‰。  结论  自杀是深圳市居民首要伤害死因, 男、女各伤害死因死亡率呈现不同的年龄变化趋势, 需根据重点人群采取针对性的措施。伤害导致严重的寿命损失, 给家庭和社会带来重大影响, 社会各界需加强对伤害的预防, 减少伤害尤其是致死性伤害的发生。     

Measuring the health of nations: updating an earlier analysis

We compared trends in deaths considered amenable to health care before age seventy-five between 1997-98 and 2002-03 in the United States and in eighteen other industrialized countries. Such deaths account, on average, for 23 percent of total mortality under age seventy-five among males and 32 percent among females. The decline in amenable mortality in all countries averaged 16 percent [corrected] over this period. The United States was an outlier, with a decline of only 4 percent. If the United States could reduce amenable mortality to the average rate achieved in the three top-performing countries, there would have been 101,000 fewer deaths per year by the end of the study period.     

Thyroid cancer incidence trends in Belarus: examining the impact of Chernobyl

BACKGROUND: While prior studies of thyroid cancer incidence within Belarus have increased since the 1986 Chernobyl reactor accident, the magnitude of increase is not well quantified. METHODS: Using Belarussian national cancer registry data, trends in average annual age-adjusted thyroid cancer incidence rates were examined by calendar year and gender. Incidence rates were also examined across specified time intervals, for specific age groups at diagnosis, and in 'higher exposure' regions compared with 'lower exposure' areas. RESULTS: Age-adjusted thyroid cancer incidence rates (adjusted to the WHO 2000 world population) have increased between 1970 and 2001 from 0.4 per 100 000 to 3.5 per 100 000 among males (+775%) and from 0.8 per 100 000 to 16.2 per 100 000 among females (+1925%). The relative increase among males (+1020%) and females (+3286%) in 'high exposure' areas exceeded increases among males (+571%) and females (+250%) in 'lower exposure' areas of Belarus. Dramatic increases in thyroid cancer incidence rate ratios were noted among both males and females and in all age groups. The highest incidence rate ratios were observed among people from 'higher exposure' areas ages 0-14 yr at time of diagnosis. CONCLUSIONS: Marked increases in the incidence of thyroid cancer have occurred over a relatively limited period of observation in all areas of the Republic of Belarus and among all age categories. The greatest increases have occurred among children, suggesting that a high prevalence of pre-existing iodine deficiency in combination with unique susceptibility among younger people might have contributed to potential carcinogenic exposures to the thyroid.