澳大利亚北部地区头颈部、唾液腺和上消化道癌症的十年(2009-2019 年)流行病学研究及总体生存结果

Nayellin Reyes-Chicuellar, Kate Thimbleby, Bhavya Balasubramanya, Hemi Patel, Suresh Mahendran
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摘要

头颈部、唾液腺和消化道癌症(HNAC)在澳大利亚癌症发病率中排名第六,给公共卫生和经济带来了巨大挑战。本研究旨在分析北领地 HNACs 的流行病学、风险因素和生存结果,重点关注土著和非土著澳大利亚人。在612例潜在病例中,有524例接受了分析,其中35.5%为原住民或托雷斯海峡岛民。HNAC主要影响男性(中位年龄:62岁),其年龄标准化发病率为每10万人21.9例,且趋势稳定。5年存活率为39.6%,澳大利亚土著居民(25%)和偏远地区(18%)的存活率明显低于全国平均水平(68%)。口咽恶性肿瘤很常见(存活率为 36%)。酗酒(73%)和吸烟(91%)等高风险行为普遍存在。大多数患者(73%)为晚期疾病(III-IV期),三分之一的患者在确诊时已接受姑息治疗。P16阴性肿瘤占多数,非土著患者中P16阳性病例有所增加。需要采取有针对性的干预措施来改善服务规划和提供,同时考虑到已确定的风险因素和文化敏感性,并促进土著居民的参与。
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Ten-year (2009–2019) epidemiological study of head and neck, salivary glands and upper aerodigestive tract cancers, and overall survival outcomes in the Northern Territory of Australia
Head and neck, salivary glands and aerodigestive tract cancers (HNACs) rank sixth in cancer incidence in Australia, posing significant public health and economic challenges. However, data on HNACs in the Northern Territory (NT) are lacking, crucial for healthcare planning.This study aims to analyse HNACs epidemiology, risk factors and survival outcomes in the NT, focusing on Indigenous and non-Indigenous Australians.We conducted a retrospective analysis (2009–2019) of HNACs cases from the NT Cancer Registry. Ethically approved, the study assessed incidence, mortality, risk factors and survival across ethnic populations.Of 612 potential cases, 524 were analysed, with 35.5% identifying as Aboriginal or Torres Strait Islanders. Predominantly affecting males (median age: 62 years), HNACs showed an age-standardised incidence of 21.9 per 100 000, with stable trends. The 5-year survival rate was 39.6%, notably lower in Indigenous Australians (25%) and remote areas (18%) vs the national average (68%). Oropharyngeal malignancies were common (36% survival). High-risk behaviours such as alcohol use (73%) and smoking (91%) prevailed. Most patients (73%) presented with advanced disease (stages III–IV), with one-third offered palliative care at diagnosis. P16-negative tumours predominated, with increasing P16-positive cases in non-Indigenous patients.HNACs survival rates in the NT are significantly lower than the national average, especially among Indigenous Australians and remote residents. Targeted interventions are needed to improve service planning and delivery, considering identified risk factors and cultural sensitivities, and promoting Indigenous participation.
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