我国太行山高发区食管癌流行趋势及防治策略  

The Trends and Preventive Strategies of Esophageal Cancer in High- risk Areas of Taihang Mountains, China

作　　者：乔友林[1] 侯俊[1] 杨玲[1] 贺宇彤[1] 刘韵源[1] 李连弟[1] 李绍森[1] 连士勇[1] 董志伟[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所流行病学研究室,北京100021

出　　处：《中国医学科学院学报》2001年第1期10-14,共5页Acta Academiae Medicinae Sinicae

基　　金：国家"九五"科技攻关项目!96- 906- 01- 01&&

摘　　要：对我国太行山区食管癌发病率及死亡率进行趋势分析及预测，并探索加速降低食管癌发病率和死亡率的策略。方法采用磁县、林县 1988～ 1997年食管癌发病、死亡资料，并运用有反馈的人工神经网络模型预测其发病率、死亡率趋势；以林县临淇镇为例，测算以内窥镜技术为主的早诊早治对于食管癌发病、死亡的降低程度及其把握度。结果近 10年来太行山区食管癌的发病率和死亡率均呈下降趋势，但较为缓慢。预测 2002年食管癌发病率男性为 115.70/10万，女性为 79.88/10万，食管癌死亡率男性为 94.00/10万，女性为 56.29/10万，食管癌发病率、死亡率均仍属较高水平；如推行以内窥镜为主的早诊早治技术 8年后，干预组的发病率为对照组的 1/3，把握度可达到 88.3％；死亡率在第 5年时为对照组的 1/4，把握度可达到 89.4％。结论太行山区食管癌发病率、死亡率均仍属较高水平，提示应该继续深入地在该地区开展食管癌的综合防治工作，推行以内窥镜技术为主的早期诊断、早期治疗；从而可在 5～ 8年内明显地降低食管癌死亡率和发生率。建议在该地区进行较大规模的食管癌二级预防。Objective To analyze and predict the trends of incidence and mortality rates of esophageal cancer in areas of Taihang Mountains, and explore the strategies for facilitating the reduction of the incidence and mortality of esophageal cancer. Methods The data were collected from Linxian and Cixian Counties registries between 1988～ 1997. The trends of the incidence and mortality rates for esophageal cancer had been fitted and predicted by the model of BP (Back Propagation) Neural Networks. Then Linqi Xiang in Linxian County was taken as an example, to determine the power for reducing incidence and mortality of esophageal cancer using endoscopic technology as an early detection and treatment method.Results There were slowly declining trends for both incidence and mortality rates during past 10 years in Taihang Mountains. The predicting rates of the esophageal cancer incidence in 2 002 are 115.70/100 000 for male and 79.88/100 000 for female; mortality rates are 94.00/100 000 and 56.29/100 000 respectively. Both incidence and mortality rates a still in high level. But when using endoscopic technology as an early detection and treatment method, the incidence rate is nearly 1/3 of a control group and the power is 88.30％ at the end of eight years. The mortality rate is 1/4 of the control group and power is 89.44％ after five years intervention (both powers based on 0.05 significant levels).Conclusions The incidence and mortality rates for esophageal cancer are still on high levels in Taihang Mountains. We should continue to enhance our preventive effort there. After using endoscopic technology as an early detection and treatment method, the incidence and mortality rates will be decreased markedly during 5 to 8 years. It is recommended to implement a large- scale secondary prevention strategy in these areas.

关 键 词：食管癌 二级预防 神经网络模型 把握度 防治 太行山 中国 

分 类 号：R735.10[医药卫生—肿瘤] R730.1[医药卫生—临床医学]