2002—2017年上海市女性乳腺癌生存分析  

Survival analysis of female breast cancer in Shanghai:a population-based study from 2002 to 2017

作　　者：吴春晓[1] 庞怡 顾凯[1] 颜佳颖 王春芳[2] 向詠梅[1] 施燕[3] WU Chunxiao;PANG Yi;GU Kai;YAN Jiaying;WANG Chunfang;XIANG Yongmei;SHI Yan(Department of Cancer Control and Prevention,Division of Noncommunicable Diseases and Injury,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Department of Vital Statistics,Division of Health Information,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Division of Noncommunicable Diseases and Injury,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市疾病预防控制中心慢性非传染病与伤害防治所肿瘤防治科,上海200336 [2]上海市疾病预防控制中心疾病预防控制信息所生命统计科,上海200336 [3]上海市疾病预防控制中心慢性非传染病与伤害防治所,上海200336

出　　处：《中国癌症杂志》2025年第3期291-297,共7页China Oncology

基　　金：国家重点研发计划项目(2022YFC3600805);上海市加强公共卫生体系建设三年行动计划(2023-2025)项目(GWVI-8)。

摘　　要：背景与目的:上海市疾病预防控制中心每年更新上海市恶性肿瘤流行统计资料。乳腺癌是女性常见的恶性肿瘤之一,近年来上海市女性乳腺癌发病率仍在上升,死亡率已呈下降趋势,本研究旨在进一步分析2002—2017年上海市女性乳腺癌诊断病例的生存情况。方法:采用上海市疾病预防控制中心建立的人群基础肿瘤登记管理系统和全死因登记系统收集的2002—2017年上海市女性乳腺癌发病、死亡和随访资料,按诊断年份、年龄、病理组织学类型和诊断时期别分层分析,计算数量、构成比和生存率指标。5年观察生存率应用寿命表法计算,应用Elandt-Johnson模型推算0~99岁逐岁的生存概率,再根据EdererⅡ方法计算期望生存率,最终获得5年相对生存率。应用Joinpoint软件计算生存率的年度变化百分比(annual percent change,APC)并分析变化趋势。结果:2002—2017年上海市女性乳腺癌诊断病例共73600例,其中病理学诊断67681例,占91.96%。截至2022年12月31日,已死亡23745例(32.26%),因肿瘤死亡19466例,占所有病例的26.45%;已死亡和随访生存期满5年的完全随访病例共68332例(92.84%);失访病例5268例(7.16%)。纳入观察队列73538例,占99.92%。逐年观察病例数从2002年的3330例增长至2017年的6095例,增幅接近翻倍;5年观察生存率从2002年的78.77%动态变化至2017年的84.55%,呈现缓慢增长趋势,年均增速为0.50%(APC=0.50%,t=8.75,P<0.001);5年相对生存率也从83.46%缓慢增长至89.24%,年均增速为0.47%(APC=0.47%,t=9.80,P<0.001)。2002—2017年上海市女性乳腺癌总体5年观察生存率为83.24%(82.96%~83.52%),5年相对生存率为87.58%(87.29%~87.87%),并随着时间变化持续上升,随着年龄的增长而降低,随着诊断时期别的增加而降低。其中,15~64岁各组间的5年相对生存率差异无统计学意义(P>0.05)。病例数以期别不详组最多,其次是Ⅱ期组,再是Ⅰ期组。Ⅰ期病例的5年相对生�Background and purpose:The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on cancer statistics in Shanghai.Breast cancer is one of the common malignant tumors among women.In recent years,the incidence of female breast cancer was increasing,while its trend of mortality showed declining.This study aimed to investigate the survival rates of new female breast cancer cases in Shanghai from 2002 to 2017.Methods:Data of new cases and deaths of female breast cancer patients with follow-up information from 2002 to 2017 were obtained from the Population-based Cancer Registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention.Numbers,proportions,and survival rates were stratified by year of diagnosis,age,histological type and stage at diagnosis for analysis.The 5-year observed survival rates were calculated based on the life table method.The probabilities of surviving from 0 to 99 years were estimated with the Elandt-Johnson model,and then cumulative expected survival rates were calculated using the EdererⅡmethod.Finally,the 5-year relative survival rates were calculated.The annual percent change(APC)of survival rates was estimated by Joinpoint Regression Program.Results:A total of 73600 new female breast cancer cases were diagnosed from 2002 to 2017 in Shanghai.Among them,67681 cases were morphological verification,accounting for 91.96%.By December 31,2022,23745(32.26%)cases had died,and 19466(26.45%)cases had died of cancer.A total of 68332(92.84%)cases,who were either dead or followed for over 5 years,were considered to have complete follow-up.The remaining 5268(7.16%)cases were lost to follow-up.73538(99.92%)cases were included in the observed cohort for survival analysis.The number of observed cases nearly doubled from 3330 in 2002 to 6095 in 2017.The 5-year observed survival rate changed from 78.77%in 2002 to 84.55%in 2017 dynamically,showed a low increasing trend with an average rate of 0.50%per year(APC=0.50%,t=8.75,P<0.001).The 5-year

关 键 词：乳腺癌 生存 流行病学 上海 

分 类 号：R737.9[医药卫生—肿瘤]