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新西兰子宫内膜癌发病率的快速上升及种族差异

Rapid increase in endometrial cancer incidence and ethnic differences in New Zealand.

作者信息

Scott Oliver W, Tin Tin Sandar, Bigby Susan M, Elwood J Mark

机构信息

Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, 261 Morrin Road, St Johns, Auckland, 1072, New Zealand.

Counties Manukau Health Laboratory Services, Middlemore Hospital, Counties Manukau District Health Board, 100 Hospital Road, Otahuhu, Auckland, 2025, New Zealand.

出版信息

Cancer Causes Control. 2019 Feb;30(2):121-127. doi: 10.1007/s10552-019-1129-1. Epub 2019 Jan 22.

Abstract

PURPOSE

Endometrial cancer accounts for 3.9% of all female cancers globally, and its incidence appears to be increasing in women under 40 years of age. This paper investigated ethnic-specific trends in endometrial cancer across different age groups in New Zealand.

METHODS

Women who were diagnosed with endometrial cancer between 1996 and 2012 were identified from the New Zealand Cancer Registry. Annual age-standardized incidence and mortality rates were calculated for each ethnicity (Māori, Pacific, and non-Māori non-Pacific) in four age groups (< 40, 40-49, 50-74, and 75 +). The estimates were adjusted for hysterectomy. Joinpoint regression analysis was used to assess trends over time and annual percentage changes (APCs) were estimated.

RESULTS

Between 1996 and 2012, age-standardized incidence rates increased in all women and significantly in the < 40, 40-49, and 50-74 age groups (APC 9.22, 3.56, and 1.65 respectively). Incidence rates were highest in Pacific women and increased most rapidly in those under 50 years of age (APC 9.36). Conversely, age-standardized mortality rates decreased in all women and significantly in the 50-74 and 75 + age groups (APC - 5.25 and - 5.06 respectively), with the highest rate observed in Pacific women.

CONCLUSION

Pacific women had the highest incidence of endometrial cancer and the trend was increasing, particularly in young women. This could be attributed, at least in part, to a high and increasing rate of obesity in these women and should be explored in future research.

摘要

目的

子宫内膜癌占全球所有女性癌症的3.9%,且在40岁以下女性中的发病率似乎呈上升趋势。本文调查了新西兰不同年龄组中子宫内膜癌的种族特异性趋势。

方法

从新西兰癌症登记处识别出1996年至2012年间被诊断为子宫内膜癌的女性。计算了四个年龄组(<40岁、40 - 49岁、50 - 74岁和75岁及以上)中每个种族(毛利人、太平洋岛民和非毛利非太平洋岛民)的年龄标准化发病率和死亡率。这些估计值针对子宫切除术进行了调整。采用连接点回归分析来评估随时间的趋势,并估计年度百分比变化(APC)。

结果

1996年至2012年间,所有女性的年龄标准化发病率均有所上升,在<40岁、40 - 49岁和50 - 74岁年龄组中显著上升(APC分别为9.22、3.56和1.65)。太平洋岛民女性的发病率最高,且在50岁以下女性中上升最为迅速(APC为9.36)。相反,所有女性的年龄标准化死亡率均有所下降,在50 - 74岁和75岁及以上年龄组中显著下降(APC分别为 - 5.25和 - 5.06),太平洋岛民女性的死亡率最高。

结论

太平洋岛民女性的子宫内膜癌发病率最高,且呈上升趋势,尤其是在年轻女性中。这至少部分可归因于这些女性中肥胖率较高且不断上升,未来研究应对此进行探讨。

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