提示: 手机请竖屏浏览!

癌症的流行病学标签
Epidemiologic Signatures in Cancer


H. Gilbert Welch ... 肿瘤 • 2019.10.03
相关阅读
• 解决过度诊断的问题 • 权变知识和循环效应——一名通过前列腺特异性抗原检测出前列腺癌并 感到后悔的66岁男性 • 为期30年的乳腺钼靶筛查对乳腺癌发病率的影响 • 幽门螺杆菌感染

一个多世纪以来,美国一直致力于测量人群癌症负担。这项工作首先要测量疾病特定死亡率。年度死亡率统计数据的汇总工作始于1900年,1933年覆盖全美国1。测量发病率显然更具挑战性,因为收集死亡信息比收集诊断信息更容易。康涅狄格州于1935年建立了人群癌症登记系统2,美国国立癌症研究院于1973年建立了国家癌症登记系统,即监测、流行病学和最终结果(SEER)计划3

随着时间的推移,另一个挑战变得显而易见:观察到的癌症负担会受到诊断方法的影响4。新的影像学和其他诊断方法可使癌症在病程的更早期被诊断出,可使我们检测出以前不知晓的淋巴结和转移病灶(将癌症分期上移)5,甚至可发现某些原本在临床上不会变得明显的癌症,这一现象现在被称为过度诊断6。某些惰性亚临床类型有大量患者,这些类型的癌症发病率尤其易受到诊断详尽程度的影响。诊断的详尽程度是以下三方面的综合作用:诊断或筛查(包括体格检查、影像学检查和实验室检查)频率、检查方法对微小异常的检测能力及异常被视为癌症的阈值。这些因素可导致报告的发病率出现医源性的快速波动,共同导致作为真实癌症发病率指标的癌症发病率变得不可靠。





作者信息

H. Gilbert Welch, M.D., M.P.H., Barnett S. Kramer, M.D., M.P.H., and William C. Black, M.D.
From the Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston (H.G.W.); the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD (B.S.K.); and the Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, NH (W.C.B.). Address reprint requests to Dr. Welch at P.O. Box 114, Thetford, VT 05074, or at drgilwelch@gmail.com.

 

参考文献

1. Historical development of cause of death statistics. Technical paper 55. Bethesda, MD: International Institute for Vital Registration and Statistics, September 1993 (https://www.cdc.gov/nchs/data/isp/055_historical_development_of_cause_of_death_stat.pdf. opens in new tab).

2. Haenszel W, Curnen MG. The first fifty years of the Connecticut Tumor Registry: reminiscences and prospects. Yale J Biol Med 1986;59:475-484.

3. National Research Council, Committee on National Statistics. The U.S. Vital Statistics System: a national perspective. Washington, DC: National Academies Press, 2009 (https://www.ncbi.nlm.nih.gov/books/NBK219884/. opens in new tab).

4. Black WC, Welch HG. Advances in diagnostic imaging and overestimations of disease prevalence and the benefits of therapy. N Engl J Med 1993;328:1237-1243.

5. Feinstein AR, Sosin DM, Wells CK. The Will Rogers phenomenon: stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med 1985;312:1604-1608.

6. Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst 2010;102:605-613.

7. Bailar JC III, Smith EM. Progress against cancer? N Engl J Med 1986;314:1226-1232.

8. Bailar JC III, Gornik HL. Cancer undefeated. N Engl J Med 1997;336:1569-1574.

9. Chu KC, Kramer BS, Smart CR. Analysis of the role of cancer prevention and control measures in reducing cancer mortality. J Natl Cancer Inst 1991;83:1636-1643.

10. Cho H, Mariotto AB, Schwartz LM, Luo J, Woloshin S. When do changes in cancer survival mean progress? The insight from population incidence and mortality. J Natl Cancer Inst Monogr 2014;49:187-197.

11. Kwan A, Chadwick N, Hancock B. Improving survival of patients with Hodgkin lymphoma over 4 decades: experience of the British National Lymphoma Investigation (BNLI) with 6834 patients. Clin Lymphoma Myeloma Leuk 2017;17:108-119.

