2016年上海市前列腺癌发病和死亡情况与2002—2016年变化趋势分析

Analysis on prostate cancer incidence and mortality in Shanghai 2016 and trends of 2002-2016

目的:分析2016年上海市前列腺癌发病和死亡的基本情况及其2002—2016年的变化趋势,为前列腺癌的防治研究提供依据。方法:2002—2016年上海市前列腺癌发病和死亡资料来源于上海市疾病预防控制中心人群基础肿瘤登记管理系统和死因登记系统。根据诊断或死亡年份、性别、年龄组统计各亚组人群发病和死亡数、粗率、构成比、年龄别率以及累积率;使用Segi’s 1960年世界标准人口构成计算年龄标准化发病率和死亡率以及相应的35~64岁截缩率;使用Z检验、加权χ^(2)检验分别比较不同亚组年龄别率和标化率的差异。使用Joinpoint 4.9.1.0软件分析逐年率值的时间趋势。结果:2016年上海市新诊断前列腺癌3226例,死亡1067例,粗发病率为44.91/10万,粗死亡率为14.85/10万,标化发病率和死亡率分别为15.47/10万和4.34/10万。年龄别发病率和死亡率均随年龄的增加而上升,发病率和死亡率分别在80~84岁年龄组和85~岁年龄组达到顶峰,市区发病率在50~54岁年龄组、75~79岁年龄组和80~84岁年龄组高于郊区,死亡率的差异无统计学意义。2002—2016年前列腺癌发病率和死亡率逐年上升,2012年后标化发病率上升放缓,市区标化死亡率出现下降,郊区发病率增长速度快于市区,低年龄组的发病率增速较快。结论:上海市前列腺癌发病和死亡低于世界水平但高于全国水平,2002—2016年发病率逐年上升,年均增长率放缓,死亡率在2012—2016年出现下降的情况,但无统计学意义。前列腺癌的市区发病率和死亡率均高于郊区,但郊区的增长速度快于市区,低年龄组发病率增长更快,诊断时早期病例占比较低,应考虑合适的筛查策略。

Objective:To analyze the incidence and mortality of prostate cancer in Shanghai in 2016 and trends during 2002-2016,and to provide a basis for prostate cancer prevention and treatment.Methods:The data of prostate cancer incidence and mortality in Shanghai from 2002-2016 were obtained from the Population-Based Cancer Registry and Vital Statistics of Shanghai Municipal Center for Disease Control and Prevention.The incidence,mortality,proportion,crude rate,age-specific rate and age standardized rate of prostate cancer were calculated.Age-standardized incidence and mortality were calculated using Segi’s 1960 world standard population.Trends of prostate cancer incidence,mortality,age-standardized rate and agespecific rate were estimated by Joinpoint 4.9.1.0 software.Results:In 2016,there were 3226 cases of newly diagnosed prostate cancer and 1067 deaths in Shanghai,crude rate of incidence was 44.91/10^(5),crude rate of mortality was 14.85/10^(5),agestandardized incidence and mortality were 15.47/10^(5)and 4.34/10^(5).Age-specific incidence and mortality increased with age,and reached the highest level in the 80-84 year-old group and 85-year-old group.Urban incidence was higher than suburb in the 50-54 year-old group,75-79 year-old group,and 80-84 year-old group,with no statistical difference in mortality.Between 2002 and 2016,incidence and mortality increased gradually,the rise of age-standardized incidence slowed down after 2012,and the age-standardized mortality in urban area declined after 2012.The age-standardized incidence in suburb increased faster than that in urban area,and the incidence rate increased faster in the younger age groups.Conclusion:The incidence and mortality of prostate cancer in Shanghai were lower than the world level but higher than the national level,and the incidence increased gradually between 2002 and 2016.Incidence and mortality were higher in urban area than in suburb,but increased faster in suburb,and the incidence increased more rapidly in younger age groups,but the proportion of early stages at diagnosis was still low,suggesting that appropriate screening strategies should be considered.