中国食管癌发病状况与趋势分析

Incidence and trend analysis of esophageal cancer in China

目的：通过对中国肿瘤登记地区食管癌发病数据进行分析，了解中国食管癌的发病现状和变化趋势，为食管癌的防治提供基础信息。方法提取全国肿瘤登记中心2012年的食管癌发病数据，分析不同地区、性别和年龄别食管癌的发病率，结合2012年全国人口数据估计食管癌发病情况。对22个有连续数据登记处的2000—2011年食管癌的发病数据进行整理，分析登记地区食管癌发病率的变化趋势。结果2012年中国食管癌新发病例数约为28．67万，发病率为21．17／10万；中国人口标准化发病率（中标率）为14．73／10万，世界人口标准化发病率（世标率）为14．93／10万；0～74岁患者的累积发病率为1．91％。2000—2011年，中国22个肿瘤登记地区食管癌发病率平均每年降低0．9％[年平均变化率（AAPC）为－0．9％，95％CI为－1．6％～－0．1％]，其中城市地区无明显变化，农村地区平均每年升高1．3％（95％CI为0．2％～2．5％）。调整人口结构后，食管癌世标率平均每年以4．0％的幅度下降（AAPC 为－4．0％，95％CI 为－5．5％～－2．6％），其中城市地区 AAPC 为－3．8％（95％CI为－4．9％～－2．7％），农村地区AAPC为－1．7％（95％CI －3．0％～－0．4％）。结论食管癌是中国常见的恶性肿瘤，是肿瘤防治工作的重点，多年来通过对高发区主要危险因素的预防控制以及食管癌筛查技术的有效开展，中国食管癌的发病率呈现明显的下降趋势。

Objective Incidence data retrieved from population-based cancer registration were used to analyze the esophageal cancer incidence and trend in China. The results can provide basic information for prevention and control of esophageal cancer. Methods Esophageal cancer incidence data in 2012 were retrieved from the National Central Cancer Registry, nationwide new esophageal cancer cases were estimated using age-specific rate by urban or rural and gender and national population in 2012. Esophageal cancer incidence data from 22 cancer registries were used to analyze the trend during 2000-2011. Results The estimates of new cases of esophageal cancer were about 286.7 thousand in 2012 in China. The incidence rate was 21.17/105 , the age-standardized incidence rates by Chinese standard population and by world population were 14.73/105 and 14. 93/105 , respectively, and the cumulative incidence rate was 1. 91%. There was a decreasing trend of incidence rate of esophageal cancer in registration areas of China during 2000-2011 with an average annual percentage change （AAPC） of 0.9% （95%CI： -1.6% to -0.1%）, no significant differences were observed in urban area and an increasing trend with AAPC of 1. 3% （ 95%CI： 0. 2% to 2.5%） in rural area. After age standardization, the incidence rate was significantly decreased, with AAPC of-4.0% （95%CI：-5.5% to -2.6%） overall, -3.8% （95%CI：-4.9% to -2.7%） in urban and -1.7%（95%CI： -3.0% to -0.4%） in rural areas. Conclusions Esophageal cancer is one of the most common cancers in China and is an emphasis for cancer control. After effective control of risk factors and development of esophageal cancer screening techniques in high-risk areas for years, esophageal cancer incidence appears to have a significant decreasing trend.