2002-2016年上海市杨浦区肝癌流行现况与生存分析  

Epidemiological status and survival rate of liver cancer in Yangpu District of Shanghai,2002−2016

作　　者：赵佳[1] 陈灵颖 周隽隽 谢梦[1] 韩雪[1] ZHAO Jia;CHEN Ling-ying;ZHOU Jun-jun;XIE Meng;HAN Xue(Yangpu District Center for Disease Control and Prevention,Shanghai 200090,China)

机构地区：[1]上海市杨浦区疾病预防控制中心,上海200090

出　　处：《上海预防医学》2021年第10期913-916,共4页Shanghai Journal of Preventive Medicine

基　　金：上海市杨浦区卫生健康委员会医学重点学科(YP19ZB11)。

摘　　要：【目的】分析2002—2016年上海市杨浦区肝癌发病和死亡的流行趋势和生存情况。【方法】收集上海市杨浦区户籍人口肿瘤登记系统中2002—2016年肝癌发病与死亡的数据,获取公安部门公布的每年户籍人口数,用世界标准人口构成计算标化肝癌发病率与死亡率,分析肝癌总体、性别和年龄别的发病率和死亡率趋势。用寿命表法计算生存率,log-rank检验分析不同性别肝癌患者的5年生存率的差异和诊断时期别。【结果】2002—2016年杨浦区肝癌的发病率与死亡率整体呈现下降趋势,去除人口老龄化的影响,标化后的发病率年度变化百分比(APC)为−3.10%(P<0.01),标化后的死亡率APC为−3.44%(P<0.01)。经Z检验,男性的发病率和死亡率均显著高于女性(P<0.01)。从年龄分析,肝癌发病率从40岁开始上升明显,死亡率从50岁开始明显升高。4007名肝癌患者已追踪随访5年,5年生存率为12.45%,生存期中位数为281.48 d。男性肝癌患者5年生存率高于女性,有显著性差异(P<0.01)。46.58%的肝癌患者诊断时已为Ⅳ期,Ⅰ期比例仅占13.46%,男女各期别之间的比例无统计学差异(P=0.85)。【结论】2002—2016年杨浦区肝癌发病率与死亡率总体呈现缓慢下降趋势,男性的发病率与死亡率高于女性。中老年是肝癌发病与死亡的主要人群,5年生存率较低,诊断时的期别多为中晚期。[Objective]To analyze the prevalence trend and survival of liver cancer in Yangpu District,Shanghai,from 2002 to 2016.[Methods]Data on liver cancer incidence and mortality from 2002 to 2016 were collected from the Shanghai cancer registry system for the registered population in Yangpu District and the number of the registered population published by the public security department.The standardized liver cancer incidence and mortality rates were calculated using the world standard population to analyze the trends of the liver cancer incidence and mortality,in general,by gender and by age.Life table method was used to calculate the survival rate,and log-rank test was used to analyze the difference of 5-year survival rates and the period of diagnosis between patients with liver cancer by gender.[Results]The overall incidence and mortality of liver cancer showed a decreasing trend from 2002 to 2016.After removing the influence of community aging,the standardized annual percentage change(APC)of morbidity and mortality was−3.10%(P<0.01)and−3.44%(P<0.01),respectively.The morbidity and mortality of males were significantly higher than that of females(P<0.01)by Z test.The incidence of liver cancer started to rise obviously from 40 years old,and the death rate raised obviously from 50 years old.4007 liver cancer patients were followed up for 5 years.The 5 years observed survival rate was 12.45%,and the median survival time was 281.48 days.The 5-year survival rate of male liver cancer patients was higher than that of female patients,and there was a significant difference(P<0.01).46.58%of liver cancer patients were diagnosed in the advanced stage,and only 13.46%was diagnosed at the early-stage.There was no statistical difference in the proportion between men and women at different stages(P=0.11).[Conclusion]The overall incidence and mortality rates of liver cancer from 2002 to 2016 show a slowly decreasing trend,with higher incidence and mortality rates in men than in women.Middleaged and elderly people are still the main

关 键 词：肝癌 发病率 死亡率 5年生存率 诊断时的期别 

分 类 号：R735.7[医药卫生—肿瘤]