河北省磁县近三十年食管癌发病死亡趋势分析

Study on the esophageal cancer incidence and mortality rate from 1974-2002 in Cixian,China

目的分析河北省磁县1974-2002年食管癌发病、死亡趋势。方法食管癌发病资料取自磁县肿瘤登记处,全部资料录入计算机,采用SPSS11.5软件进行统计分析。结果磁县1974-2002年食管癌新发病例18471例,年平均发病率为118.2/10万,其中男性11068例,女性7403例。男女性年平均发病率分别为140.13/10万和95.66/10万。29年来食管癌发病率总体有下降的趋势。从25岁组开始,各年龄组发病率均随时间推移有所降低,低年龄组发病下降较为明显,发病年龄逐渐后移。1974-2002年山区共发生食管癌2511例,年平均发病率为104.57/10万。经过近30年的防治,山区食管癌发病率明显下降。丘陵地区共发生5934例,年平均发病率114.17/10万,丘陵地区食管癌发病率也有下降。平原地区共发生食管癌10026例,年平均发病率124.73/10万,平原地区食管癌发病率基本稳定,近年来略有上升趋势。磁县1969-2002年,全县34年共死亡食管癌患者18736例,年平均死亡率106.00/10万,其中男性11598例,女性7138例,年平均死亡率分别为129.91/10万、81.61/10万。2002年较1969年食管癌死亡率下降53.48/10万,下降了37.96%。各年代食管癌死亡占恶性肿瘤总死亡的百分比明显下降。结论1974-2002年磁县食管癌发病呈现下降趋势,发病年龄逐渐后移。山区下降尤为显著,丘陵地区下降幅度较小,平原地区发病基本稳定,近年来略有上升趋势。1969-2002年磁县食管癌死亡有明显的下降。

Objective To describe the incidence and mortality rates of esophageal cancer from 1974-2002 in Cixian county of Hebei province. Basic information on comparative geographical, epidemiological,and clinical research was collected. Methods In early 1970s, cancer registry system in Cixian was established, collecting information on all the esophageal cancer cases in Cixian. Data was checked manually, then computerized, coded and analyzed using the software -- SPSS 11.5. Results From 1974 to 2002,there were 18 471 esophageal cancer cases in Cixian, with 11 068 males and 7403 females, respectively. The age standardized incidence rate（ASR） for males was 208.77 per 100 000, while 120.47 per 100 000 for females. The trend of incidence rate of esophageal cancer had decreased during the 29 years from 1974 to 2002（trend X^2 = 19.94,P〈0.001）. From 25 years of age onward,the incidence rates of the lower age groups declined with the increase of age. As for geographic distribution, the incidence rate in mountainous areas and hilly areas showed a significan declining trend in mountainous areas, X2 = 195.00, P〈0.001; hilly areas,x2= 46.08, P〈 0.001. The esophageal cancer incidence in plain areas remained steady,but had a slight increase in recent years. From 1969 to 2002, there were 18 736 cases died of esophageal cancer with 11 598 males and 7138 females. The ASR for male was 127.17 per 100 000 and 101.57 per 100 000 for female. Compared with the year 1969, the mortality rate of esophageal cancer in 2002 had a 37.96% decline. The proportion of esophageal cancer among malignant tumors in different decades decreased significantly. Conclusion The trend of the incidence rate of esophageal cancer had been decreasing for the last 29 years. The incidence rate in mountainous areas and hilly areas showed a declining trend while in the plain areas it remained steady but having slight increase in the recent years. The mortality rate of esophageal cancer had a significant decrease from 1969 to 2002.