上海市长宁区1973-2013年前列腺癌发病率和死亡率趋势分析  

Time trend analysis of prostate cancer incidence and mortality in Changning District of Shanghai,1973-2013

作　　者：刘大可[1] 王洁 冯国杉 吴婳 蒋宇飞 沈秋明 周鹏[2] 张磊[2] 张云[2] 姜玉[2] 夏庆华[2] 赵文穗[2] 项永兵[1] LIU Da-ke;WANG Jie;FENG Guo-shan;WU Hua;JIANG Yu-fei;SHEN Qiu-ming;ZHOU Peng;ZHANG Lei;ZHANG Yun;JIANG Yu;XIA Qing-hua;ZHAO Wen-sui;XIANG Yong-bing(State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology,Shanghai Cancer Institute,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200032,China;Shanghai Changning District Center for Disease Control and Prevention,Shanghai 200051,China)

机构地区：[1]上海交通大学医学院附属仁济医院上海市肿瘤研究所,癌基因及相关基因国家重点实验室和流行病学研究室,上海200032 [2]上海市长宁区疾病预防控制中心,上海200051

出　　处：《复旦学报（医学版）》2020年第6期809-815,824,共8页Fudan University Journal of Medical Sciences

基　　金：国家重点研发计划(2016YFC1302503)。

摘　　要：目的分析上海市长宁区1973-2013年前列腺癌发病率与死亡率的趋势,评估年龄、诊断时期、出生队列对其发病和死亡的影响。方法利用上海市肿瘤登记处与长宁区疾病预防控制中心提供的前列腺癌发病和死亡资料以及长宁区公安局提供的本区相应人口资料,计算1973-2013年前列腺癌发病和死亡的粗率、年龄标化率和累积率。利用Joinpoint软件分析发病率与死亡率的时间趋势变化,计算其年度变化百分比(annual percent change,APC)和平均年度变化百分比(average annual percent change,AAPC)。采用年龄-时期-队列(age-period-cohort)模型分析和评价年龄、诊断时期和出生队列对其发病率和死亡率的影响。结果 1973-2013年长宁区前列腺癌新发病例数从6例升至740例,世标发病率从0.85/10万升至19.00/10万;死亡例数从4例升至300例,世标死亡率从0.78/10万升至6.82/10万。发病率与死亡率的趋势均有统计学意义(P<0.05)。发病率的APC为8.78%(P<0.05);死亡率的APC在1973-1997年为1.23%,在1998-2013年为7.11%,后者有统计学意义(P<0.05)。诊断时期的发病危险比从1.1升至5.9(P<0.01),死亡危险比从1.2升至1.7(P=0.016),均有统计学意义。从最早的出生队列(1893-1897年)起,发病危险比从0.1持续上升,至1941-1945年的出生队列达到峰值2.3,之后至1961-1965年的出生队列,危险比保持在2.1~2.3。出生队列的发病危险比有统计学意义(P<0.01),死亡危险比无统计学意义。结论上海市长宁区前列腺癌在1973-2013年的发病率和死亡率均显著上升,发病率上升幅度大于死亡率。年龄、诊断时期和出生队列对发病率趋势均有显著影响,而对死亡率趋势仅诊断时期有显著影响。Objective To analyze the time trends of the incidence and mortality of prostate cancer in Changning District of Shanghai from 1973 to 2013,and to evaluate the effects of age,diagnosis period,and birth cohort on the incidence and mortality of prostate cancer.Methods Based on the data of the incidence and death of prostate cancer provided by Shanghai Cancer Registry and the Changning District Center For Disease Control and Prevention,as well as the corresponding population data provided by the Public Security Bureau of Changning District,the crude incidence and mortality rates,the age-standardized incidence and mortality rates and the accumulation rates of prostate cancer from 1973 to 2013 were calculated.Joinpoint software was used to analyze the time trends of incidence and mortality of prostate cancer,and to calculate the annual percentage change(APC)and average annual percent change(AAPC).Age-period-cohort model was used to analyze and evaluate the effects of age,diagnosis period,and birth cohort on incidence and mortality of prostate cancer.Results From 1973 to 2013,the number of new cases of prostate cancer in Changning District increased from 6 to 740 per year,and the age standardized rate(ASR)by world population of incidence increased from 0.85/100000 to 19.00/100000;the number of deaths due to prostate cancer rose from 4 to 300 per year,and the ASR of mortality rose from 0.78/100000 to 6.82/100000.Both the incidence and mortality trends were statistically significant(P<0.05).The APC of incidence was 8.78%(P<0.05);the APC of mortality was 1.23%during 1973-1997 and 7.11%during 1998-2013,with the latter being statistically significant(P<0.05).The relative risk ratios of the diagnosis period in incidence increased from 1.1 to 5.9(P<0.01),and that in mortality increased from 1.2 to 1.7(P=0.016),both of which were statistically significant.From the earliest birth cohort(1893-1897),the relative risk ratios of incidence continued to rise from 0.1 to a peak of 2.3 in the birth cohort of 1941-1945.For the birth coho

关 键 词：前列腺癌 发病率 死亡率 时间趋势 年龄-时期-队列模型 

分 类 号：R737.25[医药卫生—肿瘤]