检查美国常见癌症的发病率和死亡率之间的关系:使用基于人口的SEER数据库进行观察性研究
Adewole S Adamson1, Vishal R Patel2, H Gilbert Welch2
1Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, Texas, USA adewole.adamson@austin.utexas.edu.
BMJ open
|February 7, 2025
概括
癌症发病率和死亡率在不同癌症类型的美国各县之间显示出不同的相关性. 一些癌症,如肺癌和胰腺癌,有很强的相关性,而其他癌症,如乳腺癌和前列腺癌,几乎没有关系.
科学领域:
- 流行病学 流行病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 发病率和死亡率是癌症负担的关键指标.
- 很少有研究探讨了癌症发病率和死亡率之间的地理相关性.
- 了解这种关系对于有效的癌症控制策略至关重要.
研究的目的:
- 评估美国各县常见癌症癌症发病率和死亡率之间的关系.
- 为了确定发生率和死亡率之间具有强烈,中等和弱相关性的癌症类型.
- 探索观察到的相关性的潜在原因,例如诊断实践.
主要方法:
- 基于人口的观察性研究,利用美国县级数据.
- 12种常见的非血液性癌症的发病率 (2000年至2016年) 和死亡率 (2002年至2018年) 的数据来自SEER数据库.
- 计算了县级的相关系数 (r),并根据相关性强度将癌症分成三位数. 还检查了10年死亡风险.
主要成果:
- 在肺癌,胃癌,肝癌和胰腺癌中观察到强烈的相关性 (r:0.96-0.78),诊断出癌症的死亡风险更高.
- 在结肠癌,膀癌,癌和子宫癌中发现了中等相关性 (r:0.75-0.58).
- 黑色素瘤,前列腺癌,乳腺癌和甲状腺癌的相关性较弱或不存在 (r:0.33至-0.10),与其他原因相比,诊断出癌症的死亡风险较低或相似.
结论:
- 癌症发病率和死亡率之间的关系在美国不同类型的癌症中存在显著差异.
- 对于某些癌症,发病率不再是县级死亡率的可靠预测指标.
- 诊断实践和过度诊断的差异可能解释了在某些癌症中观察到的低相关性.
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