2009-2020年新西兰奥特亚罗瓦头颈癌发病率及两年死亡率：一项全国性人群队列研究
Head and neck cancer incidence and two-year mortality in Aotearoa New Zealand, 2009-2020: a national population-based cohort study.
文献信息
| PMID | 42914788 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Angad S Chauhan |
| 作者单位 | Wellington Hospital, Te Whatu Ora Capital, Coast and Hutt Valley, 49 Riddiford Street, Newtown, Wellington, 6021, New Zealand; University of Otago, Wellington, 23A Mein Street, Newtown, Wellington, 6242, New Zealand. Electronic address: chaan447@otago.ac.nz. |
| 期刊 | Cancer epidemiology |
| SCI 分区 | Q2 |
| IF | 3.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 头颈癌（HNC）在新西兰奥特亚罗瓦（AoNZ）造成沉重负担，但关于不同社会人口学群体发病率及早期死亡率的当代人群水平数据仍然有限。
方法： 这项基于人群的回顾性队列研究使用新西兰癌症登记处识别2009年至2020年所有原发性HNC诊断（n = 6980）。病例按ICD-10亚部位分类。按年龄、性别、族裔、社会经济剥夺程度和城乡属性估计发病率（IRs）、年龄标化发病率及年龄标化率比。使用回归模型估计发病率的年度百分比变化，并估计两年全因死亡率的校正风险比。
结果： 共有6980人被诊断为HNC；总发病率为每10万人年13.5例（PY）。口咽癌（OPC）是最常见亚部位，从2009-2011年的每10万人年3.4例上升至2018-2020年的每10万人年4.9例，而第二常见的口腔癌（OCC）发病率较为稳定。HNC发病率在男性、老年人、毛利人、太平洋岛民以及居住在社会经济最剥夺地区的人群中更高，并存在亚部位差异：毛利人OPC发病率更高，而太平洋岛民OCC发病率更高。诊断后两年内，25.2%的患者死亡。两年全因死亡率在下咽癌为44.4%，OCC为30.9%，OPC为22.7%。在HNC患者中，校正可用的社会人口学因素和治疗时机后，毛利人、太平洋岛民以及最剥夺五分位人群的两年全因死亡率更高。城乡属性与发病率或两年死亡率无一致关联。
结论： 这些发现表明AoNZ的HNC流行病学发生了由OPC驱动的转变，并且疾病发生和早期死亡方面持续存在不公平负担，支持加强监测和以公平为重点的癌症控制应对。
英文摘要
BACKGROUND: Head and neck cancer (HNC) imposes a substantial burden in Aotearoa New Zealand (AoNZ), yet contemporary population-level data on incidence and early mortality across sociodemographic groups remain limited.
METHODS: This population-based retrospective cohort study used New Zealand Cancer Registry to identify all primary HNC diagnoses from 2009 to 2020 (n = 6980). The cases were classified according to ICD-10 subsites. Incidence rates (IRs), age-standardised IRs, and age-standardised rate ratios were estimated by age, sex, ethnicity, socioeconomic deprivation, and rurality. Regression models were used to estimate annual percentage change in IRs and to estimate adjusted risk ratios for two-year all-cause mortality.
RESULTS: In total 6980 people were diagnosed with HNC; an overall incidence rate of 13.5 per 100,000 person-years (PY). Oropharyngeal cancer (OPC), the most common subsite, increased from 3.4 per 100,000 PY in 2009-2011-4.9 per 100,000 PY in 2018-2020, whereas IRs for oral cavity cancer (OCC), the second most common, were more stable. HNC IRs were higher among males, older adults, Māori, Pacific Peoples and people living in the most socioeconomically deprived areas, with subsite-specific differences: Māori experienced higher OPC incidence rates, while Pacific Peoples experienced higher OCC IRs. Within two years of diagnosis, 25.2% of patients had died. Two-year all-cause mortality was 44.4% for hypopharyngeal cancer, 30.9% for OCC, and 22.7% for OPC. Among people diagnosed with HNC, after adjusting for available sociodemographic factors and treatment timing, two-year all-cause mortality was higher for Māori, Pacific Peoples, and those in the most deprived quintile. Rurality showed no consistent association with incidence or two-year mortality.
CONCLUSIONS: These findings indicate an OPC-driven shift in HNC epidemiology in AoNZ and a persistent inequitable burden of both disease occurrence and early mortality, supporting stronger surveillance and equity-focused cancer-control responses.