Home Medizin Neue Analyse gibt Aufschluss über die Krebsinzidenz- und Mortalitätstrends im Vereinigten Königreich

Neue Analyse gibt Aufschluss über die Krebsinzidenz- und Mortalitätstrends im Vereinigten Königreich

von NFI Redaktion

A recent study published in the BMJ examined trends in cancer incidence and mortality in the United Kingdom (UK) among individuals aged 35 to 69 years.

Study: 25-Year Trends in Cancer Incidence and Mortality in Adults Aged 35-69 in the United Kingdom, 1993–2018: Retrospective Secondary Analysis. Image Source: Image Point Fr/Shutterstock.com
Study: 25-Year Trends in Cancer Incidence and Mortality in Adults Aged 35-69 in the United Kingdom, 1993–2018: Retrospective Secondary Analysis. Image Source: Image Point Fr/Shutterstock.com

Background

Over the past 25 years, the UK has seen significant improvements in cancer risk factors, including a decrease in smoking prevalence due to tax hikes, advertising restrictions, and smoke-free laws. Poor diet and lack of exercise have led to an increase in the number of overweight or obese individuals.

Between 1993 and 2018, three screening programs for cervical, breast, and colon cancer were introduced, providing the opportunity to detect early-stage cases. However, there is limited current research on cancer incidence and mortality in the age group of 35 to 69 years.

About the Study

In this study, researchers examined changes in cancer incidence and deaths in the United Kingdom between 1993 and 2018 among individuals aged 35 to 69 years.

The researchers analyzed cancer registrations, deaths, and nationwide population data from Public Health Wales, the Office for National Statistics (ONS), the Northern Ireland Cancer Registry, Public Health Scotland, the General Register Office for Northern Ireland, and the National Health Service ( NHS) England.

They studied 23 cancer sites in the UK to determine cancer incidence and deaths in individuals aged 35 to 69 years who were diagnosed with cancer or died of cancer between 1993 and 2018.

The team used the International Classification of Diseases, Tenth Revision (ICD-10) codes to diagnose cancer. The primary outcomes were age-specific changes in cancer incidence and deaths over time.

Gender-specific cancer groups excluding breast and prostate cancer were analyzed to examine general trends when the most common cancer site for each gender was missing.

Mesothelioma was a new, specific code released in ICD-10, and credible mortality statistics for this site were not available before 2001. Therefore, the researchers did not consider this type of malignancy.

Non-melanocytic skin cancer codes of the brain and spinal cord, despite their benign nature, were included because their presence in the skull cavity can lead to death.

Due to incomplete documentation of these tumors, the researchers excluded non-melanocytic skin cancer from the incidence statistics, making the data unreliable. To account for annual volatility at sites with low case counts, the researchers estimated age-standardized three-year average rates per 100,000 population. They used generalized linear modeling for analysis.

Results

Cancer incidence in individuals aged 35 to 69 years increased by 57% in men (86,297 from 55,014) and 48% in women (88,970 from 60,187), with an average annual growth of 0.80% for both genders.

Between 2003 and 2013, prostate and breast cancer diagnoses increased in both genders, with the age-standardized incidence rate decreasing in men before 2000 and increasing in women. Rarer malignant diseases such as melanoma, skin, liver, oral, and kidney cancers also showed alarming increases.

For men aged 35 to 69 years, the highest annual percentage increases were observed in liver tissue malignancies (4.70%), prostate (4.20%), and skin melanomas (4.20%). The highest annual declines were in stomach (4.20%), bladder (4.10%), and lung cancer (2.10%).

For women, the highest annual percentage increases were in liver (3.90%), skin melanomas (3.50%), and oral cancer (3.30%), while the highest annual declines were in bladder (3.60%) and stomach cancer (3.10%).

Over the past 25 years, cancer deaths decreased by 20% in men (26,322 from 32,878) and 17% in women (23,719 from 28,516). Age-standardized mortality rates for all malignant diseases decreased by 37% in men (2.0% per year) and 33% in women (1.6% per year).

The study found that male mortality rates significantly declined after prostate cancer was excluded from the mortality trends, while female mortality decreased by 1.3% each year. The steepest decline in mortality was observed before 2000, with a 14% decrease in men and an 11% decrease in women.

The most significant declines were observed in bladder, mesothelioma, and stomach tumors in men, as well as in stomach, cervical, and Non-Hodgkin lymphomas in women.

For men, the cancers with an average annual decrease in mortality rate of ≥ 1.0% were stomach (5.10%), mesothelioma (4.20%), bladder (3.20%), lung (3.10%), Non-Hodgkin lymphoma (2.90%), testicular (2.80%), Hodgkin lymphoma (2.60%), larynx (2.50%), colon (2.50%), prostate (1.80%), myeloma (1.70%), and leukemia (1.60%).

For women, the cancers with an average annual decrease in mortality rate of ≥ 1.0% were stomach (4.20%), cervical (3.60%), Non-Hodgkin lymphomas (3.20%), ovarian (2.80%), breast (2.80%), myeloma (2.30%), colon (2.20%), mesothelioma (2.0%), larynx (2.0%), leukemia (2.0%), bladder (1.60%), esophagus (1.20%), and kidney (1.00%).

Both genders experienced an average annual increase in mortality of ≥ 1.0% for liver (2.70%) and oral (1.20%) cancers.

Conclusion

The study results revealed a significant decrease in cancer mortality among men and women aged 35 to 69 years over the past 25 years, primarily attributed to cancer prevention, early detection, improved diagnostic tests, and successful treatment.

However, an increase in non-smoking risk factors can lead to an uptick in certain malignant diseases. The research provides a foundation for the years ahead and assesses the impact of Coronavirus Disease 2019 (COVID-19) on cancer incidence and outcomes.

There are growing concerns regarding specific cancer sites, with the predominant worry being the need to accelerate the decline in female lung cancer.

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