2011—2015年上海市结直肠癌发病及死亡特征分析
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摘要
【目的】分析2011—2015年上海市结直肠癌的主要发病特征,为制定预防与控制措施和筛查效果评估提供依据。【方法】收集上海市恶性肿瘤病例报告登记系统中2011—2015年结直肠癌病例的资料,统计分析发病概况、性别和年龄分布以及诊断部位、诊断时期别等诊断特征。【结果】2011—2015年,上海全市年均新诊断结直肠癌病例8 508例,占所有部位恶性肿瘤病例的12.85%,发病率为59.54/10万,标化发病率为24.68/10万;年均结直肠癌死亡例数为4 612例,占所有部位恶性肿瘤死亡病例的12.18%,死亡率为32.28/10万,标化死亡率为11.22/10万。新发病例中结肠癌占60.45%,直肠癌占39.55%,病理诊断比例为85.95%,早期比例为8.11%(包括期别不详的病例)。【结论】上海地区结直肠癌发病率和死亡率高于全国水平,结肠癌比例较高,早期诊断比例较低。结直肠癌的性别、年龄和部位差异以及筛查对发病和诊断时期别的影响值得进一步关注。
[Objective] To describe the patterns of incidence and mortality of colorectal cancer in Shanghai during 2011-2015,and to provide reference for prevention and control strategies on colorectal cancer and comprehensive evaluation of screening program. [Methods] The data on colorectal cancer cases were collected from the Shanghai Cancer Registry.The distributions of incidences and mortality during 2011-2015 were described.The patterns were analyzed according to gender,age,basis of diagnosis,histological type,diagnostic stage in detail. [Results] A total of 8 508 new cases of colorectal cancer were diagnosed on average per year during 2011-2015,accounting for 12.85% of all cancers; the incidence was 59.54/10~5,and the ASR 24.68/10~5.The average annual deaths due to colorectal cancer were 4 612,accounting for 12.18% of all cancers.The mortality was 32.28/10~5,and the ASR 11.22/10~5.The proportion of colon cancer in new cases was higher than that of rectal cancer.The histologically verified rate was 85.95%,the percentage of early stage being 8.11% in newly diagnosed cases(unknown stage cases were included). [Conclusion] The incidence and mortality of colorectal cancer in Shanghai are higher than the level in China.The proportion of colon cancer is higher than that of rectum cancer.Gender,age and location differences,changes of incidence and staging influenced by screening program deserve more attention.
[Objective] To describe the patterns of incidence and mortality of colorectal cancer in Shanghai during 2011-2015,and to provide reference for prevention and control strategies on colorectal cancer and comprehensive evaluation of screening program. [Methods] The data on colorectal cancer cases were collected from the Shanghai Cancer Registry.The distributions of incidences and mortality during 2011-2015 were described.The patterns were analyzed according to gender,age,basis of diagnosis,histological type,diagnostic stage in detail. [Results] A total of 8 508 new cases of colorectal cancer were diagnosed on average per year during 2011-2015,accounting for 12.85% of all cancers; the incidence was 59.54/10~5,and the ASR 24.68/10~5.The average annual deaths due to colorectal cancer were 4 612,accounting for 12.18% of all cancers.The mortality was 32.28/10~5,and the ASR 11.22/10~5.The proportion of colon cancer in new cases was higher than that of rectal cancer.The histologically verified rate was 85.95%,the percentage of early stage being 8.11% in newly diagnosed cases(unknown stage cases were included). [Conclusion] The incidence and mortality of colorectal cancer in Shanghai are higher than the level in China.The proportion of colon cancer is higher than that of rectum cancer.Gender,age and location differences,changes of incidence and staging influenced by screening program deserve more attention.
引文
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[20]顾凯,吴春晓,龚杨明,等.上海市区1973年至2007年结肠直肠癌的发病趋势[J].诊断学理论与实践,2014,13(4):377-382.
[21]李曙光,顾晋,王宽婷.中国人大肠癌发病部位的变迁[J].医学研究通讯,2004,33(7):45-47.
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[23]徐继英,姚海宏,严青华,等.上海市15岁以上人群超重率和肥胖率的现状及发展趋势[J].中国慢性病预防与控制,2014,22(2):170-173.
[24]HOWLADER N,NOONE A M,KRAPCHO M,et al.SEER cancer statistics review,1975—2012[EB/OL].(2015-11-18) [2018-03-28].https://seer.cancer.gov/archive/csr/1975_2012/.
[25]武子涛,李世荣,范如英,等.粪便脱落细胞学与粪隐血试验联合检测在大肠癌筛查中的作用[J].中国误诊学杂志,2007,7(18):4225-4226.
[26]CDC.Screening for colorectal cancer—United States,1997[J].MMWR Morb Mortal Wkly Rep,1999,48(6):116-121.
[27]郑莹,龚杨明,周晓伟,等.从社区实践到公共卫生政策——“上海社区居民大肠癌筛查”项目的规划和实施[J].上海预防医学,2017,29(2):89-94,113.
