上海市长宁区1988～2013年胃癌发病率和死亡率趋势分析
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摘要
[目的]分析1988～2013年上海市长宁区居民胃癌发病与死亡情况及其变化趋势。[方法]利用上海市长宁区1988～2013年恶性肿瘤发病与死亡登记资料,以Segi’s世界标准人口计算胃癌年龄标化发病率和死亡率,采用Joinpoint趋势分析软件估计年均变化百分比。进一步拟合年龄—时期—队列模型(APC model),并评估三者效应对胃癌发病和死亡趋势的影响。[结果] 1988～2013年期间,上海市长宁区男女性胃癌标化发病率分别为29.80/10万和15.45/10万;男女性胃癌标化死亡率分别为22.80/10万和11.20/10万。男性胃癌发病和死亡率以平均每年3.6%和4.0%的幅度下降;女性以平均每年2.6%和4.1%的幅度下降。APC模型结果提示,年龄、时期和出生队列效应对女性胃癌发病风险的影响没有统计学意义;在男性中高年龄组和早期出生队列者其胃癌发病风险较低,但时期效应对发病风险的影响也没有统计学意义。此外,三者对男女性胃癌死亡风险的影响效应均较小。[结论]近25年上海市长宁区男女性胃癌标化发病率和死亡率呈下降趋势,但控制年龄和出生队列因素后,时期效应对胃癌发病和死亡风险无显著影响。
[Purpose] To analyze the long-term trends of gastric cancer incidence and mortality from 1988 to 2013 in Changning district of Shanghai.[Methods] Using the data on cancer incidence and mortality in Changning district of Shanghai,the age-standardized rates(ASRs) were calculated with the Segi's world standard population. The average annual percent change(AAPC) was used to evaluate the trends of cancer incidence and mortality by the Joinpoint program. Age-period-cohort model was further implemented to assess the contribution of age,period and cohort effects on the trends of incidence and mortality. [Results] During 1988～2013,the age-standardized incidence rates of male and female were 29.80/10~5 and 15.45/10~5. The age-standardized mortality rates were 22.80/10~5 and 11.20/10~5 in males and females. The AAPCs of incidence and mortality were -3.6% and -4.0% in males,while in women those were -2.6% and -4.1%. Age,period and birth cohort effects had no statistical impact on female gastric cancer incidence. Lower incidence risk was observed for the population of old age groups and early birth cohort in males,but no statistical impact of period effect. The results also indicated there was no age,period and birth cohort effects on gastric cancer mortality in both males and females. [Conclusion] The decreased trend of incidence and mortality of gastric cancer in the Changning district has been observed in past 25 years. After controlling for both age and cohort effects,it shows no period effect on incidence and mortality of gastric cancer.
[Purpose] To analyze the long-term trends of gastric cancer incidence and mortality from 1988 to 2013 in Changning district of Shanghai.[Methods] Using the data on cancer incidence and mortality in Changning district of Shanghai,the age-standardized rates(ASRs) were calculated with the Segi's world standard population. The average annual percent change(AAPC) was used to evaluate the trends of cancer incidence and mortality by the Joinpoint program. Age-period-cohort model was further implemented to assess the contribution of age,period and cohort effects on the trends of incidence and mortality. [Results] During 1988～2013,the age-standardized incidence rates of male and female were 29.80/10~5 and 15.45/10~5. The age-standardized mortality rates were 22.80/10~5 and 11.20/10~5 in males and females. The AAPCs of incidence and mortality were -3.6% and -4.0% in males,while in women those were -2.6% and -4.1%. Age,period and birth cohort effects had no statistical impact on female gastric cancer incidence. Lower incidence risk was observed for the population of old age groups and early birth cohort in males,but no statistical impact of period effect. The results also indicated there was no age,period and birth cohort effects on gastric cancer mortality in both males and females. [Conclusion] The decreased trend of incidence and mortality of gastric cancer in the Changning district has been observed in past 25 years. After controlling for both age and cohort effects,it shows no period effect on incidence and mortality of gastric cancer.
引文
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[16]Peng H,Huang F,Zhang YY,et al.A case-control study on risk factors of stomach cancer in Jiading district[J].Chinese Journal of Preventive Control of Chronic NonCommunicable Diseases,2012,20(6):668-671.[彭慧,黄芳,张一英等.上海市嘉定区胃癌危险因素的病例对照研究[J].中国慢性病预防与控制,2012,20(6):668-671.]
[17]Shi XO Shu,Li HL,Yang G,et al.Cohort profile:the Shanghai men’s health study[J].Int J Epidemiol,2015,44(3):810-818.
[18]Zheng W,Chow WH,Yang G,et al.The Shanghai women’s health study:rationale,study design,and baseline characteristics[J].Am J Epidemiol,2005,162(11):1123-1131.
[2]Gao YT,Lu W.Cancer incidence,mortality and survival rates in urban Shanghai(1973-2000)[M].Shanghai:The Second Military Medical University Press,2007.69-348.[高玉堂,卢伟.上海市区恶性肿瘤发病率、死亡率和生存率(1973-2000)[M].上海:第二军医大学出版社,2007.69-348.]
