结直肠癌的相互作用趋势：筛查和出生队列的综合作用
Interacting trends of colorectal cancer incidence: the combined effects of screening and birth cohort
影响因子:5.90000
分区:医学2区 Top / 公共卫生1区
发表日期:2024 Aug 14
作者:
Chih-Lin Kuo, Jing-Rong Jhuang, Shih-Yung Su, Chun-Ju Chiang, Ya-Wen Yang, Li-Ju Lin, Pei-Chun Hsieh, Tsui-Hsia Hsu, Wen-Chung Lee
摘要
大肠癌仍然是全球主要的公共卫生挑战。它的发病率是由筛查计划，年龄，周期和队列因素的复杂相互作用的塑造。我们引入了一种新颖的年龄 - 周期性筛查模型（APC）模型，以分析台湾从2000年到2019年台湾发病率的趋势。 （95％CI：9.2％，22.4％）的女性。随后，每年下降3.4％（95％CI：2.8％，4.1％）和3.1％（95％CI：2.4％，3.9％）。到2015年，男性和2014年女性，年龄标准化的发病率降至未预言的情况下预计的水平。到2019年，男性的发病率进一步下降了12.4％（95％CI：11.8％，13.1％），女性为11.6％（95％CI：10.7％，12.6％），与无筛查情况相比。队列效应显示从1920年到1980年持续上升：男性发病率增加了5.8倍，女性的发病率增加了3.1倍。 1980年之后，这种趋势开始稳定，妇女的下降显着下降。台湾通过其筛查计划，截至2019年，台湾已成功地将结直肠癌的发病率降低了10％。此外，由于队列效应引起的发病率已经平稳，甚至开始下降。但是，持续的监测仍然至关重要。高级APCS模型可以作为其他研究人员和决策者评估癌症筛查计划对发病率趋势的影响的强大分析工具。
Abstract
Colorectal cancer remains a major global public health challenge. Its incidence is shaped by a complex interplay of screening programmes and age, period and cohort factors.We introduce a novel Age-Period-Cohort-Screening (APCS) model to analyse trends in colorectal cancer incidence in Taiwan from 2000 to 2019.In 2010, the incidence of colorectal cancer in Taiwan increased by 19.2% (95% CI: 13.5%, 25.3%) for men and 15.6% (95% CI: 9.2%, 22.4%) for women. This was followed by annual declines of 3.4% (95% CI: 2.8%, 4.1%) and 3.1% (95% CI: 2.4%, 3.9%), respectively. By 2015 for men and 2014 for women, the age-standardized incidence had fallen below the levels projected in a no-screening scenario. By 2019, the incidence had further declined by 12.4% (95% CI: 11.8%, 13.1%) for men and 11.6% (95% CI: 10.7%, 12.6%) for women, compared with the no-screening scenario. Cohort effects have shown a persistent rise from 1920 to 1980: incidence increased 5.8-fold for men and 3.1-fold for women. The trend began to plateau after 1980, with a noticeable decline in women.Through its screening programme, Taiwan has successfully reduced colorectal cancer incidence by 10% as of 2019. Furthermore, the incidence due to cohort effects has plateaued and even begun to decline. However, continued monitoring remains crucial. The advanced APCS model could serve as a robust analytical tool for other researchers and policy makers evaluating the impacts of cancer screening programmes on incidence trends.