台灣乳癌發生率及死亡率之年齡-年代-世代效應分析與國際比較

Abstract

研究背景：乳癌為世界上發生率最高的惡性腫瘤。台灣近一百年經歷日本殖民、二次大戰結束並於1960年代開始工業化。不同出生世代生活經驗很大不同，因此將以年齡-年代-世代方法分析台灣乳癌發生率以及死亡率，並以同樣方式進行國際間比較。 材料方法：使用台灣1997-2016乳癌原位癌、侵襲癌發生率以及乳癌死亡率資料。世界各國乳癌侵襲癌發生率以五大洲癌症登記1997-2011年資料。兩者皆以“年齡-年代-世代”模式分析。 研究結果:台灣乳癌發生率有很強的世代效應，但在年輕的出生世代，上升趨勢有緩減的現象；而台灣乳癌死亡率並無世代效應。國際比較方面，乳癌世代效應排名前三依序為韓國、台灣以及日本。印度和香港有世代效應，但不若韓國、台灣以及日本明顯。菲律賓乳癌發生率並無世代效應。洛杉磯的各類族群(包含亞裔族群)乳癌發生率皆無世代效應。 結論：越早開始接觸西方事物的國家，乳癌發生率的世代效應越不明顯。乳癌可能為一西化所造成的富裕疾病。

Background: Breast cancer is the most common female neoplasm in the world. Taiwan has experienced Japanese colonization, the end of the Second World War, and industrialization began in the 1960s. The life experiences of different birth cohorts are very different. The age-period-cohort analysis will be used to analyze the incidence and mortality of breast cancer in Taiwan, and the international comparisons will be made in the same way. Materials and Methods: Data on the incidence and mortality of breast cancer from 1997 to 2016 were used in Taiwan. The international companions of breast cancer incidence were from 1997 to 2011. Both were analyzed in an age-period-cohort analysis model. Results: The incidence of breast cancer in Taiwan has a strong cohort effect, but in the younger cohorts, the upward trend has been slowed down. There is no cohort effect on breast cancer mortality in Taiwan. Internationally, the top three breast cancer cohort effects are South Korea, Taiwan and Japan. India and Hong Kong have cohort effects, but not as pronounced as South Korea, Taiwan and Japan. There was no cohort effect in the Philippines. There was no cohort effect among all ethnicity groups, including Asians, in Los Angeles. Conclusion: Breast cancer may be a disease caused by westernization.