[28]龚杨明,顾凯,彭鹏,等.社区居民大肠癌筛查工作规范解读[J].上海预防医学,2017,29(2):99-101.
[29]GONG Y M,PENG P,BAO P P,et al.The implementation and first-round results of a community-based colorectal cancer screening program in Shanghai,China[J].Oncologist,2018,23(8):928-935.
[2]陈琼,刘志才,程兰平,等.2003—2007年中国结直肠癌发病与死亡分析[J].中国肿瘤,2012,21(3):179-182.
[3]BRENNER H,KLOOR M,POX C P.Colorectal cancer[J].Lancet,2014,383(9927):1490-1502.
[4]吴凡,卢伟,李德録,等.上海市恶性肿瘤登记报告工作的调整与完善[J].中国肿瘤,2002,11(6):316-318.
[5]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.
[6]卢伟,郑莹.肿瘤命名与编码[M].上海:第二军医大学出版社,2011.
[7]BOSMAN F T,CARNEIRO F,HRUBAN R H,et al.WHO classification of Tumours of the digestive system[M].4th ed.Lyon:IARC Press,2010.
[8]JENSEN O M,PARKIN D M,MACLENNAN R,et al.Cancer registration:principles and methods[M].Lyon:IARC Scientific Publications,1991.
[9]SEGI M.Cancer mortality for selected sites in 24 countries (1950—1957)[M].Sendai,Japan:Tohoku University School of Medicine,1960.
[10]TORRE L A,BRAY F,REBECCA L,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.
[11]杜灵彬,李辉章,王悠清,等.2013年中国结直肠癌发病与死亡分析[J].中华肿瘤杂志,2017,39(9):701-706.
[12]代珍,郑荣寿,邹小农,等.中国结直肠癌发病趋势分析和预测[J].中华预防医学杂志,2012,46(7):598-603.
[13]SIEGEL R,DESANTIS C,JEMAL A.Colorectal cancer statistics,2014[J].CA Cancer J Clin,2014,64(2):104-117.
[14]MATANOSKI G,TAO X G,ALMON L,et al.Demographics and tumor characteristics of colorectal cancers in the United States,1998—2001[J].Cancer,2006,107(S5):1112-1120.
[15]GAO R N,NEUTEL C I,WAI E.Gender differences in colorectal cancer incidence,mortality,hospitalizations and surgical procedures in Canada[J].J Public Health,2008,30(2):194-201.
[16]KATANODA K,MATSUDA T,MATSUDA A,et al.An updated report of the trends in cancer incidence and mortality in Japan[J].Jpn J Clin Oncol,2013,43(5):492-507.
[17]SHIN A,KIM K Z,JUNG K W,et al.Increasing trend of colorectal cancer incidence in Korea,1999—2009[J].Cancer Res Treat,2012,44(4):219-226.
[18]MARLEY A R,NAN H M.Epidemiology of colorectal cancer[J].Int J Mol Epidemiol Genet,2016,7(3):105-114.
[19]JOHNSON C M,WEI C M,ENSOR J E,et al.Meta-analyses of colorectal cancer risk factors[J].Cancer Causes Control,2013,24(6):1207-1222.
[20]顾凯,吴春晓,龚杨明,等.上海市区1973年至2007年结肠直肠癌的发病趋势[J].诊断学理论与实践,2014,13(4):377-382.
[21]李曙光,顾晋,王宽婷.中国人大肠癌发病部位的变迁[J].医学研究通讯,2004,33(7):45-47.
[22]李明,顾晋.中国结直肠癌20年来发病模式的变化趋势[J].中华胃肠外科杂志,2004,7(3):214-217.
[23]徐继英,姚海宏,严青华,等.上海市15岁以上人群超重率和肥胖率的现状及发展趋势[J].中国慢性病预防与控制,2014,22(2):170-173.
[24]HOWLADER N,NOONE A M,KRAPCHO M,et al.SEER cancer statistics review,1975—2012[EB/OL].(2015-11-18) [2018-03-28].https://seer.cancer.gov/archive/csr/1975_2012/.
[25]武子涛,李世荣,范如英,等.粪便脱落细胞学与粪隐血试验联合检测在大肠癌筛查中的作用[J].中国误诊学杂志,2007,7(18):4225-4226.
[26]CDC.Screening for colorectal cancer—United States,1997[J].MMWR Morb Mortal Wkly Rep,1999,48(6):116-121.
[27]郑莹,龚杨明,周晓伟,等.从社区实践到公共卫生政策——“上海社区居民大肠癌筛查”项目的规划和实施[J].上海预防医学,2017,29(2):89-94,113.
[28]龚杨明,顾凯,彭鹏,等.社区居民大肠癌筛查工作规范解读[J].上海预防医学,2017,29(2):99-101.
[29]GONG Y M,PENG P,BAO P P,et al.The implementation and first-round results of a community-based colorectal cancer screening program in Shanghai,China[J].Oncologist,2018,23(8):928-935.