[3]Zheng Y,Wu CX,Jin F,et al.Cancer incidence trends from 1973 to 2005 in Shanghai[J].Journal of Diagnostics Concepts&Practice,2009,8(1):25-32.[郑莹,吴春晓,金凡,等.上海市区1973至2005年癌症的发病趋势[J].诊断学理论与实践,2009,8(1):25-32.]
[4]Li XP,Chen YC,Wang LH,et al.Trends analysis on the morbidity of gastric cancer among residents in Pudong New Area of Shanghai,2002-2014[J].Chinese Journal of Cancer Prevention and Treatment,2016,23(8):479-482.[李小攀,陈亦晨,王莉红,等.上海市浦东新区居民2002-2014年胃癌发病情况及其趋势分析[J].中华肿瘤防治杂志,2016,23(8):479-482.]
[5]Bao PP,Gao LF,Liu DK,et al.A case-control study on risk factors for stomach cancer in urban Shanghai[J].Tumor,2003,23(6):458-463.[鲍萍萍,高立峰,刘大可,等.上海市区胃癌危险因素探讨[J].肿瘤,2003,23(6):458-463.]
[6]National Cancer Center.Chinese guideline for cancer registration(2016)[M].Beijing:People’s Medical Publishing House,2016.33-75.[国家癌症中心.中国肿瘤登记工作指导手册(2016)[M].北京:人民卫生出版社,2016.33-75.]
[7]Kim HJ,Fay MP,Feuer EJ,et al.Permutation tests for joinpoint regression with applications to cancer rates[J]Statistics Med,2000,19(3):335-351.
[8]Rosenberg PS,Check DP,Anderson WF.A web tool for age-period-cohort analysis of cancer incidence and mortality rates[J].Cancer Epidemiol Biomarkers Prev,2014,23(11):2296-2302.
[9]Zhang F,Zhou J,Li WX,et al.The incidence and Cox survival analysis of gastric cancer in Minhang district of Shanghai from 2002 to 2012[J].China Cancer,2016,25(8):595-599.[张芬,周洁,李为希,等.上海市闵行区2002-2012年胃癌发病与Cox生存分析[J].中国肿瘤,2016,25(8):595-599.]
[10]Peng P,Wu CX,Gong YM,et al.Analysis of incidence characteristics of gastric cancer in Shanghai from 2003 to2012[J].Tumor,2018,38:697-703.[彭鹏,吴春晓,龚杨明,等.2003-2012年上海市胃癌发病特征分析[J].肿瘤,2018,38:679-703.]
[11]Hu WB,Zhang T,Qin W,et al.Trend of incidence and mortality of gastric cancer in Kunshan,Jiangsu Province,2006-2013[J].China Cancer,2015,24(7):559-593.[胡文斌,张婷,秦威,等.江苏省昆山市2006-2013年胃癌发病与死亡趋势分析[J].中国肿瘤,2015,24(7):559-593.]
[12]Sun XB,Hu ML,Jin PL.An analysis of mortality trend with stomach cancer in Henan,1984-2003[J].China Cancer,2006,15(5):291-293.[孙喜斌,胡美兰,金培良.河南省1984-2003年胃癌死亡率趋势分析[J].中国肿瘤,2006,15(5):291-293.]
[13]Zhou MG,Wang XF,Hu JP,et al.Geographical distribution of Cancer mortality in China,2004-2005[J].Chinese Journal of Preventive Medicine,2010,44(4):303-308.[周脉耕,王晓风,胡建平,等.2004-2005年中国主要恶性肿瘤死亡的地理分布特点[J].中华预防医学杂志,2010,44(4):303-308.]
[14]Yuri I,Akiko I,Tomio N,et al,Comparison of trends in cancer incidence and mortality in Osaka,Japan,using an age-period-cohort model[J].Asian Pac J Cancer Prev,2011,12(4):879-888.
[15]Liu DK,Tao MH,Gao LF,et al.The variation of diet structure of the Shanghai inhabitants ages from 30 to 74during the period of ten years from 1989 to 1999[J].Acta Academiae Medicinae Suzhou,2001,21(1):43-45.[刘大可,陶梦华,高立峰,等.上海市区30~74岁居民1989~1999年10年来的饮食结构变化[J].苏州医学院学报,2001,21(1):43-45.]
[16]Peng H,Huang F,Zhang YY,et al.A case-control study on risk factors of stomach cancer in Jiading district[J].Chinese Journal of Preventive Control of Chronic NonCommunicable Diseases,2012,20(6):668-671.[彭慧,黄芳,张一英等.上海市嘉定区胃癌危险因素的病例对照研究[J].中国慢性病预防与控制,2012,20(6):668-671.]
[17]Shi XO Shu,Li HL,Yang G,et al.Cohort profile:the Shanghai men’s health study[J].Int J Epidemiol,2015,44(3):810-818.
[18]Zheng W,Chow WH,Yang G,et al.The Shanghai women’s health study:rationale,study design,and baseline characteristics[J].Am J Epidemiol,2005,162(11):1123-1131.