上海市区1973年至2007年结肠直肠癌的发病趋势

Trend in colorectal cancer incidence in Shanghai urban area, 1973-2007

目的：按照性别、年龄段和发病部位,分析1973年至2007年上海市区结肠直肠癌的发病趋势。方法：数据来源于上海市肿瘤登记报告系统。按照世界标准人口计算结肠直肠癌年龄标化发病率,使用Joinpoint回归模型计算年度变化百分比（annual percentage change,APC）。结果：直肠癌是最常见的结肠直肠癌亚部位,但直肠癌的构成比从1973年至1977年的66.5%,下降至2003年至2007年的44.4%。远端结肠癌标化发病率的APC最高（男性为5.3%,女性为4.9%）,其次是近端结肠癌（男性为4.1%,女性为4.2%）,直肠癌的APC最低（男性为1.5%,女性为1.1%）。女性远端结肠癌和直肠癌发病率在30~39岁年龄段出现了显著下降的趋势（APC分别为-3.8%和-2.8%）,男性直肠癌发病率在30~39岁年龄段也出现了显著下降趋势（APC为-1.9%）。结论：1973年至2007年上海市区结肠直肠癌发病总体呈现上升趋势,其中结肠癌发病上升更为显著,而乙状结肠癌和升结肠癌发病增加是结肠癌构成比上升的最主要因素。在低年龄段人群中,开始出现男性直肠癌、女性直肠癌和远端结肠癌发病下降的趋势。

Objective： To demonstrate changing trends in colorectal cancer incidence in accordance with sex, age group, and anatomical location in Shanghai urban area from 1973 to 2007. Methods： Data from Shanghai Cancer Registry were analyzed. Age standardized incidence was calculated according to world standard population. Annual percentage changes（APC） were calculated by the Joinpoint regression model. Results： Rectum was the most common site of cancer among colorectal cancer. But the proportion of rectal cancer decreased from 66.5% in 1973-1977 to 44.4% in 2003-2007.However, the distal colon had the highest APC（5.3% among men and 4.9% among women）, followed by the proximal colon（4.1% among men and 4.2% among women）; APC was the lowest in rectum（1.5% among men and 1.1% among women）. The APC of distal colon and rectum decreased in age 30-39 women（APC,-3.8% and-2.8%）, and the APC of rectum decreased in age 30-39 men（APC,-1.9%）. Conclusions： The age-standardized incidence rate of colorectal cancer is increasing in Shanghai urban area, 1973-2007. The rapid increase in colorectal cancer incidence is mainly attributed to the increase in colon cancer, especially sigmoid cancer and ascending colon cancer. Among younger age group, the incidence of rectum cancer among men and the incidence of rectum and distal colon cancer among women show a decreasing trend.