中国胰腺癌发病趋势分析和预测

Trend and prediction on the incidence of pancreatic cancer in China

目的利用中国肿瘤登记地区1998--2007年胰腺癌发病登记数据分析胰腺癌发病趋势，并预测2008--2015年中国胰腺癌的发病情况。方法计算各年份胰腺癌的粗发病率，直接法计算中国人口标准化率，采用JoinPoint软件对中国肿瘤登记地区1998--2007年胰腺癌发病数据进行趋势分析，计算年度平均变化率。应用贝叶斯年龄-时期-队列模型对数据进行拟合，估计年龄、时期、队列参数效应并预测2008--2015年全国胰腺癌发病情况。结果1998--2007年城市男性粗发病率每年以1．86％的比例上升，中国人口标准化率上升趋势不明显；女性粗发病率每年上升2．1％，中国人口标准化率上升趋势不明显。农村男性粗发病率每年上升7．54％，中国人口标准化率每年上升4．82％；女性分别上升7．83％和5．48％。预测模型显示年龄效应、时期效应和队列效应均在胰腺癌发病中起重要作用。估计2015年新发胰腺癌103428例，其中男性60500例，女性42928例，较2008年增加15277例。结论中国胰腺癌发病率呈上升趋势，其中农村地区上升明显，城市地区上升速度略缓，到2015年总体上升趋势有所减缓，但短期内胰腺癌仍然是主要癌症。

Objective To analyze and predict the incidence trends and burden of pancreatic cancer from 2008 to 2015. Methods Registration data on pancreatic cancer of cancer registration in 1998-2007, were retrieved and utilized for analyzing the annual incidence of pancreatic cancer. Age-standardized rate by Chinese population （ASR） was calculated, using the direct method. JoinPoint software was applied for trend analysis. Bayesian Age-Period-Cohort Modeling Prediction Package was used to estimate age, period and cohort effects as well as to predict the incidence rates. Results From 1998 to 2007, the annual incidence for men and women in urban areas showed an increase of 1.86% and 2.1% per year, but the increasing trend on the age-standardized rate was not obvious in both men and women. However, the incidence rates for men and women in rural areas increased by 7.54% and 7.83% and the age-standardized rates increased by 4.82% and 5.48% per year. Results from the projection model showed that the trends were mainly caused by age, period and cohort effects. Based on the analysis, up to 2015, the annual new cases of pancreatic cancer would be 103 428 （60 500 for males and 42 928 for females） , with 15 277 cases more than that of 2008. Conclusion There appeared an increasing trend of pancreatic cancer incidence which was more significant in the rural areas than the slowly increasing trend in the urban areas. The increasing trend of pancreatic cancer would be slow until the year 2015. However, in the short term pancreatic cancer is still a major cancer.