2002-2012年上海市杨浦区社区人群肾细胞癌发病和生存情况分析

Incidence and survival analysis of renal cell carcinoma patients among permanent residents in Yangpu district of Shanghai during 2002-2012

目的阐明上海市杨浦区2002-2012年间肾细胞癌(renal cell carcinoma,RCC)发病率和死亡率。方法整理上海市肿瘤登记报告系统中的杨浦区户籍人群RCC病例资料,应用年均变化百分比(APC)模型分析患者发病的时间趋势,应用Kaplan-Meier模型并结合Log-rank检验进行生存分析。采用2000年全国人口普查的标准人口年龄构成进行标化。结果 2002-2012年间RCC新发患者1 092例,占同期全区新发恶性肿瘤的2.34%。RCC年均粗发病率为9.16/105,标化发病率为5.12/105。男性发病率高于女性(粗发病率11.79/105 vs 6.41/105,P<0.01;标化发病率6.54/105 vs 3.61/105,P<0.01)。男性50岁,女性55岁以后RCC发病率迅速增加。2002-2012年间男性粗发病率逐年增长(APC=10.45),女性粗发病率也明显增长(APC=6.37)。因RCC死亡369例,年均粗死亡率为3.10/105,标化死亡率为1.33/105。40岁以上男性、55岁以上女性死亡率明显上升。男性5年生存率高于女性(71.80%vs 69.77%,P>0.01)。手术治疗组5年生存率高于非手术组(87.75%vs 53.69%,P<0.01)。结论年龄和性别是影响RCC发病率差异的主要因素,RCC死亡率低于发病率,手术治疗可有效提高RCC患者生存期。

Objective To investigate the incidence and mortality of renal cell carcinoma （RCC） patients among permanent residents in Yangpu district of Shanghai from 2002 to 2012. Methods The data of RCC patients among permanent residents of Yangpu district were collected from the database of cancer registration and management system in Shanghai. The temporal trend of RCC incidence was analyzed by using annual percent change （APC） model. Kaplan-Meier analysis with log-rank test was employed for survival analysis. The incidence and mortality were standardized with the age structure of standard population from a nationwide census taken in 2000. Results A total of 1 092 RCC cases were newly diagnosed from 2002 to 2012 in Yangpu district, and the number accounted for 2. 34% of total cases diagnosed with malignant diseases. The annual crude incidence of RCC was 9. 16/10^5 and the standardized one was 5. 12/10^5 in our study, with the incidence of RCC being significantly higher in males than in females （crude incidence： 11.79/10^5 vs 6.41/10^5 , P〈0.01; standardized incidence; 6.54/ 10^5 vs 3.61/10^5 , P〈0. 011. The incidence of RCC was significantly increased in males elder than 40 years and in females elderthan 55 years. The crude incidences of RCC were annually increased in males （APC= 10.45） and in females （APC= 6.37） from 2002 to 2012. A total of 369 cases died of RCC during this period, with an annual crude mortality of 3.10/10s and a standardized one of 1. 33/10^5. The 5-year survival rate of RCC patients was higher in males than in females （71. 80%vs 69. 77%, P〉0.01）. The 5-year survival rate of patients receiving surgical treatments was significantly higher than that of patients receiving no surgical treatments （87.75% vs 53. 69%, P〈0.01）. Conclusion Age and gender are the main factors influencing the incidence of RCC in Yangpu district of Shanghai. The mortality of RCC is apparently lower than the incidence of RCC. Surgical treatment can effectively prolong the survival of RCC patients.