本文由小咖机器人翻译整理

期刊来源：BMJ

原文链接：https://doi.org/10.1136/bmj-2023-076962

摘要内容如下：

客观

研究和解释英国癌症发病率和死亡率的趋势，包括所有癌症和35-69岁成年人中最常见的癌症部位。

设计

回顾性二级数据分析。

数据源

癌症登记数据、癌症死亡率和全国人口数据来自国家统计局、威尔士公共卫生署、苏格兰公共卫生署、北爱尔兰癌症登记处、英国国家医疗服务系统和北爱尔兰登记总局。

设置

在英国的分析中包括了23个癌症部位。

参与者

1993年至2018年期间，35-69岁的男性和女性被诊断患有癌症或死于癌症。

主要结果指标

癌症发病率和死亡率年龄标准化比率随时间的变化。

结果

这一年龄段的男性癌症病例增加了57%（从1993年登记的55014例增加到2018年的86297例），女性癌症病例增加了48%（从60187例增加到88970例），年龄标准化比率显示，男性和女性的年均增长率均为0.8%。发病率的增加主要是由前列腺癌（男性）和乳腺癌（女性）的增加引起的。在没有这两个位点的情况下，年龄标准化发病率的所有癌症趋势都相对稳定。少数不常见癌症的趋势显示发病率有所增加，例如黑色素瘤、皮肤癌、肝癌、口腔癌和肾癌。25年来，癌症死亡人数下降，男性下降20%（从32878人降至26322人），女性下降17%（从28516人降至23719人）；所有癌症的年龄标准化死亡率在男性中降低了37%（每年-2.0%），在女性中降低了33%（每年-1.6%）。死亡率下降幅度最大的是男性的胃癌、间皮瘤和膀胱癌，女性的胃癌、宫颈癌和非霍奇金淋巴瘤。即使变化幅度相对较小，大多数发病率和死亡率的变化也具有统计学意义。

结论

在过去25年中，35-69岁的男性和女性的癌症死亡率大幅下降。这种下降可能反映了在癌症预防（如预防吸烟政策和戒烟计划）、早期检测（如筛查计划）和改进的诊断测试以及更有效的治疗方面的成功。相比之下，非吸烟风险因素的增加可能是少数特定癌症发病率增加的原因。这一分析还为下一个十年提供了基准，其中将包括新冠肺炎对癌症发病率和结果的影响。

英文原文如下：

Abstracts

OBJECTIVE  To examine and interpret trends in UK cancer incidence and mortality for all cancers combined and for the most common cancer sites in adults aged 35-69 years.

DESIGN  Retrospective secondary data analysis.

DATA SOURCES  Cancer registration data, cancer mortality and national population data from the Office for National Statistics, Public Health Wales, Public Health Scotland, Northern Ireland Cancer Registry, NHS England, and the General Register Office for Northern Ireland.

SETTING  23 cancer sites were included in the analysis in the UK.

PARTICIPANTS  Men and women aged 35-69 years diagnosed with or who died from cancer between 1993 to 2018.

MAIN OUTCOME MEASURES  Change in cancer incidence and mortality age standardised rates over time.

RESULTS  The number of cancer cases in this age range rose by 57% for men (from 55 014 cases registered in 1993 to 86 297 in 2018) and by 48% for women (60 187 to 88 970) with age standardised rates showing average annual increases of 0.8% in both sexes. The increase in incidence was predominantly driven by increases in prostate (male) and breast (female) cancers. Without these two sites, all cancer trends in age standardised incidence rates were relatively stable. Trends for a small number of less common cancers showed concerning increases in incidence rates, for example, in melanoma skin, liver, oral, and kidney cancers. The number of cancer deaths decreased over the 25 year period, by 20% in men (from 32 878 to 26 322) and 17% in women (28 516 to 23 719); age standardised mortality rates reduced for all cancers combined by 37% in men (-2.0% per year) and 33% in women (-1.6% per year). The largest decreases in mortality were noted for stomach, mesothelioma, and bladder cancers in men and stomach and cervical cancers and non-Hodgkin lymphoma in women. Most incidence and mortality changes were statistically significant even when the size of change was relatively small.

CONCLUSIONS  Cancer mortality had a substantial reduction during the past 25 years in both men and women aged 35-69 years. This decline is likely a reflection of the successes in cancer prevention (eg, smoking prevention policies and cessation programmes), earlier detection (eg, screening programmes) and improved diagnostic tests, and more effective treatment. By contrast, increased prevalence of non-smoking risk factors are the likely cause of the observed increased incidence for a small number of specific cancers. This analysis also provides a benchmark for the following decade, which will include the impact of covid-19 on cancer incidence and outcomes.

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