各國的癌症冠軍：中美英日澳什麽癌症（與其他國家相比）發病率最高？

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Slide 25

Population-Based Studies

One way of identifying the various causes of cancer is by studying populations and behaviors. This approach compares cancer rates among various groups of people exposed to different factors or exhibiting different behaviors. A striking finding to emerge from population studies is that cancers arise with different frequencies in different areas of the world. For example, stomach cancer is especially frequent in Japan, colon cancer is prominent in the United States, and skin cancer is common in Australia. What is the reason for the high rates of specific kinds of cancer in certain countries?

Table 23-1Variation Between Countries in the Incidence of Some Common Cancers

SITE OF ORIGIN OF CANCER	HIGH-INCIDENCE POPULATION		LOW-INCIDENCE POPULATION
	LOCATION	INCIDENCE*	LOCATION	INCIDENCE*
Lung	USA (New Orleans, blacks)	110	India (Madras)	5.8
Breast	Hawaii (Hawaiians)	94	Israel (non-Jews)	14.0
Prostate	USA (Atlanta, blacks)	91	China (Tianjin)	1.3
Uterine cervix	Brazil (Recife)	83	Israel (non-Jews)	3.0
Stomach	Japan (Nagasaki)	82	Kuwait (Kuwaitis)	3.7
Liver	China (Shanghai)	34	Canada (Nova Scotia)	0.7
Colon	USA (Connecticut, whites)	34	India (Madras)	1.8
Melanoma	Australia (Queensland)	31	Japan (Osaka)	0.2
Nasopharynx	Hong Kong	30	UK (Southwestern)	0.3
Esophagus	France (Calvados)	30	Romania (urban Cluj)	1.1
Bladder	Switzerland (Basal)	28	India (Nagpur)	1.7
Uterus	USA (San Francisco Bay Area, whites)	26	India (Nagpur)	1.2
Ovary	New Zealand (Polynesian Islanders)	26	Kuwait (Kuwaitis)	3.3
Rectum	Israel (European and USA born)	23	Kuwait (Kuwaitis)	3.0
Larynx	Brazil (São Paulo)	18	Japan (rural Miyagi)	2.1
Pancreas	USA (Los Angeles, Koreans)	16	India (Poona)	1.5
Lip	Canada (Newfoundland)	15	Japan (Osaka)	0.1
Kidney	Canada (NWT and Yukon)	15	India (Poona)	0.7
Oral cavity	France (Bas-Rhin)	14	India (Poona)	0.4
Leukemia	Canada (Ontario)	12	India (Nagpur)	2.2
Testis	Switzerland (urban Vaud)	10	China (Tianjin)	0.6

*: Incidence = number of new cases per year per 100,000 population, adjusted for standardized population age distribution (so as to eliminate effects due merely to differences of population age distribution). Figures for cancers of breast, uterine cervix, uterus, and ovary are for women; other figures are for men. (Adapted from V.T. DeVita, S. Hellman, and S.A. Rosenberg (eds.), Cancer: Principles and Practice of Oncology, 4th edn. Philadelphia: Lippincott, 1993; based on data from C. Muir et al., Cancer Incidence in Five Continents, Vol. 5. Lyon: International Agency for Research on Cancer, 1987.)

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