河南省林州市人群胃癌的现时生存分析

Period survival analysis of stomach cancer in the population of Linzhou City, Henan Province

目的:分析1988—2004年河南省林州市人群胃癌的生存率及不同时期的变化,评估当地胃癌二级预防及临床诊治的水平。方法:从林州市肿瘤登记处提取1988—2004年全部的胃癌发病和死亡个案记录,剔除重复和仅有死亡证明书(death certificate only,DCO)的病例。计算该地区的去肿瘤死因寿命表,并与胃癌发病死亡数据相链接。采用现时生存分析(period survival analysis)方法计算1990—1994年、1995—1999年和2000—2004年这3个时期的胃癌5年观察生存率和相对生存率,并绘制相对生存曲线。结果:林州市3个时期的胃癌5年相对生存率分别为26.66%、32.01%和40.43%,呈逐年上升趋势。男性患者的生存率要高于女性。前2个时期的贲门癌生存率要高于非贲门胃癌,而在2000—2004年则低于非贲门胃癌。结论:林州市人群胃癌生存率自20世纪90年代起逐渐提高,反映了当地胃癌二级预防及临床诊疗水平的不断提高。

Objective： To analyze the survival rate of stomach cancer patients and its variation during different periods in Linzhou city, Henan Province, from, 1988 to 2004, and evaluate the level of secondary prevention and diagnosis of stomach cancer in this area. Methods： All of the incidence and death records of stomach cancer from 1988 to 2004 were collected and matched from Linzhou Cancer Registry. The records that were identified as duplicate cases or had only death certificate （DCO） were excluded. The tumor cause eliminated life tables in this area were calculated and linked to the data of incidence and death of stomach cancer. Five-year observed survival rates and five-year relative survival rates in three periods（1990-1994, 1995-1999, and 2000-2004） were calculated using period survival analysis mehod. The relative survival curves in the three periods were plotted. Results：The 5-year relative survival rate of stomach cancer was 26.66% during 1990-1994, 32.01% during 1995-1999, and 40.43% during 2000-2004 in Linzhou city. It showed a gradually increasing trend. The 5-year survival rates were higher in males than those in females. During 1990-1994 and 1995-1999, the 5-year survival rates of gastric eardia cancer were higher than those of uon-eardia cancer. During 2000-2004 period, the 5-year survival rate of gastric cardia cancer was lower than that of non-cardia cancer. Conclusion： The survival rates of stomach cancer in Linzhou city are increasing gradually since 1990s in 20 century. It indicates that the levels of secondary prevention and clinical diagnosis and treatment on stomach cancer kept increasing in this area.