生物与医学2024bmjoncology.bmj.com
1990至2019年50岁以下癌症发病率上升80%
Cancer under age 50 increased 80% from 1990 to 2019
进阶 · 约 40 分钟读完前置知识：基础统计、流行病学概念、年龄标准化率
导读
这篇 BMJ Oncology 的研究统计了 1990–2019 年全球 50 岁以下早发癌症的发病与死亡数据，报告病例数增加了约 79%。但 HN 讨论中的关键质疑是：这一数字未考虑同期全球人口增长，按人均发病率看许多西方国家实际在下降，媒体标题有夸大之嫌。
HN 关注点：'79%'这一惊人数字是否被媒体误读——讨论焦点集中在人口增长未校正、统计口径以及环境污染（微塑料、PFAS）是否可能是诱因。
HN 评论精选
这几条评论里：质疑 2 补充 2
质疑79% 的标题数字未校正人口增长，属于误导性的糟糕科学传播
垃圾研究，看看官方回应：Zhao 等人报告的是 1990 到 2019 年实际病例数增加 79%，但这个数字有误导性，因为没有考虑人口增长。作者其实也报告了各种癌症发病率的估计年度百分比变化（EAPC），可惜媒体大多只关注总数而非人均癌症风险，给人造成年轻人癌症流行的印象。2019 年早发癌症发病数为 326 万，比 1990 年增加 79.1%——发病数只是数癌症病例，世界人口增加了当然癌症更多，这种数字根本不该出现在研究标题里。这是糟糕的科学传播。
croemer查看英文原文
Garbage, read the responses, here's one: > Zhao et al report 79% increase in actual number of cases from 1990 to 2019, but this figure can be misleading, as it does not take account of population growth. The authors therefore also report estimated annual percent change (EAPC) of the incidence rates of various cancers. However, it is unfortunate that the press has largely focused on the overall number rather than the per capita risk of cancer, giving the impression that we are facing an epidemic of cancer in young individuals. https://bmjoncology.bmj.com/content/2/1/e000049.responses The headline figure of 79% does not account at all for population increase. This is bad science (communication). > In 2019, the incidence number of early-onset cancer was 3.26 million, a 79.1% increase from 1990 (figure 1A,B). Incidence number simply counts cancers. Of course there are more cancers given world population increase. This should never be in a study headline.
补充分国家看，上升集中在南美非洲，可能是医疗检测普及所致
图 3 按国家展示了发病率变化百分比，南美和非洲国家似乎有急剧上升，而西方国家发病率主要在下降。直觉上，我会把这些地区的增长归因于当地医疗可及性的提高——所以总体上反而是好事？
twothreeone查看英文原文
Figure 3 shows incident rate changes in percent by country, it seems there are stark increases in South American and African countries and mainly declining incident rates in western countries. Intuitively, I would associate increases in those regions with increased access to medical care there - so, overall a good thing?
补充主张预防原则：即使无法证实因果，也应尽量减少各类污染
我在这里读过一篇文章说，我们对环境的污染已经严重到雨水在任何地方落下都基本不安全了——雨水啊。我知道 PFAS 可能不致癌，但我们在污染方面已经推向相当疯狂的极端，云里都有微塑料了？我真希望这些事没有关联，因为如果有就太糟了——微塑料可没法收回去。我个人认为我们应该尽一切可能减少所有类型的污染，因为我们根本无法预测其影响，即使我们认为某种东西是良性的。我可能是个极端主义者，但我连轮胎粉尘都担心，还有那些人们任其在阳光下腐烂分解的蓝色塑料篷布。我们现在的做法并不好，只是因为太可怕，我们难以对自己承认。
bamboozled查看英文原文
I read an article on here that we’ve polluted the environment so badly now that rain water is unsafe to drink basically anywhere it falls. Rainwater…[1] I get it PFAs might not cause cancer but we’re pushing things to some pretty crazy extreme when it comes to pollution. Microplastics in the clouds ? I really hope these things aren’t related because it’s going to fucking suck if they are. Can’t just put microplastics away. I’m personally in the camp that thinks we should just be doing everything we can to minimise all types of pollution because we just cannot really predict what the effects will be. Even if we think something is benign. I might be an extremist but I’m even worried about tyre dust. And even those blue plastic tarps people love to let rot in the sun and dissolve everywhere. What we’re doing isn’t good, I just think we struggle to admit to ourselves because it’s quite horrific. [1] https://phys.org/news/2022-08-rainwater-unsafe-due-chemicals.html
质疑以气候目标数字类比，提醒对带议程色彩的研究数字保持怀疑
我读完了文章，分享一个小故事。我最近在大学上了全球变暖课程，讲师更像行业人士而非发论文的学者。课程里讲到全球平均气温已升高几度，当前目标是将进一步升温限制在 1.5°C、最坏 2°C。这些数字很好，但谁来决定这些数字？谁来牵头实现目标？这些数字带有很强的议程色彩，足以让天真的孩子上街抗议。癌症患者增加似乎很合理，但研究考虑人口增长了吗？还是只是统计报告人数？我想没有。我们都想让世界更好，但对这些数字要持保留态度。
mav3ri3k查看英文原文
I read through the article. Let me share a small story. I recently completed course for Global Warming in College. I would say my instructor was a quite good. He gave the vibe more of a person in industry who taught than a teacher who published papers. Naturally in course of Global Warming we had figures about how much the globe is warming. We have already raised average temperature by few degree. Current goal of global climate organization is to limit any further increase to 1.5 C and at max, at most dire 2 C. Changes to climate are already somewhat irreversible. So this figure of 1.5 is very sensitive and important. Now this is all good but who decides these numbers ? Who is going to take initiative to meet goals ? Who's fault it was to reach these numbers ? Moral: These are very loaded figures. Enough to make small naive children make protests and the world to notice. The numbers are very diluted based on agenda. Cancer patients might have increased, seems very plausible. But did the study account population increase or simply number of people reporting ? I don't think so. We all want to make world a better place but take these numbers with a grain of salt.
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