上海市胃癌发病流行现况与时间趋势分析

Pattern of changing incidence of gastric cancer and its time trend in Shanghai

目的:表述上海市胃癌的发病流行现况,分析胃癌的时间趋势,探寻病因学研究线索,为预防控制工作提供依据。方法:取材于上海市肿瘤登记报告和随访管理系统收集的胃癌发病资料,以及年度变化百分比对上海市市区1973～2004年男女胃癌发病的时间趋势进行分析。结果:2002～2004年,上海全市共新诊断胃癌16370例,总发病粗率为40.82/10万,发病标率为22.06/10万。胃癌是上海市男性发病第2位、女性第3位的恶性肿瘤。郊区男性胃癌发病粗率和发病标率均高于市区,郊区女性胃癌发病粗率低于市区而发病标率高于市区。62.79%的病例集中在65岁以上年龄组,80～84岁组发病率最高。1973～2004年,市区男性和女性的发病标率均呈下降趋势。结论:上海市胃癌发病仍居世界高发水平;上海市胃癌的发病特点提示,胃癌高发与人口老龄化有密切关系,而胃癌标化发病率下降则提示上海地区其他导致胃癌发生的危险因素正在逐年下降和(或)保护性因素正在增多,这些因素可能与社会经济、膳食营养和卫生条件的改善有关。

Objective To study the trend in the incidence of gastric cancer in Shanghai, in order to provide some helpful preventive measures. Methods The data from gastric cancer cases were collected by the Shanghai Cancer Registry Organization. The distribution of gastric cancer incidence was described according to gender,age, district and histologic typing. The trend of incidence in male and female in the urban population from 1973 to 2004 was assessed by using the APC analysis. Results A total of 16 370 new cases of gastric cancer were diagnosed during the 2002-2004 period with a crude incidence of 40.82 per 100 000 and an age-adjusted incidence of 22.06 per 100 000. Gastric cancer still held the second place among the common cancers in the male and the third place in the female in Shanghai. The male erode incidence rate and the age-adjusted rate in the rural population were higher than those in the urban population, the female erode incidence rate was lower and the age-adjusted rate was higher in the rural population than those in the urban population. 62.79% of the cases were over 65 years old. The highest incidence was observed in the 80-84 age group for both in the male and the female. The age-adjusted incidence rate in the male and the female had showed a decreasing trend in the urban area during the past 32 years. Conclusions Shanghai is still among the areas with the highest incidence of gastric cancer in the world. The pattern of its changing incidence suggests a strong relationship between the high prevalence of gastric cancer and aging. Beneficial effects of improved socioeconomic status, diet and nutrition, and amelioration of hygienic conditions might have contrbuted the down-regulation of the age-adjusted incidence rate.