12. Longo DL. Imatinib changed everything. N Engl J Med 2017;376:982-983.

13. Estimated new cancer cases and deaths for 2018. SEER Cancer Statistics Review 1975-2015 (https://seer.cancer.gov/csr/1975_2015/browse_csr.php?sectionSEL=1&pageSEL=sect_01_table.01. opens in new tab).

14. Wynder EL, Graham EA. Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma: a study of 684 proved cases. J Am Med Assoc 1950;143:329-336.

15. Doll R, Hill AB. Smoking and carcinoma of the lung: preliminary report. Br Med J 1950;2:739-748.

16. Doll R, Hill AB. Lung cancer and other causes of death in relation to smoking: a second report on the mortality of British doctors. Br Med J 1956;2:1071-1081.

17. Cigarettes peril health, U.S. report concludes: ‘remedial action’ urged: cancer link cited. New York Times. January 12, 1964:A1-A1.

18. Holford TR, Meza R, Warner KE, et al. Tobacco control and the reduction in smoking-related premature deaths in the United States, 1964-2012. JAMA 2014;311:164-171.

19. Richmond R. You’ve come a long way baby: women and the tobacco epidemic. Addiction 2003;98:553-557.

20. Dinan MA, Curtis LH, Carpenter WR, et al. Stage migration, selection bias, and survival associated with the adoption of positron emission tomography among Medicare beneficiaries with non-small-cell lung cancer, 1998-2003. J Clin Oncol 2012;30:2725-2730.

21. Geiger GA, Kim MB, Xanthopoulos EP, et al. Stage migration in planning PET/CT scans in patients due to receive radiotherapy for non-small-cell lung cancer. Clin Lung Cancer 2014;15:79-85.

22. Fuchs CS, Mayer RJ. Gastric carcinoma. N Engl J Med 1995;333:32-41.

23. Cannistra SA, Niloff JM. Cancer of the uterine cervix. N Engl J Med 1996;334:1030-1038.

24. Welch HG, Robertson DJ. Colorectal cancer on the decline — why screening can’t explain it all. N Engl J Med 2016;374:1605-1607.

25. Berry DA, Cronin KA, Plevritis SK, et al. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 2005;353:1784-1792.

26. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005;365:1687-1717.

27. Blanks RG, Moss SM, McGahan CE, Quinn MJ, Babb PJ. Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990-8: comparison of observed with predicted mortality. BMJ 2000;321:665-669.

28. Kalager M, Zelen M, Langmark F, Adami HO. Effect of screening mammography on breast-cancer mortality in Norway. N Engl J Med 2010;363:1203-1210.

29. Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med 2012;367:1998-2005.

30. Welch HG, Prorok PC, O’Malley AJ, Kramer BS. Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness. N Engl J Med 2016;375:1438-1447.

31. Negoita S, Feuer EJ, Mariotto A, et al. Annual report to the nation on the status of cancer. II. Recent changes in prostate cancer trends and disease characteristics. Cancer 2018;124:2801-2814.

32. Welch HG, Brawley OW. Scrutiny-dependent cancer and self-fulfilling risk factors. Ann Intern Med 2018;168:143-144.

33. Welch HG, Gorski DH, Albertsen PC. Trends in metastatic breast and prostate cancer — lessons in cancer dynamics. N Engl J Med 2015;373:1685-1687.

34. American Cancer Society, Cancer Statistics Center. Thyroid at a glance: incidence by sex. 2019 (https://cancerstatisticscenter.cancer.org/cancer-site/Thyroid/dw1qthUo. opens in new tab).

35. American Cancer Society, Cancer Statistics Center. Thyroid at a glance: mortality by sex. 2019 (https://cancerstatisticscenter.cancer.org/cancer-site/Thyroid/YDOaHk0C. opens in new tab).

36. Extramural Committee to Assess Measures of Progress Against Cancer. Measurement of progress against cancer. J Natl Cancer Inst 1990;82:825-835.

37. Kramer BS, Elmore JG. Projecting the benefits and harms of mammography using statistical models: proof or proofiness? J Natl Cancer Inst 2015;107(7):djv145-djv145.

服务条款 | 隐私政策 | 联系我们