北京城区女性乳腺癌发病死亡和生存情况20年监测分析

Analysis of the incidence and survival of female breast cancer in Beijing during the last 20 years

目的探讨北京城区乳腺癌发病率、死亡率及生存率的变化特点,为乳腺癌的预防与控制提供依据。方法利用1982—2001年北京城区肿瘤登记报告资料,并结合1982年1月1日至1983年12月30日和1987年1月1日至1988年12月30日两个时期新发病例的随访资料,对北京城区女性乳腺癌的发病率、死亡率、生存率进行比较分析。结果1982—2001年北京城区女性乳腺癌发病率及世界标准人口标化率呈逐年上升趋势,平均每年递增4.6%和4.9%。其流行特征:(1)年龄别发病率呈现一条由低到高的双峰曲线;(2)20年间各年龄组发病率均呈增高趋势;(3)35～64岁截缩发病率高达95.3/10万;(4)1982—1983年和1987—1988年两个时期相比,5年观察生存率(OSR)从62.0%上升到68.7%,相对生存率(RSR)由66.3%增长到74.2%;(5)20年间,死亡率一直在8/10万～10/10万的水平上波动。结论北京城区女性乳腺癌发病率呈逐年上升的流行趋势,死亡率呈平稳状态,5年生存率在不断提高。北京市乳腺癌的二级预防是有效果的。

Objective To provide scientific evidence for breast cancer prevention and control through epidemiological analysis of the incidence, mortality and survival rate of female breast cancer in Beijing. Methods The registration data of females in Beijing urban area from 1982 to 2001 were retrospectively reviewed. The incidence, mortality and survival rate of female breast cancer were analyzed using routine and life table statistical methods. Results There was a trend of annual increase by an average of 4.6% and 4.9% in the Beijing urban incidence and world population standardized incidence of female breast cancer during the period of 1982 to 2001. The epidemiological features of Beijing urban female breast cancer showed： （ 1 ） The incidence curve of different age groups from 25 to 80 years elevated with two peaks at age of ≥45 and ≥70 years; （2）There was an elevation in each age group during the last 20 years; （3） The interception rate at age of 35 to 64 reached 95.3/100 000 population, which made the breast cancer become the number one cancer in female. The changes of survival rate showed： the 5-year observed survival rate（OSR） increased from 62.0% in 1982-1983 to 68.7% in 1987-1988, the relative survival rate （RSR） increasetd from 66.3% to 74.2%. The OSR and RSR in 1987-1988 were 60.3% and 65.1% at 10 years, and 57.7% and 61.3% 15 years, respectively. The mortality rate of breast cancer fluctuated at 8 to 10 per 10^5 population during the last 20 years. Conclusion There is a trend of an annual increase in female breast cancer in Beijing. The 5-year survival is being improved gradually while the mortality rate remains stable. The results demonstrate that the ＂early prevention, early diagnosis and early treatment ＂ principles for breast cancer is effective in Beijing.