Methods and Applications for Population-based Incidence and Mortality Statistics

基于人群的发病率和死亡率统计的方法和应用

• 批准号: 7734563
• 负责人: Gregg Dinse
• 金额: $ 12.04万
• 依托单位: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7734563
• 关键词: Accounting; Age; Area; Attention; Birth; Categories; Cohort Analysis; County; Data; Data Analyses; Databases; Demographic Factors; Diagnostic; Diffuse Lymphoma; Environmental Health; Epidemiology; Generations; Goals; HIV; HIV Infections; Incidence; International; Journals; Light; Malignant Neoplasms; Manuscripts; Medical Surveillance; Methods; Modeling; Mortality Decline; National Cancer Institute; Non-Hodgkin' s Lymphoma; Pattern; Pennsylvania; Population; Preparation; Race; Range; Rate; Relative (related person); Research; Research Personnel; Residual Cancers; Residual state; Risk; Risk Factors; Rosa; SEER Program; Screening procedure; Source; Statistical Methods; Techniques; Time; Tobacco; Tobacco use; United States; Universities; Woman; Work; age group; base; cancer care; cancer risk; cigarette smoking; cohort; concept; design; human data; men; mortality; national surveillance; neoplasm registry; sex; statistics; trend

In the past year, my research on this project was concentrated in three areas: (1) analyses of long-term linear trends in cancer incidence and mortality, (2) analyses of cancer incidence and mortality trends that allow for curvature, and (3) comparisons of statewide (Pennsylvania) and national (US) data on the incidence of non-Hodgkin's lymphoma. Research in these areas involved age-period-cohort and joinpoint analyses. This work is collaborative with researchers at the University of Pittsburgh. The three areas of research are described in more detail below. Area 1: We examined cancer incidence and mortality trends in the United States using population-based data from the SEER program. The incidence data were from 1975-2004 and the mortality data were from 1970-2004. We used APC models to investigate the effects of age group, time period, and birth cohort on the rates of cancer in three categories: cancers related to tobacco use, cancers detectable by screening, and all other cancers. By design, time trends observed in the residual category cannot be attributed to temporal changes in cigarette smoking or screening practices. Incidence and mortality rates were analyzed with respect to long-term trends, which can reflect changes in cancer risk factors. Studying trends in light of known risk factors may indicate unexplained cancer patterns. Specifically, we focused on linear trends in the log-transformed rates, summarized by average annual percentage changes and generational risks. The latter concept assesses relative cancer rates between one point in time and another 25 years (i.e., one "generation") earlier. Among whites over a 25-year span, cancer incidence in the residual category increased 34% in men and 23% in women, while mortality decreased 14% in men and 18% in women, with similar results among blacks. Changes in tobacco use and screening practices do not completely explain observed changes in cancer trends over the last three decades. Hopefully a focus on the cancers in the residual category will provide clues about the causes of these unexplained increases in cancer incidence. A manuscript was submitted to Environmental Health Sciences. Area 2: We extended our APC analysis to account for non-linear trends. Specifically, we assumed a constant curvature model for the log-transformed incidence and mortality rates, of which linearity is a special case. Again we focused on a residual cancer category, but in addition to tobacco-related and screen-detectable cancers, we also excluded cancers associated with HIV infection. Incidence rates increased in every race-sex group, and factors related to both time period and birth cohort membership appeared to accelerate these increases in women. Mortality rates decreased in black and white men and women, with the declines decelerating in white women but accelerating in the other race-sex groups. Increasing incidence of cancers not related to tobacco, screening, or HIV may signify increasing cancer risks, changing diagnostic practices, or better case ascertainment. Declining mortality may signify improvements in cancer care. A manuscript was submitted to Cancer. Area 3: We investigated the incidence of non-Hodgkin's lymphoma (NHL) in greater detail, studying the effects of both temporal and demographic factors. We used data from the SEER program and the Pennsylvania Cancer Registry (PCR), which is not part of the SEER program. Data from the PCR were available from 1985 to 2004, so we restricted our attention to the same 20 years for the SEER data. Results based on the national (SEER) and statewide (PCR) data were compared and contrasted. The incidence of NHL rose between 1985 and 2004 among black and white men and women, both nationally and in Pennsylvania. The magnitudes of the increases were similar, ranging from 1.5% to 3.2% across the four race-sex groups, except among white men, where the SEER increases were smaller than the PCR increases. Diffuse lymphoma appeared to be the most important component of this increase. In Pennsylvania, NHL incidence was higher in counties with a greater percentage of urban residents. A manuscript is in preparation and should be ready to submit to a scientific journal soon.

