2002-2012年上海市杨浦区社区人群膀胱癌的发病和生存情况分析

Incidence and survival analysis of bladder cancer patients among permanent residents in Yangpu district of Shanghai during 2002-2012

目的阐明2002年1月至2012年12月间上海市杨浦区户籍人群膀胱癌的发病率和死亡率。方法系统整理上海市肿瘤登记报告系统中的杨浦区户籍人群膀胱癌发病和死亡资料,应用年均变化百分比(APC)模型分析患者发病率和死亡率的时间变化趋势,应用Kaplan-Meier模型结合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年间膀胱癌新发患者1 252例,占同期全区新发恶性肿瘤的2.69%。膀胱癌年均粗发病率为10.51/105,其中男性为15.59/105,显著高于女性(5.18/105,P<0.01);标化发病率为4.83/105,其中男性标化发病率为7.26/105,高于女性(2.32/105,P<0.01)。2002-2012年间膀胱癌粗发病率明显上升(APC=4.14,P<0.01),但标化发病率无明显变化。50岁以后膀胱癌发病率迅速增加。因膀胱癌死亡690例。年均粗死亡率男性为8.61/105,女性为2.84/105(P<0.01);标化死亡率男性为3.64/105,女性为1.15/105(P<0.01)。2002-2012年间膀胱癌粗死亡率明显上升,标化死亡率未见明显改变。新发膀胱癌患者的5年生存率为63.15%,其中手术治疗组5年生存率为74.31%,高于非手术组(51.80%,P<0.01)。结论 2002-2012年间杨浦区户籍人群膀胱癌粗发病率和死亡率有明显的上升。手术治疗能显著提高患者生存期,提高膀胱癌早期诊断率和及时手术切除率有望提高患者整体生存。

Objective To analyze the incidence and mortality of bladder cancer patients among permanent residents in Yangpu district of Shanghai from January 2002 to December 2012. Methods The data of bladder cancer patients among the permanent residents of Yangpu district were obtained from the database of cancer registration and management system in Shanghai. The temporal trend in the incidence and mortality of bladder cancer was assessed using annual percent change （APC） model. Kaplan-Meier analysis with log-rank test was performed for survival analysis. The incidence and mortality were standardized with age composition of standard population from a nationwide census carried out in 2000. Results A total of 1 252 cases with bladder cancer were newly diagnosed between 2002 and 2012 in Yangpu district, and it accounted for 2. 69% of the total patients with malignant diseases. The annual crude incidence of bladder cancer was 10.51/10^5 , with that of malesbeing significantly higher than that of females （15.59/10^5 vs 5.18/10^5 , P〈0. 01）. The standardized incidence was 4.83/10^5 , with that of males being also significantly higher than that of females （7.26/10^5 vs 2.32/10^5 , P〈0.01）. The crude incidence of bladder cancer showed a significant increase （APC= 4.14, P〈0.01） from 2002 to 2012 ; however, the standardized incidence showed no significant increase. The incidence increased rapidly after 50 years old. A total of 690 cases died of bladder cancer during the study period. The annual crude mortality of bladder cancer was 8.61/10^5 in males, which was significantly higher than that in females （2.84/10^5 , P〈0.01）. The standardized martality was 3.64/10^5 in males and 1.15/10^5 in females （P〈0. 01）. The crude mortality of bladder cancer were increased significantly and the standardized oae did not alter significantly during this period. The 5-year survival rate of the newly diagnosed bladder cancer patients was 63.15%, with that of surgically treated ones being significantly higher that of non-surgically treated ones （74.31% vs 51.80%, P〈0. 01）. Conclusion The crude incidence and mortality of bladder cancer are greatly increased during 2002-2012. Surgical treatment can significantly prolong the survival of bladder cancer patients. Early diagnosis and prompt surgical resection can improve the overall survival of bladder cancer patients.