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JAMA:看美国!35年癌症死亡率的差异趋势变化

2017-01-29 MedSci MedSci原创

癌症是美国发病率和死亡率的主要原因,并且也是导致经济负担增高的主要原因之一。近期,一项发表在JAMA杂志上的文章估计了美国各州的29种癌症的年龄标准化死亡率。研究数据来自国家卫生统计中心(NCHS)识别的死亡记录和人口普查局,NCHS和人类死亡率数据库的人口计数从1980年直至2014年。使用验证的小面积估计模型来估计29种癌症的死亡率:唇和口腔、鼻咽其他咽部、食管、胃、结肠和直肠、肝、胆囊和胆汁

癌症是美国发病率和死亡率的主要原因,并且也是导致经济负担增高的主要原因之一。


近期,一项发表在JAMA杂志上的文章估计了美国各州的29种癌症的年龄标准化死亡率。

研究数据来自国家卫生统计中心(NCHS)识别的死亡记录和人口普查局,NCHS和人类死亡率数据库的人口计数从1980年直至2014年。使用验证的小面积估计模型来估计29种癌症的死亡率:唇和口腔、鼻咽其他咽部、食管、胃、结肠和直肠、肝、胆囊和胆汁、胰、喉、气管、支气管和肺、恶性皮肤黑素瘤、非黑色素瘤皮肤癌、乳房、子宫颈、子宫、卵巢、前列腺、睾丸、肾、膀胱、脑和神经系统、甲状腺、间皮瘤、霍奇金淋巴瘤、非霍奇金淋巴瘤、多发性骨髓瘤、白血病以及所有其他癌症相结合。

主要结果及评估方法为:按地区、年龄、性别和癌症类型划分的年龄标准化癌症死亡率。

调查研究结果给显示:在1980年至2014年期间,美国共记录19511910例癌症死亡,包括5656423例由于气管、支气管和肺癌;2484476例由于结肠和直肠癌;1573593例由于乳腺癌;1077030例由于前列腺癌;1157878例由于胰腺癌;209314例由于子宫癌;421628例由于肾癌;487518例由于肝癌;13927例因睾丸癌;和829396例由于非霍奇金淋巴瘤死亡。

在1980年至2014年期间,癌症死亡率从每100000人中的240.2(95%不确定性区间[UI],235.8-244.1)下降到192.0(95%UI,188.6-197.7),死亡率下降了20.1%(95%UI,18.2%-21.4%)。

不同地区的癌症死亡率差异很大,1980年,癌症死亡率从科罗拉多州萨米特县每100000人口的130.6(95%UI,114.7-146.0)到阿拉斯加州北坡县的386.9(95%UI,330.5-450.7);在2014年从科罗拉多州萨米特县的70.7(95%UI,63.2-79.0)到佛罗里达州联合县的503.1(95%UI,464.9-545.4)。

对于许多癌症,存在具有特别高死亡率的不同群体的地区。这些聚集发病的位置根据癌症的类型而变化,并且在美国的不同区域中扩散。

乳腺癌群落存在于南部地带及沿密西西比河,而肝癌沿德克萨斯-墨西哥边界高,并且肾癌沿北部和南部达科他州和西弗吉尼亚州,俄亥俄州,印第安纳州,路易斯安那州,俄克拉何马州,德克萨斯州,阿拉斯加和伊利诺伊州分布。

调查研究表明:自1980年至2014年期间,美国的癌症死亡率总体下降。在同一时期,美国各县的癌症死亡率的趋势、模式和差异有重要变化。这些模式可以为进一步研究改进预防和治疗提供信息。

原始出处:
Mokdad AH, Dwyer-Lindgren L, Fitzmaurice C, et al. Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014. JAMA. 2017 Jan 24;317(4):388-406. doi: 10.1001/jama.2016.20324.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=2045339, encodeId=734620453392e, content=<a href='/topic/show?id=7e4de13990f' target=_blank style='color:#2F92EE;'>#癌症死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71399, encryptionId=7e4de13990f, topicName=癌症死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sat Apr 22 17:45:00 CST 2017, time=2017-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=174029, encodeId=a3031e40292f, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Feb 03 21:57:32 CST 2017, time=2017-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173736, encodeId=02d51e373612, content=好文,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Feb 02 07:55:18 CST 2017, time=2017-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173705, encodeId=66e21e3705c1, content=长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOWcPEsEP4FrvDcicue5V6rMkmXmY73KjYP59vQrEdjU89iaN4ZkOhsItlHkmGTjhV3b5S3zOQA4E0/0, createdBy=cc261682151, createdName=卡圣, createdTime=Thu Feb 02 04:50:37 CST 2017, time=2017-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473561, encodeId=d3e514e3561cd, content=<a href='/topic/show?id=0e3be140052' target=_blank style='color:#2F92EE;'>#癌症死亡率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71400, encryptionId=0e3be140052, topicName=癌症死亡率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eba97230640, createdName=wenjie, createdTime=Tue Jan 31 04:45:00 CST 2017, time=2017-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173259, encodeId=58731e3259bd, content=争取消灭癌症, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=071c2012037, createdName=wmu姿, createdTime=Mon Jan 30 09:11:03 CST 2017, time=2017-01-30, status=1, ipAttribution=)]
    2017-02-03 李东泽

    很好,不错,以后会多学习

    0

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    2017-02-02 1e10c84am36(暂无匿称)

    好文,值得学习

    0

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    2017-02-02 卡圣

    长见识了

    0

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    2017-01-30 wmu姿

    争取消灭癌症

    0

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