在过去的一年中，我对该项目的研究集中在三个领域：（1）分析癌症发病率和死亡率的长期线性趋势，（2）癌症发病率和死亡率趋势的分析，以及（3）比较全州范围（Pennsylvania）（Pennsylvania）和（US（US）对非怪异的Lymphoma的数据。 在这些领域的研究涉及年龄 - 周期和加入点分析。 这项工作与匹兹堡大学的研究人员合作。 下面更详细地描述了这三个研究领域。 区域1： 我们使用SEER计划中的基于人群的数据检查了美国的癌症发病率和死亡率趋势。 发病率数据来自1975年至2004年，死亡率数据是从1970 - 2004年开始的。 我们使用APC模型来研究年龄组，时间段和出生队列对三类癌症率的影响：与烟草使用有关的癌症，可通过筛查可检测到的癌症以及所有其他癌症。 根据设计，在残留类别中观察到的时间趋势不能归因于吸烟或筛查实践的时间变化。 相对于长期趋势分析了发病率和死亡率，这可能反映了癌症危险因素的变化。 根据已知危险因素研究趋势可能表明无法解释的癌症模式。 具体而言，我们重点介绍了对数转换率的线性趋势，总结了平均年度百分比变化和世代风险。 后一个概念评估了一个时间点和较早25年（即一个“一代”）之间的相对癌症率。 在25年的白人中，残留类别的癌症发病率增加了34％，女性的癌症发生率增加了34％，而男性的死亡率降低了14％，女性的死亡率下降了14％，黑人的癌症率降低了14％，而黑人的死亡率则相似。 在过去三十年中，烟草使用和筛查实践的变化并不能完全解释癌症趋势的变化。 希望关注残留类别中的癌症将提供有关这些无法解释的癌症发病率增加的原因的线索。 手稿已提交给环境健康科学。 区域2： 我们扩展了APC分析以说明非线性趋势。 具体而言，我们假设了对数转换的发病率和死亡率的恒定曲率模型，其中线性是一种特殊情况。 再次，我们专注于残留的癌症类别，但是除了与烟草有关的筛查和可检测的癌症外，我们还排除了与HIV感染相关的癌症。 每个种族性别群体的发病率都会提高，与时间段和出生队列成员有关的因素似乎加速了女性的这些增加。 黑人和白人男性和女性的死亡率下降，白人妇女的下降减速，但在其他种族性别群体中加速。 与烟草，筛查或艾滋病毒无关的癌症发生率的增加可能表明癌症风险增加，诊断习惯的改变或更好的病例确定。 死亡率下降可能意味着癌症护理的改善。 手稿已提交癌症。 区域3： 我们更详细地研究了非霍奇金淋巴瘤（NHL）的发生率，研究了时间和人口统计学因素的影响。 我们使用了SEER计划和宾夕法尼亚州癌症注册中心（PCR）的数据，这不是SEER计划的一部分。 从1985年到2004年，来自PCR的数据可获得，因此我们将注意力限制在SEER数据的20年中。 比较基于国家（SEER）和全州（PCR）数据的结果并进行了对比。 NHL的发病率在1985年至2004年之间在宾夕法尼亚州的黑人和白人男女中升起。 这些增加的幅度相似，在四个种族性别组中，除了白人，在白人中，先知的增加小于PCR的增加。 弥漫性淋巴瘤似乎是这种增加的最重要组成部分。 在宾夕法尼亚州，在城市居民中，NHL的发病率更高。 手稿正在准备，应该准备好尽快服从科学期刊。