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美国年轻女性肺癌发病率高于年轻男性
Higher Lung Cancer Incidence in Young Women than Young Men in the United States


Ahmedin Jemal ... 肿瘤 呼吸系统疾病 • 2018.05.24
相关阅读
• 从未吸烟者中肺癌患者的比例正在增加

美国年轻女性肺癌发病率已超过男性

 

田林玮†,黄云超‡*

†香港大学公共卫生学院;‡昆明医科大学第三附属医院,云南省肿瘤医院

*通讯作者

 

曾几何时,女性肺癌发病率较低,不能与男性肺癌相提并论,到如今却与男性平分秋色。在2018年5月24日出版的《新英格兰医学杂志》(NEJM)上,美国癌症学会的Jemal和同事1发表论文,其结果显示美国肺癌发病率持续下降,但是女性下降的速度不及男性,目前美国50岁以下年轻女性的肺癌发病率开始超过年轻男性。

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摘要


背景

以前的研究显示,美国年轻女性肺癌的发病率高于年轻男性。这种模式是否在当代出生队列中持续存在,如果存在,是否可以用吸烟行为的性别差异充分解释,这些问题的答案尚不清楚。

 

方法

我们根据性别、人种或族群、年龄组(30~34岁、35~39岁、40~44岁、45~49岁和50~54岁)、出生年份(1945~1980年)和诊断时的历期(calendar period,1995~1999年、2000~2004年、2005~2009年和2010~2014年)分类,研究了全国基于人群的肺癌发病率,并计算了女性与男性的发病率比。我们还使用1970~2016年美国国家健康访问调查(National Health Interview Survey)的数据研究了吸烟率。

 

结果

在过去的20年中,在所有人种和族群的30~54岁男性和女性中,肺癌的年龄别发病率普遍下降,但男性的下降幅度较大。因此,在非西班牙语裔白种人中,女性与男性的发病率比增加,在30~34岁、35~39岁、40~44岁和45~49岁年龄组中,发病率比超过1.0。例如,在40~44岁的白种人中,女性与男性的发病率比从1995~1999年的0.88(95%置信区间[CI],0.84~0.92)增加至2010~2014年的1.17(95% CI,1.11~1.23)。在1965年以后出生的非西班牙语裔白种人中,两种性别的肺癌发病率发生了交叉。在非西班牙语裔黑种人、西班牙语裔,以及非西班牙语裔亚洲人和太平洋岛民中,两种性别的发病率差异缩小,但仅在西班牙语裔中,两种性别的发病率发生交叉,由男性发病率较高变为女性发病率较高。1965年后出生女性的吸烟率已经接近,但通常尚未超过男性吸烟率。

 

结论

在20世纪60年代中期以后出生的非西班牙语裔白种人和西班牙语裔中,历史上男性肺癌发病率高于女性的模式已经逆转,这不能用吸烟行为的性别差异完全解释。需要将来的研究来确定年轻女性肺癌发病率较高的原因(由美国癌症学会[American Cancer Society]资助)。





作者信息

Ahmedin Jemal, D.V.M., Ph.D., Kimberly D. Miller, M.P.H., Jiemin Ma, Ph.D., Rebecca L. Siegel, M.P.H., Stacey A. Fedewa, Ph.D., Farhad Islami, M.D., Ph.D., Susan S. Devesa, Ph.D., and Michael J. Thun, M.D.
From Surveillance and Health Services Research, American Cancer Society, Atlanta (A.J., K.D.M., J.M., R.L.S., S.A.F., F.I., M.J.T.); and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD (S.S.D.). Address reprint requests to Dr. Jemal at the American Cancer Society, 250 Williams St., NW, Atlanta, GA 30303, or at ahmedin.jemal@cancer.org.

 

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