台灣女性乳癌發生率世代效應的城鄉差異

Abstract

乳癌是全世界女性最容易罹患的癌症。乳癌發生率的世代效應在西方國家並不明顯，但是包含臺灣在內的部分亞洲國家世代效應卻非常的強。一個國家/區域內部也可能存在世代效應的差異。本研究使用臺灣癌症登記中心1997至2016年的女性乳癌資料，並利用年齡-年代-世代模型來比較臺灣城鄉之間乳癌發生率的世代效應。我們發現臺灣女性乳癌發生率的世代效應在城鄉之間有明顯的差異。都市地區的乳癌發生率在所有的世代都高於鄉鎮地區的乳癌發生率。但是鄉鎮地區的乳癌發生率上升速度比都市地區快。出生於1992年的女性相較於出生於1917年的女性，罹患乳癌的風險在都市地區和鄉鎮地區分別約為22倍和11倍。城鄉之間乳癌發生率的差異正隨著世代增加而縮小。都市化和西方化可能為這些趨勢背後的原因。

Female breast cancer has been the most prevalently diagnosed cancer among women in the world. Birth cohort effects on breast cancer incidence rates in western countries are minimal, but a noticeable cohort effect is observed in some Asian countries including Taiwan. There may be also internal differences in breast cancer risk within a country. We abstracted the female invasive breast cancer data from Taiwan Cancer Registry from 1997 to 2016. The age-period-cohort model was used to compare cohort effects on breast cancer incidence in urban and rural regions in Taiwan. There is a notable urban-rural disparity in cohort effects on breast cancer incidence rates in women in Taiwan. The rates in the urban region are higher than in the rural region for all cohorts. But the rates rise faster in the rural region than in the urban region. The risks of breast cancer for women born in 1992 were roughly 22 times and 11 times the risks for women born in 1917 in rural and urban regions, respectively. The gap in breast cancer rates of these two regions gradually disappears over the cohorts. Urbanization and westernization in Taiwan may be the driver behind these trends.