1973-1999年上海市区老年人恶性肿瘤发病趋势分析

Cancer incidence trend among elderly people in urban Shanghai in 1973-1999

目的分析1973-1999年上海市区老年人恶性肿瘤发病趋势。方法根据国际癌症研究中心/国际癌症登记协会推荐的肿瘤登记方法和要求,计算各部位肿瘤的发病例数、粗率和标化率。发病率年均变化百分比用线性回归模型计算,并用病例数加权。结果27年间上海市区老年男性主要恶性肿瘤中,食管癌(年均变化百分比为-3.94%,下同)、胃癌(-1.84%)、肝癌(-0.73%)、骨癌(-2.23%)和非霍奇金淋巴瘤(-3.86%)发病率呈现下降趋势,结肠癌(4.63%)、直肠癌(2.24%)、胆囊癌(5.47%)、胰腺癌(2.85%)、肺癌(0.86%)、前列腺癌(6.61%)、膀胱癌(1.18%)、肾癌(5.26%)、脑和神经系统肿瘤(5.09%)、霍奇金淋巴瘤(2.88%)和多发性骨髓瘤(3.72%)发病率上升。老年女性肿瘤中食管癌(-4.36%)、胃癌(-1.33%)、肝癌(-0.89%)、喉癌(-3.48%)和子宫颈癌(-8.52%)发病率呈下降趋势,结肠癌(4.76%)、直肠癌(1.86%)、胆囊癌(5.57%)、胰腺癌(3.06%)、乳腺癌(2.12%)、子宫内膜癌(4.41%)、卵巢癌(1.94%)、肾癌(4.44%)、脑和神经系统肿瘤(8.07%)、霍奇金淋巴瘤(4.57%)和多发性骨髓瘤(4.37%)发病率上升,男、女的变化都具有统计学意义(P<0.05或P<0.01)。结论27年间上海市区老年恶性肿瘤发病趋势总体呈平稳态势,但部分肿瘤变化较大。

Objective Incidence rates for commonly seen cancers during 1973 ～ 1999 among residents aged 60 years and over in urban Shanghai were analyzed to discover the trend changes. Methods New cancer cases number, the crude rates and standardized rates were calculated by the methods of cancer registry recommended by IARC/IACR. Annual percent changes in the incidence were estimated by means of a linear regression of respective rates on the mid point of calendar years, and weighted by the number of cases. Results The decreasing rates were observed for the cancers ofoesophagus（APC： -3.94%）, stomach（-1.84%）, liver（0.73%）, bone（-2.23%） and non-Hodgkin＇s lymphoma （-3.86%） among elderly men. The increasing rates were observed for the cancers of colon（4.63%）, rectum（2.24%）, gallbladder（5.47%）, pancreas（2.85%）, lung（0.86%）, prostate（6.61%）, bladder（1.18%）, kidney（5.26%）, brain and nervous system（5.09%）, Hodgkin lymphoma（2.88%） and multiple myeloma（3.72%）. Rates were declined for cancers of oesophagus （-4.36%）,stomach（-1.33%）, liver（-0.89%）, larynx（0.38%） and cervix（-8.52%） among elderly women. But the increasing cancers were colon （4.76%）, rectum （1.86%）, gallbladder （5.57%）, pancreas （3.06%）, breast （2.12%）, corpus uteri （4.41%）, ovary（1.94%）, kidney （4.44%）, brain and nervous system（8.07%）,Hodgkin lymphoma（4.57%） and multiple myeloma （4.37%）among elderly women. The trend changes of above cancers were statistically significant （P〈0.05 or P〈0.01）, but no changes for the not mentioned cancer sites. Conclusions From 1973 to 1999, the overall incidence rates in the elderly are stable, however trends for some commonly seen cancers vary substantially. Further epidemiological research in Shanghai is needed to identify risk factors influencing the cancer incidence trends.