據(jù)5月5日刊JAMA上的一則研究披露，在過去的30年中,，各個年齡組和族裔中的某種類型的胃癌發(fā)病率有所下降,，但25-39歲年齡組的白人例外。在本期雜志的另外一篇報告中,，基于從前研究的分析發(fā)現(xiàn),，那些在胃癌手術(shù)后接受化療的患者比那些僅接受外科治療的患者有著更高的存活率。
在全世界范圍內(nèi),，胃癌是排第四的最常見的癌癥,，它也是癌癥死亡率排第二的最常見癌癥。根據(jù)由National Cancer Institute, Rockville, Md.的William R. Anderson, M.D.及其同僚所做的一項研究中的背景資料,，與食道比鄰的胃上部的賁門腫瘤可能與胃食道返流有關(guān),，但大多數(shù)的非賁門癌與幽門螺旋桿菌的慢性粘膜感染有關(guān)。
研究人員分析了美國的基于年齡特異性的非賁門胃癌的數(shù)據(jù),，（使用的是來自National Cancer Institute's Surveillance, Epi-demiology, and End Results Program的數(shù)據(jù)）該數(shù)據(jù)所涵蓋的是約26%的美國人口,。從1977年到2006年，共有8萬3225例新發(fā)的成人原發(fā)性胃癌,，其中包括3萬9003例非賁門癌病例,。
文章的作者發(fā)現(xiàn)，每10萬人中的總體年齡標準化年發(fā)病率在研究期間從5.9下降至4.0（白人）,、從13.7下降至9.5（黑人）以及從17.8下降至11.7（其他族裔）,。 “在老年和年輕白人中的年齡特異性趨勢有著相當大的差別：每10萬人的發(fā)病率從19.8顯著下降至12.8（60-84歲）、從2.6下降至2.0（40-59歲）,，但該發(fā)病率在25-39歲年齡組則從0.27上升至0.45,。相反，在黑人和其他族裔中,，所有年齡組的發(fā)病率或是有所下降,，或是處于穩(wěn)定狀態(tài)。年齡-階段-組群分析證實,，在自1952年出生的較年輕的白人組群中,，該發(fā)病率有了顯著的增加。”（生物谷Bioon.com）
生物谷推薦原文出處：
JAMA. 2010;303(17):1723-1728.
Age-Specific Trends in Incidence of Noncardia Gastric Cancer in US Adults
William F. Anderson, MD; M. Constanza Camargo, MSc; Joseph F. Fraumeni Jr, MD; Pelayo Correa, MD; Philip S. Rosenberg, PhD; Charles S. Rabkin, MD
Context For the last 50 years, overall age-standardized incidence rates for noncardia gastric cancer have steadily declined in most populations. However, overall rates are summary measures that may obscure important age-specific trends.
Objective To examine effects of age at diagnosis on noncardia gastric cancer incidence trends in the United States.
Design, Setting, and Participants Descriptive study with age-period-cohort analysis of cancer registration data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, which covers approximately 26% of the US population. From 1977 through 2006, there were 83 225 adults with incident primary gastric cancer, including 39 003 noncardia cases.
Main Outcome Measures Overall and age-specific incidence rates, adjusted for period and cohort effects using age-period-cohort models. Results were stratified by race, sex, and socioeconomic status.
Results Overall age-standardized annual incidence per 100 000 population declined during the study period from 5.9 (95% confidence interval [CI], 5.7-6.1) to 4.0 (95% CI, 3.9-4.1) in whites, from 13.7 (95% CI, 12.5-14.9) to 9.5 (95% CI, 9.1-10.0) in blacks, and from 17.8 (95% CI, 16.1-19.4) to 11.7 (95% CI, 11.2-12.1) in other races. Age-specific trends among whites varied significantly between older and younger age groups (P < .001 for interaction by age): incidence per 100 000 declined significantly from 19.8 (95% CI, 19.0-20.6) to 12.8 (95% CI, 12.5-13.1) for ages 60 to 84 years and from 2.6 (95% CI, 2.4-2.8) to 2.0 (95% CI, 1.9-2.1) for ages 40 to 59 years but increased significantly from 0.27 (95% CI, 0.19-0.35) to 0.45 (95% CI, 0.39-0.50) for ages 25 to 39 years. Conversely, rates for all age groups declined or were stable among blacks and other races. Age-period-cohort analysis confirmed a significant increase in whites among younger cohorts born since 1952 (P < .001).
Conclusions From 1977 through 2006, the incidence rate for noncardia gastric cancer declined among all race and age groups except for whites aged 25 to 39 years, for whom it increased. Additional surveillance and analytical studies are warranted to identify risk factors that may explain this unfavorable trend.
