Trends in cancer incidence in the Nordic countries. A collaborative study of the five Nordic Cancer Registries.

T Hakulinen, A Andersen, B Malker, E Pukkala, G Schou, H Tulinius
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Abstract

Time trends and differentials in cancer incidence in the five Nordic countries, Denmark, Finland, Iceland, Norway and Sweden, were investigated, using material collected by the cancer registries in each country. The incidence at all sites combined and at 23 anatomical sites was studied by age, birth cohort and time period. The maximum lengths of the trends were used for each country. In Denmark the material comprised all the tumours diagnosed in 1943-1980, in Finland and Norway those diagnosed in 1953-1980, in Iceland those diagnosed in 1955-1980, and in Sweden those diagnosed in 1958-1980. For males the age-adjusted cancer incidence rates at all sites combined were highest in Denmark and Finland, and lowest in Sweden and Norway. In females the incidence was highest in Denmark and Iceland, and lowest in Finland. The rates increased slightly for both sexes. For cancer of the pancreas, Hodgkin's disease, acute leukaemia and childhood cancer (all sites combined) the rates in all the Nordic countries were similar every year. For cancers of the stomach, colon, breast, corpus uteri, ovary, prostate, testis, urinary bladder, melanoma of the skin and non-Hodgkin's lymphomas the trends were similar but on different levels. For cancers of the larynx and lung in males the rates in Finland decreased during the 1970s, whereas the rates were increasing in the other Nordic countries. For cancer of the rectum, the trend showed a decrease in Denmark but an increase in the other Nordic countries. For lip cancer the rate in Sweden was almost constant over time, but in Denmark, Finland and Norway a decrease occurred. For oesophageal cancer in males the rates decreased in Finland and Iceland in the 1970s, whereas in Denmark and Norway there was very little change, and in Sweden there was an increase in the rates. For cancer of the cervix uteri the rates started to decrease in Denmark, Finland, Iceland and Sweden in the mid-1960s, but in Norway not until some ten years later. The differentials between the countries were largest for cancers of the testis and thyroid, in which the highest incidence was five to six times as large as the lowest. For testicular cancer the rate was the highest in Denmark, for thyroid cancer in Iceland. For both of these cancers the rate was the lowest in Finland. Melanoma of the skin was the cancer with the most rapid increase in incidence with time in all the Nordic countries.(ABSTRACT TRUNCATED AT 400 WORDS)

北欧国家癌症发病率趋势。北欧五个癌症登记处的合作研究。
利用每个国家癌症登记处收集的材料,对丹麦、芬兰、冰岛、挪威和瑞典这五个北欧国家癌症发病率的时间趋势和差异进行了调查。按年龄、出生队列和时间段对所有部位和23个解剖部位的发病率进行了研究。对每个国家使用趋势的最大长度。丹麦的资料包括1943年至1980年诊断的所有肿瘤,芬兰和挪威的资料包括1953年至1980年诊断的肿瘤,冰岛的资料包括1955年至1980年诊断的肿瘤,瑞典的资料包括1958年至1980年诊断的肿瘤。对于男性,所有地区的年龄调整后的癌症发病率在丹麦和芬兰最高,在瑞典和挪威最低。女性发病率最高的是丹麦和冰岛,最低的是芬兰。这一比例在两性中都略有上升。对于胰腺癌、何杰金氏病、急性白血病和儿童癌症(所有地点加起来),北欧国家的发病率每年都是相似的。胃癌、结肠癌、乳腺癌、子宫癌、卵巢癌、前列腺癌、睾丸癌、膀胱癌、皮肤黑色素瘤和非霍奇金淋巴瘤的趋势相似,但程度不同。就男性喉癌和肺癌而言,芬兰的发病率在20世纪70年代有所下降,而其他北欧国家的发病率却在上升。对于直肠癌,丹麦的趋势是下降的,而其他北欧国家的趋势是上升的。就唇癌而言,瑞典的发病率几乎一直保持不变,而丹麦、芬兰和挪威的发病率则有所下降。20世纪70年代,芬兰和冰岛的男性食道癌发病率有所下降,而丹麦和挪威几乎没有变化,瑞典的发病率有所上升。在丹麦、芬兰、冰岛和瑞典,宫颈癌的发病率在20世纪60年代中期开始下降,但在挪威,直到大约十年后才开始下降。两国之间的差异最大的是睾丸癌和甲状腺癌,这两种癌症的最高发病率是最低发病率的五到六倍。丹麦的睾丸癌发病率最高,冰岛的甲状腺癌发病率最高。这两种癌症的发病率在芬兰最低。在所有北欧国家中,皮肤黑色素瘤是发病率随时间增长最快的癌症。(摘要删节为400字)
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