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米国における甲状腺がんの発生率増加,1973年~2002年
Louise Davies1, H Gilbert Welch
1VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vt 05009, USA. louise.davies@dartmouth.edu
JAMA
|May 11, 2006
まとめ
甲状腺がんの発生率は2倍以上に増加しており,主に小型の甲状腺 papillary がんの検出が増加しているためです. 安定した死亡率は,この上昇はよりよいスクリーニングを反映していることを示唆し,病気の発生率の真の増加ではない.
科学分野:
- 腫瘍学 腫瘍学
- エピデミオロジー エピデミオロジー
- 病理学 パトロジー
背景:
- 癌の発生傾向は,診断基準と精査によって影響を受けます.
- 甲状腺結節の評価の変化は,明らかに甲状腺がんの発生率に影響を与える可能性があります.
研究 の 目的:
- 米国における甲状腺がんの発生率,組織学,サイズ,死亡率の動向を分析する.
- 甲状腺がんの診断の増加を観察した原因を調査する.
主な方法:
- 甲状腺がん患者 (1973年-2002年) の遡及コホート研究.
- 利用された監視,疫学,および最終結果 (SEER) プログラムデータ.
- 死亡率に関するインコーポレイテッド・ナショナル・ヴィタル・スタティスティックス・システムデータ.
主要な成果:
- 甲状腺がんの発生率は,1973年から2002年の間に2.4倍 (約10万人当たり3.6~8.7人) 増加した.
- 増加の原因はパピラリ甲状腺がんで,増加率は2.9倍でした.
- ほとんどの新規症例は小型の腫瘍 (≤2cm) であり,死亡率は安定したままでした.
結論:
- 甲状腺がんの発生率の上昇は,主に小さなパピラ癌の検出が増加しているためです.
- 癌の発生率の本当の上昇ではなく,サブクリニカル疾患の検出の増加が,この傾向を説明している可能性が高い.
- 安定した死亡率は,増加した疾患の有病率に対する検出の増加の解釈を支持する.
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