大连市区1991-2005年食管癌流行趋势分析

Epidemic trend of esophageal cancer incidence from 1991 to 2005 in Dalian City

目的:分析大连市区1991-2005年食管癌流行趋势,为制定防治策略提供依据。方法:利用食管癌新发病例资料,计算粗发病率、世界人口调整发病率、截缩率、累积率、年度变化百分比(APC),拟合性别、年龄、时期、队列等因素,筛选有显著性的因素效应,进行年龄、时期、队列三因素相互调整后的RR和95%CI的估计。结果:流行趋势概况:男女性粗发病率分别为10.7/10万和1.9/10万,世界人口调整发病率分别为8.8/10万和1.3/10万,35～64岁调整截缩率分别为16.41/10万和2.42/10万。0～74岁累积率分别为1.06%和0.16%,0～64岁累积率为0.44%和0.11%。时间趋势分析:男女性粗发病率的APC分别为+1.92%(P<0.05)和-3.83%(P<0.05),调整发病率的APC分别为-1.39%(P>0.05)和-6.29%,P<0.05。流行趋势分析显示,男女性的发病风险分别在40岁和45岁以后随年龄增加而增加,P<0.001。男女性1921年以后出生队列的发病风险逐年降低(P<0.01),同一队列的发病风险均为女性低于男性。男性时期发病风险变化不大(P>0.05),女性2001-2005年的发病风险明显低于1991-1995年,P<0.01。结论:1991-2005年大连市区女性食管癌的发病率呈下降趋势,男性粗发病率呈上升趋势,应加强以男性为重点的食管癌防治工作。

OBJECTIVE： To analyse the secular trend of esophageal cancer （EC） incidence 1991-2005 in Dalian and to provide scientific basis for prevention and control. METHODS= The EC registration data collected during the period of 1991- 2005 were used to calculate the crude rate（CR）, world age-standardized rate（WASR ）, truncated rate （TR）, cumulative rates （CR）, annual percent change（APC）. To fit and filtrate the dominant factors from sex, age, period/age, cohort/age, after ad- justment for age, period, cohort, relative risk （RR） and 95 % confidence interval were estimated. RESULTS： Outline of preva- lent trend： The CRs were 10.7 per 100 000 for males and l. 9 per 100 000 for females, and the WASRs were 8.8 per 100 000 for males and 1.3 per 100 000 for females, The TRs of those aged 35-64 were 16.41 per 100 000 for males and 2.42 per 100 000 for females. The CRs of aged 0--74 were 1.06%and 0. 16%, the CRs of aged 0-64 were 0.44% and 0.11%. Analysis of time trend： The APCs of CRs were＋1.92%/0（P〈0.05） for males and -3.83% （P〈0.05） for females, and the APCs of WASRs were -1.39 % （P〉0.05） for males and -6.29 % （P〉0.05） for females. Secular trend：Above 40 y for males and 45 y for females, the risk of EC increased constantly（P〈0.001 ）. For those cohorts who born after 1921, the risk of EC decreased gradually（P〈0.01）. In the same cohort, females had fewer risk than males. As the risk for period, there were not significant difference in each group for males（P〉0.05） ; but for females, the EC risk of the group of 2001-2005 was obviously below than that of 1991-1995（P〈0.01）. CONCLUSION： In the last 15 years, the trend of the incidence rate of EC had been decreasing for fe- males but increasing of CRs for males, suggesting more attention should be paid to the males.