上海市肺癌的流行现况和时间趋势

Incidences and time trends of lung cancer in Shanghai during the last 33 years

目的:对上海市肺癌发病现状的流行病学描述,以掌握肺癌的流行特征,评价控制吸烟等措施的效果。方法:利用上海市肿瘤登记报告和随访管理系统收集肺癌患者的发病资料,对2002～2004年上海全市肺癌发病情况在性别、年龄、地区、病理学类型等分布进行描述,利用年度变化百分比对上海市中心区1972～2004年男女肺癌发病的时间趋势进行分析。结果:2002～2004年,上海全市共新诊断肺癌23196例,总发病率为57.85/10万,总的新发病例中男性占71.02%。肺癌是上海市男性发病率第1位、女性第2位的恶性肿瘤。周边城区男性肺癌的粗发病率和标化发病率均高于市中心区。69.05%的病例集中在65岁以上年龄组,中年组男女(45～64岁)发病率最高。33年来市中心区男性标化发病率有下降趋势,女性无变化。结论:上海市肺癌发病居于世界高发地区;上海市肺癌的发病特点提示上海肺癌高发与人口老龄化有密切关系;采取有效手段控制吸烟有助于控制上海肺癌的高发态势。

Objective To describe the patterns and trends of lung cancer incidence in Shanghai, and to provide the evidence for evaluating the preventive measures. Methods The lung cancer cases were collected by Shanghai cancer registry system. The distribution of lung cancer incidence was described according to gender, age, district and histological types. The time trends of the male and female incidence in the urban population from 1972 to 2004 were assessed using APC analysis. Results Totally 23 196 new cases of lung cancer were diagnosed in 2002-2004 with the average incidence rate of 57.85/100 000, among which male cases accounted for 71.02%. Lung cancer was the first commonly seen cancer in the male and the second in the female. The male crude incidence rate and the age-adjusted rate in the rural population were higher than those in the urban population. About 69.05% of the cases were over 65 years old. The highest incidence was observed in the middle-age group （age 45-64） for both the male and the female. The age-adjusted incidence rate in the male had the trend of decrease in the urban area, but no changes in the female during the past 33 years.Conclusions Shanghai is one of the high-incidence area of lung cancer in the world. The pattern of lung cancer incidence in Shanghai suggests a strong relationship between the high prevalence of lung cancer and the age. Effective measures of tobacco control must be taken for controlling the high incidence.