2006-2017年中国女性乳腺癌和生殖系统癌症发病趋势分析  

Analysis on incidence trend of breast cancer and reproductive system cancers in women in China,2006-2017

作　　者：元玫雯 冯雨舒 赵雪莲[1] 胡尚英[1] 赵方辉[1] Yuan Meiwen;Feng Yushu;Zhao Xuelian;Hu Shangying;Zhao Fanghui(Department of Cancer Epidemiology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家癌症临床医学研究中心/中国医学科学院北京协和医学院癌症医院流行病学研究室,北京100021

出　　处：《中华流行病学杂志》2024年第5期647-655,共9页Chinese Journal of Epidemiology

基　　金：中国医学科学院医学与健康科技创新工程(2021-I2M-1-004)。

摘　　要：目的评估2006-2017年不同年龄和地区女性乳腺癌和生殖系统癌症的发病趋势。方法结合发病率、人口数计算全国分地区、分年龄的女性乳腺癌、外阴癌、阴道癌、宫颈癌、子宫体癌及卵巢癌的发病数及平均诊断年龄。通过世界标准人口进行标化。采用Joinpoint 4.5.0.1软件计算平均年变化百分比(AAPC)。结果2006-2017年,6种癌症的合计年龄标化发病率(ASIR)从39.48/10万上升至51.11/10万(AAPC=2.24%,95%CI:1.59%~2.89%)。这一上升趋势在农村地区更加显著(AAPC=4.65%,95%CI:3.67%~5.64%),而城市地区未见明显上升(AAPC=0.15%,95%CI:-0.26%~0.56%)。除子宫体癌外,其他5种癌症发病均呈上升趋势。宫颈癌的ASIR在城市和农村地区上升趋势相近。乳腺癌、阴道癌和外阴癌的ASIR在城市地区无明显上升趋势,而在农村地区明显上升。卵巢癌的ASIR在城市地区呈下降趋势,而在农村地区则呈上升趋势。从发病年龄上看,除子宫体癌外,所有女性癌症平均诊断年龄均呈上升趋势。通过世界标准人口标化后,仅在宫颈癌和阴道癌中观察到标化平均诊断年龄的上升,从49.11岁和55.15岁分别上升至52.13岁和58.81岁。结论2006-2017年,女性癌症标化发病率总体呈上升趋势,且农村地区上升趋势高于城市地区。同时,农村居民的医疗资源可及性需进一步提升,保证医疗保健服务和早诊早治,从而弥合女性癌症城乡差距。Objective To understand the incidence trend and temporal distribution of breast cancer and reproductive system cancers in women in different age groups and areas in China from 2006 to 2017.Methods Based on the incidences of breast cancer,vulvar cancer,vaginal cancer,cervical cancer,uterine corpus cancer,and ovarian cancer in women,average age at diagnosis and cases in different age groups and areas in China were calculated,standardized through world population.Software Joinpoint 4.5.0.1 was used to calculate average annual percent of change(AAPC).Results Between 2006 and 2017,the overall age-standardized incidence rate(ASIR)of the six cancers showed an increasing trend from 39.48/100000 to 51.11/100000(AAPC=2.24%,95%CI:1.59%-2.89%).The increasing trend was more obvious in rural area(AAPC=4.65%,95%CI:3.67%-5.64%),whereas no significant increase was observed in urban area(AAPC=0.15%,95%CI:-0.26%-0.56%).Except uterine corpus cancer,the incidences of 5 cancers showed increasing trends.The incidences of cervical cancer showed similar upward trends in urban and rural areas.In urban area,the ASIRs of breast cancer,vaginal cancer and vulvar cancer showed no significant increase,while in rural area it showed significant increase.The ASIR of ovarian cancer showed a decreasing trend in urban area and an increasing trend in rural area.The average age at diagnosis increased for all the cancers,except uterine corpus cancer.However,after standardizing through world population,the increases in the standardized average age at diagnosis were observed only in cervical cancer and vaginal cancer from 49.11 and 55.15 years to 52.13 and 58.81 years,respectively.Conclusions The overall ASIR of breast cancer and reproductive system cancers in women showed increase trend in China in 2006-2017,and the increase trend was more obvious in rural area than in urban area.Meanwhile,the accessibility to medical facilities in rural area needs to be improved to ensure medical care,early diagnosis and early treatment for the purpose of bridging the g

关 键 词：肿瘤 乳腺 肿瘤 生殖系统 发病率 趋势分析 

分 类 号：R737.9[医药卫生—肿瘤] R737.3[医药卫生—临床医学]