2016年上海市肺癌发病和死亡的特征及其在2002—2016年的变化趋势

The incidence and mortality of lung cancer in 2016 and their trends from 2002 to 2016 in Shanghai

目的:分析2016年上海市肺癌发病和死亡的基本特征及其在2002—2016年的变化趋势。方法:2002—2016年肺癌发病和死亡资料来源于上海市疾病预防控制中心全人群肿瘤登记管理系统和死因登记系统,按患者诊断或死亡年份、性别和年龄组分层,计算各亚组人群肺癌发病和死亡人数、构成比、粗率、年龄别率、年龄标准化率(简称为标化率)、35~64岁截缩年龄标准化率(简称为截缩率)以及累积率等统计指标。应用Segi’s 1960年世界标准人口构成进行调整计算标化率和截缩率。应用Joinpoint回归模型计算各统计指标的年度变化百分比,分析其变化趋势。结果:2016年上海市肺癌新发病例数和死亡人数分别为14395例和9170例,粗发病率为99.41/10万,标化发病率为39.76/10万。在上海所有恶性肿瘤中,肺癌新发病例占比为19.34%,居恶性肿瘤发病谱的第1位。2016年上海市肺癌粗死亡率为63.33/10万,标化死亡率为21.57/10万,死亡病例数占所有恶性肿瘤死亡病例总数的24.78%,居恶性肿瘤死亡谱的第1位。男性各项发病和死亡分类统计指标均高于女性。年龄别发病和死亡的病例数和率值随着年龄的增长而增加,年龄别发病的数量和率值分别在60~64岁组和80~84岁组达到高峰,年龄别死亡的病例数和率值分别在80~84岁组和85岁以上组达到高峰。肺癌标化发病率从2002年的33.70/10万逐渐变化至2016年的39.76/10万。Joinpoint分析结果显示,2002—2010年上海市肺癌标化发病率维持在较稳定状态[年度变化百分比(annual percent change,APC)=-0.79,t=-1.46,P=0.175],2010—2016年则以年均5.12%的幅度著上升(APC=5.12,t=6.97,P<0.001)。2002—2016年上海市肺癌标化死亡率年均下降0.87%(APC=-0.87,t=-2.87,P=0.013)。结论:2002—2016年上海市肺癌发病率呈上升趋势,死亡率呈缓慢下降的趋势,且不同性别和年龄组人群的肺癌流行情况存在差异。

Objective:To investigate the lung cancer incidence and mortality in 2016 and their trends from 2002 to 2016 in shanghai.Methods:The data of incidence and death on lung cancer in shanghai from 2002 to 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.Lung Cancer incidence and mortality stratified by age of diagnosis or death,gender and age-group were analyzed.The number of cases and deaths,proportion,crude rates,age-specific rates,age-standardized rates,corresponding truncated age-standardized rates(35-64 years)and cumulative rates were calculated.Segi’s 1960 world standard population was used for calculating age-standardized rates of incidence and mortality as well as truncated age-standardized rates.Trends in age-standardized rates of incidence and death for lung cancer in Shanghai from 2002-2016 were estimated by Joinpoint analysis and characterized by the annual percent change(APC).Results:The new lung cancer cases and deaths were 14395 and 9170 in Shanghai in 2016.The crude rate of incidence was 99.41/105,and the age-standardized rate of incidence was 39.76/105.New cases of lung cancer accounted for 19.34%of all malignant tumors in shanghai,ranking the first in the incidence spectrum of malignant tumors.The crude rate of mortality was 63.33/105,and the agestandardized rate was 21.57/105.Deaths of lung cancer accounted for 24.78%of all malignant tumor deaths in shanghai,ranking the first in the mortality spectrum of malignant tumors.The agestandardized rates of incidence and mortality for males were higher than those for females.The age-specific numbers and rates of incidence and mortality increased with age.The age-specific number and rate of incidence reached the peak at the age group of 60-64 years and 80-84 years respectively,and those of mortality peaked at the age group of 80-84 years and older than 85 years respectively.The incidence of lung cancer increased from 33.70/105 in 2002 to 39.76/105 in 2016 in Shanghai.Joinpoint analyses showed that the age-standardized rate of lung cancer incidence remained stable from 2002 to 2010(APC=-0.79,t=-1.46,P=0.175)but showed a significant upward trend with an average annual increase rate of 5.12%from 2010 to 2016(APC=5.12,t=6.97,P<0.001).The standardized mortality showed a downward trend with an average annual decrease rate of 0.87%from 2002 to 2016(APC=-0.87,t=-2.87,P=0.013).Conclusion:The incidence of lung cancer in Shanghai during 2002-2016 presented an upward trend while the mortality of lung cancer showed a gradual downward trend.There are differences in the incidence and mortality of lung cancer among different gender and age groups.