上海市杨浦区2002-2012年户籍人口结直肠癌发病和生存分析  

Incidence and survival of colorectal carcinoma among permanent residents in Yangpu district ofShanghai, from 2002 to 2012

作　　者：韩雪[1] 黄辰曦 赵佳[1] 丁一波[2] 张宏伟[2] 曹广文[2] 

机构地区：[1]上海市杨浦区疾病预防控制中心,200090 [2]第二军医大学流行病学教研室

出　　处：《中华流行病学杂志》2014年第3期289-294,共6页Chinese Journal of Epidemiology

基　　金：上海市自然科学基金（12ZRl429300）;上海市卫生局科研项目（20114066）;国家杰出青年基金（81025015）;上海市公共卫生重点学科建设项目（12GWZX0102）

摘　　要：目的了解2002-2012年上海市杨浦区结直肠癌发病和生存情况。方法系统整理上海市肿瘤登记和管理系统中的杨浦区户籍人群结直肠癌患者资料，应用年均变化百分比（APC）模型分析发病趋势、KaplanMeier模型结合Logrank检验进行生存分析。采用2000年全国人口普查的标准人口年龄构成进行标化。结果20022012年上海市杨浦区结直肠癌总新发患者5881例，粗发病率为49．36／10万，标化发病率为31．21／10万。结肠癌和直肠癌的粗发病率分别为31．09／10万和18．27／10万；标化发病率为14．49／10万和8．83／10万。不同性别结肠癌发病率差异无统计学意义（P〉0．05），男性直肠癌发病率高于女性，差异有统计学意义（P〈0．001）。50岁以后结直肠癌发病率迅速增加。结直肠癌粗发病率逐年增长（APC=3．48），但标化发病率未见明显增长（APC=0．39）。因结直肠癌死亡3735例。年均粗死亡率为31．35／10万，标化死亡率为13．72／10万。60岁之后死亡率明显上升。男性直肠癌死亡率高于女性，差异：卣统计学意义（P〈0．01）。结肠癌和直肠癌5年生存率分别为48．88％和54．16％，其中手术治疗组5年生存率分别为58．10％和66．18％，高于非手术组37．22％和39．37％，差异有统计学意义（P〈0．001）。结论年龄是上海市杨浦区结直肠癌发病率和死亡率升高的主要因素，其死亡率显著低于发病率，手术治疗可能是影响患者生存期的一个重要因素。Objective To clarify the incidence and survival of colorectal carcinoma （CRC） patients among permanent residents in Yangpu d/strict of Shanghai, from 2002 to 2012. Methods Data of CRC patients in permanent residents of Yangpu district were collected from the database of the registration and management system in Shanghai city. Temporal trend in the incidence of CRC was analyzed by using Annual Percent Change （APC） model. Kaplan-Meier analysis with Log-rank testing was employed to estimate the survival. Incidence and mortality rates were standardized on age composition of standard population from 2000 nationwide census. Results A total of 5 881 CRC cases were diagnosed from 2002 to 2012 with crude incidence as 50.60/105 and standardized one as 31.21/105. The crude incidence rates of colon cancer and rectal cancer ＇were 31.09/105 and 18.27/105, respectively and the standardized rates were 14.49/105 and 8.83/10~, respectively. The incidence rates of colon cancer were not significantly different between different gender. However, the incidence of rectal cancer in males was significantly higher than in females （P〈0.001）. The incidence rates of CRC significantly increased in the age group older than 50 years. However, the standardized incidencerate did not change significantly （APC = 0.39）. A total of 3 735 cases died of CRC in this period. The annual crude mortality of CRC was 31.35/105 with the standardized rate as 13.72/105. The mortality kept increasing significantly in the population older than 60 years. Mortality of rectal cancer was significantly higher in males than in females （P〈0.001）. The 5-year survival rates in both colon cancer and rectal cancer patients were 48.88% and 54.16%, respectively. Survivals were significantly higher in those who had received surgical treatments than in those without surgical treatments （colon cancer： 58.10% vs. 37.22%, P〈0.001 ; rectal cancer： 66.18% vs. 39.37%, P〈0.001）. Conclusion Age seemed to have contributed to an increased morbidity an

关 键 词：结直肠癌 发病率 死亡率 社区 

分 类 号：R735.3[医药卫生—肿瘤]