2016年上海市卵巢和输卵管等子宫附件癌发病和死亡情况与2002—2016年的变化趋势分析

Analysis on the current status of ovarian,fallopian tube and other uterine adnexa cancer incidence and mortality in Shanghai,2016 and trends of 2002-2016

目的:分析2016年上海市卵巢和输卵管等子宫附件癌发病和死亡的基本情况及其2002—2016年的变化趋势。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死因登记系统收集2002—2016年卵巢和输卵管等子宫附件癌的发病和死亡资料,按诊断或死亡年份、部位和年龄组分层,计算数量、构成比、粗率、年龄别率、年龄标化率等指标,分析发病和死亡数量、年龄别率和标化率等的变化趋势。采用Joinpoint回归模型计算卵巢癌标化率年度变化百分比(annual percent change,APC),分析变化趋势。计算卵巢癌和输卵管癌新发病例的部分诊断特征指标的数量和构成比。采用Segi’s 1960年世界标准人口构成进行调整,计算标化率。结果:2016年上海市子宫附件癌新发病例和死亡人数分别为813例和440人,卵巢癌分别为751例(92.37%)和419人(95.23%),输卵管癌分别为48例(5.91%)和17人(3.86%)。卵巢癌的粗发病率为10.29/10万,标化发病率为5.33/10万,粗死亡率为5.74/10万,标化死亡率为2.44/10万,年龄别发病率和死亡率整体上均随着年龄的增长而升高,分别在55~59岁组和80~84岁组达到高峰。2002—2016年上海市子宫附件癌的合计和各部位的发病例数和死亡人数均呈增多趋势,但卵巢癌在发病和死亡总数中的占比均持续下降,输卵管癌在发病中的占比持续上升。卵巢癌的标化发病率以年均1.78%的速度下降(APC=-1.78,P<0.001),标化死亡率的变化差异无统计学意义,病理诊断比例提升至85.02%,Ⅲ期和Ⅳ期的比例持续升高。结论:上海市卵巢癌标化发病率稳步下降,但诊断时为晚期的比例上升,输卵管癌的发病数持续增多。

Objective:To investigate the incidence and mortality of ovarian,fallopian tube and other uterine adnexa cancer in 2016 and their trends during 2002 through 2016 in Shanghai.Methods:Data on new ovarian,fallopian tube and other uterine adnexa cancer diagnoses and deaths during 2002 through 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.The incidence and mortality stratified by year of diagnosis or death,site and age-group were analyzed.The number,proportion,crude rate,age-specific rate,age-standardized rate and others were calculated.Trends in number,age-specific rate,age-standardized rate and others were estimated.Trends in age-standardized rate of incidence and mortality for the ovarian cancer were estimated by Joinpoint analysis and characterized by the annual percent change(APC).The number and proportion of selected indexes of diagnostic characteristics of new ovarian and fallopian tube cancer cases were also calculated.Segi’s 1960 world standard population was used for calculating age-standardized rates.Results:The new uterine adnexa cancer cases and deaths were 813 and 440 in Shanghai in 2016.There were 751 cases(92.37%)and 419 deaths(95.23%)of ovarian cancer,and 48 cases(5.91%)and 17 deaths(3.86%)of fallopian tube cancer.The crude rate of ovarian cancer incidence was 10.29/10^(5),and the age-standardized rate was 5.33/10^(5).The crude rate of mortality was 5.74/10^(5),and the age-standardized rate was 2.44/10^(5).Overall,the age-specific rates of incidence and mortality increased with aging.They reached the peak at the age group of 55-59 years and 80-84 years,respectively.Joinpoint analyses showed a significant decreasing trend in the standardized incidence of ovarian cancer in Shanghai from 2002 to 2016,with an average annual increase of 1.78%(APC=-1.78,P<0.001),while the increase in standardized mortality was not statistically significant.The proportion of pathological diagnosis on ovarian cancer increased to 85.02%,and the proportions of stageⅢandⅣcontinued to increase.The incidence of ovarian cancer in Shanghai from 2002 to 2016 showed a decreasing trend,while the mortality showed a fluctuating trend.Conclusion:In Shanghai,the age-standardized incidence rate of ovarian cancer was declined steadily,but the proportion of diagnosed advanced increased.The number of fallopian tube cancer cases increased steadily.