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1985 - 2012年西班牙南部肺癌组织学亚型的发病趋势:一项基于人群的研究

Trends in lung cancer incidence by histologic subtype in the south of Spain, 1985-2012: a population-based study.

作者信息

Linares I, Molina-Portillo E, Expósito J, Baeyens J A, Suárez C, Sánchez M J

机构信息

Radiotherapy and Oncology Department, University Hospital Complex of Granada, Avda. fuerzas Armadas s/n, 18014, Granada, Spain.

Andalusian School of Public Health, Biosanitary Investigation Institute ibs, Granada, Spain.

出版信息

Clin Transl Oncol. 2016 May;18(5):489-96. doi: 10.1007/s12094-015-1392-x. Epub 2015 Sep 2.

Abstract

PURPOSE

To analyze and interpret age- and sex-specific incidence trends of lung cancer in Granada over the period 1985-2012 and to further analyze these trends by histologic subtype.

METHODS

Incidence data were obtained from the population-based cancer registry located in Granada (Southern Spain). All cases with newly diagnosed primary lung cancer over the period 1985-2012 (n = 8658) and defined by International Classification of Diseases 10th Revision (codes C33-C34) were included. Joinpoint regression analysis of age-standardized incidence rates was used to estimate the annual percent change (APC) and 95% confidence intervals. Results are presented overall and by sex, age groups (0-34, 35-54, 55-64, 65-74, ≥75 years) and histologic subtypes.

RESULTS

Temporal trends of incidence rates by sex, over the period 1985-2012, showed a distinct pattern. A significant change point of the trend was observed in males in 1994 (APC: +2.5%; 95% CI 0.7-4.4 from 1985 to 1994 and -1.4%; 95% CI -2.0 to -0.7 from 1994 onward). This general change was mainly caused by the age group 65-74 years and by the higher incidence of squamous cell carcinoma histologic subtype. In females, lung cancer incidence increased over the entire study period by +4.2% per year (95% CI 3.1-5.4); this trend was mainly caused by the age group 55-64 years (APC = +7%) and by adenocarcinoma incidence between women (APC = +6.8%).

CONCLUSION

Male lung cancer incidence rates have decreased in Granada, while female rates have increased overall especially in younger women. These trends may reflect the increased consumption of cigarettes in women, especially during younger ages. Lung cancer prevention through tobacco control policies are therefore of utmost importance.

摘要

目的

分析并解读1985年至2012年格拉纳达地区肺癌的年龄和性别特异性发病率趋势,并按组织学亚型进一步分析这些趋势。

方法

发病率数据来自位于格拉纳达(西班牙南部)的基于人群的癌症登记处。纳入了1985年至2012年期间所有新诊断的原发性肺癌病例(n = 8658),这些病例由国际疾病分类第10版(编码C33 - C34)定义。采用年龄标准化发病率的Joinpoint回归分析来估计年度百分比变化(APC)和95%置信区间。结果按总体、性别、年龄组(0 - 34岁、35 - 54岁、55 - 64岁、65 - 74岁、≥75岁)和组织学亚型呈现。

结果

1985年至2012年期间,按性别划分的发病率时间趋势呈现出不同模式。1994年男性发病率趋势出现显著变化点(APC:1985年至1994年为+2.5%;95%置信区间0.7 - 4.4,1994年以后为 - 1.4%;95%置信区间 - 2.0至 - 0.7)。这一总体变化主要由65 - 74岁年龄组以及鳞状细胞癌组织学亚型的较高发病率导致。在女性中,肺癌发病率在整个研究期间每年增加+4.2%(95%置信区间3.1 - 5.4);这一趋势主要由55 - 64岁年龄组(APC = +7%)以及女性腺癌发病率(APC = +6.8%)导致。

结论

格拉纳达地区男性肺癌发病率有所下降,而女性发病率总体上升,尤其是年轻女性。这些趋势可能反映了女性尤其是年轻女性吸烟量的增加。因此,通过烟草控制政策预防肺癌至关重要。

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