每两位男性或每三位女性即有一人可能罹患癌症


  February 9, 2007 – 在美国,每两位男性或每三位女性就可能有一位罹患癌症,且在2050年时罹患癌症的人数可能增加一倍;这两项预测是根据美国国家癌症机构(NCI)的 SEER (the Surveillance Epidemiology and End Results)计画所收集的统计数据。
  
  这样的预测是根据收集1975年到2003年的数据资料分析,整合在1月号的癌症学家期刊中。
  
  癌症学家期刊的主编Bruce Chabner医师表示,NCI的SEER计画是美国癌症诊断、治疗与预后的重要指标;透过了解美国人罹患癌症的现况,以及这些病患在诊断罹患癌症后的存活时间,SEER计画可以告诉公共卫生官员目前的进展如何?以及哪里里须要再多加努力的。
  
  2003年1月时,美国估计有1050万人被诊断罹患癌症(该图表包括未罹患癌症),其中超过一半、约580万人为女性。
  
  新诊断罹患癌症的人数将会从2000年的136万人加倍到2050年的300万人,因为美国人口逐渐老化且逐渐增加;NCI的研究者表示,新癌症增加的大多数为65至84岁,且这样的情形将会在2030年达到最高峰,当达到婴儿潮的最高峰时。
  
  欧洲也有同样的癌症增加趋势,且与人口老化有关,该报告刊登于癌症学志中,且于上周由Medscape报导。
  
  【癌症盛行率的趋势】
  NCI研究者也强调许多1975年至2003年癌症盛行率的趋势表现。
  
  对妇女而言,所有试验中心年龄校正的癌症盛行率从1979年至2003年持续上升,虽然盛行率上升的幅度在1987年后开始下降;盛行率增加的癌症包括白血病、肺癌、黑色素瘤、非何杰金氏淋巴瘤与甲状腺癌,这些癌症盛行率在1980年代初期快速上升;研究者表示,妇女的甲状腺癌尤其令人注意,男性的盛行率倍增,且部分是因为诊断其它癌症后再发造成。
  
  研究者表示,卵巢癌的盛行率自1985年开始下降,且到了2003年仍然下降中,而乳癌盛行率已经显示出逐渐稳定且开始下降的趋势;该趋势已于2006年圣安东尼奥乳癌会议中讨论,且由Medscape报导;在这项文献中,NCI研究者指出,乳癌盛行率的详细检验显示,最近几年(2001年至2003年)趋向稳定,自1987年以来盛行率上升的速度就开始减缓;解释这种情形的可能原因,包括自从2002年妇女健康行动研究结果发表后,停经后妇女使用荷尔蒙疗法的情况减少,以及以乳房摄影筛检乳癌的情形增加。
  
  对男人而言,所有部位的癌症盛行率显著增加至1992年,在后来几年快速下降,且自1995年之后开始稳定;男性癌症盛行率增加的部位,包括肾脏与肾盓癌、白血病、与黑色素瘤(虽然在2001年之后开始趋向稳定),盛行率下降的癌症包括口腔癌、咽喉癌与肺癌;摄护腺癌的趋势似乎起起伏伏,于1992年与1995年显著下降,之后于1995年自2003年之间些微成长。
  
  【黑人盛行率与死亡率最高】
  黑人男性与女性不论部位,盛行率与死亡率都是最高的;举例来说,黑人男性罹患摄护腺癌的盛行率为每100,000位有258.3位,相较于白人男性则是每100,000位有163.4位。
  
  NCI的研究者表示,一般而言,黑人病患的相对存活率较低,不论癌症发生位置与诊断分期,这样不同的情形部分因为危险因子盛行率不同、使用筛检比例的差异、接受健康服务的比例不同、以及/或是社会经济地位与流行病学因子。

Cancer strikes 1 in 2 men and<

By Zosia Chustecka
Medscape Medical News

February 9, 2007 – Cancer will affect 1 in 2 men and 1 in 3 women in the United States, and the number of new cases of cancer is set to nearly double by the year 2050. Both predictions are based on statistics collected by the Surveillance Epidemiology and End Results (SEER) program at the National Cancer Institute (NCI).

The predictions come from an analysis of data collected from 1975 to 2003, summarized in a paper in the January issue of the Oncologist.

"NCI's SEER program is a finger on the pulse of cancer diagnosis, treatment, and outcome in the United States," says Bruce Chabner, MD, editor-in-chief of the Oncologist. "By looking how frequently cancer occurs in Americans and how long they live after the diagnosis, the SEER program can tell public health officials where progress has occurred as well as where there is a need to redouble our efforts."

As of January 2003, there were an estimated 10.5 million people in the United States who had received a diagnosis of cancer (the figure includes those who are cancer-free). More than half, 5.8 million, were women.

The number of new cases of cancer is expected to nearly double, from 1.36 million in 2000 to almost 3 million in 2050, due to aging and the growing US population. Much of this increase in the number of new cancers will be in the 65-to-84-year age group, and this will reach a peak at 2030, as the baby-boomer generation ages, the NCI researchers comment.

This future increase in new cases of cancer is similar to that predicted in Europe, where it is also being attributed to the aging of the population, as reported from the Annals of Oncology earlier this week by Medscape.

Trends of Cancer Incidence

The NCI researchers also highlight several trends in cancer incidence that have emerged during the 1975-2003 period.

In women, the age-adjusted incidence rates for cancers at all sites have continued to rise from 1979 to 2003, although the rate of increase diminished after 1987. Cancers on the increase in women include leukemia, lung cancer, melanoma, non-Hodgkin's lymphoma, and thyroid cancer, which began to increase sharply during the early 1980s. The increase in thyroid cancer in women is "particularly notable," the researchers comment; the incidence is double that in men and is due partially to occurrence after diagnosis of other primary cancers.

Ovarian cancer began to decline in 1985 and has continued to decline to 2003, and the incidence of breast cancer has shown a "recent stabilization and possible decline," the researchers note. This trend was discussed at the San Antonio Breast Cancer meeting in December 2006 and was reported at that time by Medscape. In this paper, the NCI researchers say a detailed examination of breast cancer incidence shows stable rates in the most recent time period (2001-2003), preceded by a deceleration in the rate of increase since about 1987. Factors that may explain this possible decline include the reduction in hormone therapy among postmenopausal women following the 2002 publication of the Women's Health Initiative and population effects of screening practices with mammography.

In men, the age-adjusted incidence rates for cancer at all sites increased dramatically until 1992, fell sharply during the next few years, and have been stable since 1995. Cancers on the increase in men include those of the kidney and renal pelvis, leukemia, and melanoma (although this began to stabilize in 2001), while decreases were seen for cancer of the oral cavity, pharynx, and lung. The trend for prostate cancer seemed to fluctuate, with a sharp decline between 1992 and 1995, followed by a modest increase in the most recent segment from 1995 to 2003.

Blacks Had Highest Incidence and Mortality

Blacks had the highest incidence rates and also the highest death rates for men and women for all sites combined. For example, prostate cancer had an incidence among black men of 258.3 per 100,000 compared with 163.4 per 100,000 for white men.

In general, black patients have a lower relative survival, independent of cancer site and stage at diagnosis, the NCI researchers comment. This health disparity may be partially due to variations in the prevalence of risk factors, the use of screening tests, access to healthcare services, and/or social and demographic factors, they suggest.

Oncologist. 2007;12:20-37.

    
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