2000—2013年山东省肥城市上消化道癌发病、死亡及早诊早治效果分析  

Analysis of incidence and mortality for upper digestive tract cancers and results of early detection and treatment program in Feicheng,Shandong Province

作　　者：伊丽 赵腾 李琰琰 陈万青[2] 赵德利 

机构地区：[1]山东省肥城市人民医院肿瘤防治中心,271600 [2]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院/全国肿瘤防治研究办公室

出　　处：《中华预防医学杂志》2017年第5期403-408,共6页Chinese Journal of Preventive Medicine

摘　　要：目的 分析山东省肥城市2000—2013年上消化道癌症发病死亡趋势,对2006至2015年肥城市上消化道癌早诊早治效果进行评估.方法 提取山东省肥城市肿瘤登记处的肿瘤登记系统中2000—2013年国际疾病分类编码第10版中编码为C15、C16全部患者信息,共计26569例,覆盖人口21679882人年.分析上消化道癌症发病、死亡率的变化趋势,计算年度变化百分率（APC）.2006—2015年先后对肥城市3个街道办事处和11个乡镇的40-69岁户籍人口居民进行上消化道癌症危险因素调查和风险评估,对评估的高危人群进行内镜筛查.分析上消化道癌症筛查和早诊早治项目的检出率、早诊率、早治率.结果 2000—2013年间,肥城市食管癌和胃癌新发病例26569例,食管癌发病率从2000年的76.06/10万（575/756005）上升至2010年的118.76/10万（852/717429）,APC为4.3%（95%CI：2.7%-5.9%）,然后开始呈现下降趋势,APC为-7.1%（95%CI：-15.8%-2.5%）,但无统计学意义.胃癌发病率自2000年的37.70/10万（285/756005）上升至2013年的54.59/10万（538/985512）,APC为3.3%（95%CI：2.1%-4.5%）.2000—2013年食管癌和胃癌死亡率均呈现相对平稳的趋势,食管癌、胃癌死亡率APC分别为0.1%（95%CI：-1.3%-1.5%）、0.8%（95%CI：-0.5%-2.0%）.2006—2015年,共完成问卷评估206105名,58579例40-69岁人群接受内镜癌筛查且数据完整,检出病例1124例,检出率为1.92%;其中早期病例941例,早诊率为83.72%.接受治疗患者1000例,治疗率为88.97%.结论 肥城市上消化道癌症发病、死亡水平较高,防控形势严峻,筛查和早诊早治对上消化道癌的控制具有重要意义.Objective To investigate the trend of esophageal and stomach cancer incidence and mortality in Feicheng during 2000 to 2013, and to evaluate the effects of the national project of screening for upper digestive tract cancers from 2006 to 2015 in Feicheng. Methods We collected 26569 cases, which were coded of C15 and C16 in the 10th edition of international classification of diseases （ICD） during the period of 2000-2013. The data came from cancer registration system of Feicheng, Shandong Province, China. These cases already covered 21679882 person-year. The annual percent change （APC） of incidence and mortalit were analyzed. The risk factors of upper gastrointestinal cancer were investigated and evaluated for people aging 40-69 in three street offices and eleven townships of Feicheng, and endoscopic screening was conducted among people who was in high risk. The corresponding data were used to analyze the early detection project of upper gastrointestinal cancer screening and early diagnosis, with the index of detection rate, early diagnosis rate, early treatment rate and other indicators. Result There were 26569 new cases of esophageal cancer and gastric cancer occurred in Feicheng from 2000 to 2013. The incidence of esophageal cancer gradually increased since 2000 with 76.06 per 100000 people （575/756005） and reached the peak in 2010 with incidence rate of 118.76 per 100000 people （852/717429）, with the annual percent change at about 4.3% （95%CI： 2.7%-5.9%） and showed a downward trend after then but has no significance, with APC about-7.1%（95%CI：-15.8%-2.5%）. The incidence of gastric cancer was increased from 2000 with＆amp;nbsp;an incidence rate of 37.70 per 100000 people （285/756005） to 2013 with an incidence rate of 54.59 per 100000 （538/985512）, with an annual percent change of about 3.3% （95%CI： 2.1%- 4.5%）. Esophageal cancer and gastric cancer mortality showed a relatively stable trend during 2000 to 2013, esophageal cancer with APC about 0.1%（95%CI：-1.3%-1.5%）

关 键 词：食管肿瘤 治疗效果 死亡率 筛查 趋势分析 

分 类 号：R735[医药卫生—肿瘤]