大连市区1991-2010年肺癌流行趋势分析

Epidemic trend of lung cancer incidence from 1991 to 2010 in Dalian City

目的分析大连市区1991-2010年肺癌流行趋势,为该区人群防治措施的制定提供依据。方法利用肺癌新发病例资料,分析组织学类型,计算粗发病率、世界人口调整发病率、截缩率、累积率和年度变化百分比（APC%）,拟合性别、年龄、时期和队列等因素,筛选有显著性的因素效应,进行年龄、时期和队列三因素相互调整后的RR和95%CI的估计。结果流行概况,男女性粗发病率分别为74.7/10万和41.5/10万,世界人口调整发病率分别为55.3/10万和27.7/10万,35~64岁调整截缩率分别为115.55/10万和63.13/10万。0~74岁累积率分别为6.75%和3.37%,0~64岁累积率为2.43%和1.34%。时间趋势分析,男女性粗发病率的APC分别为＋3.98%（P〈0.001）和＋5.44%（P〈0.001）,调整发病率的APC分别为＋0.50%（P〉0.05）和＋2.02%（P〈0.001）。流行趋势分析显示,男女性2001-2005年和2006-2010年两时期发病风险呈上升趋势,P〈0.001;1941年以后出生队列发病风险呈下降趋势,P〈0.05;≥35岁发病风险呈增加趋势,P〈0.001。男性年龄发病风险均高于女性,女性队列与时期发病风险高于男性。结论人口老龄化与男女性肺癌粗发病率的上升趋势密切相关,女性世调率的上升趋势提示可能存在女性肺癌特定危险因素的作用。

OBJECTIVE To analyse the lung trend of bladder cancer（LC） in Dalian and to provide basal informa- tions of epidemiological study. METHODS The EC regiatration data collected during the period of 1991--2010 were used to analyze the histological type and 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 adjustment for age, period, cohort, relative risk（RR） and 95% confidence interval were estimated. RESULTS Outline of prevalent trend：The CRs were 74.7 per 100 000 for males and 41.5 per 100 000 for females,and the WASRs were 55.3 per 100 000 for males and 27. 7 per 100 000 for females. The TRs of those aged 35-- 64 were 115.55 per 100 000 for males and 63.13 per 100 000 for females. The TRs of aged 0--74 were 6.75 per 100 000 for males and 3.37 per 100 000 for females. The TRs of aged 0--64 were 2.43 per 100 000 for males and 1.34 per 100 000 for fe- males. Analysis of time trend：The APCs of CRs were ＋3.98% （P〈0. 001） for males and ＋5.44%（P〈0. 001） for fe- males,and the APCs of WASRs were ＋0. 50% （P〉0.05） for males and ＋2. 02% （P〈0. 001） for females. Secular trend：For males and females,the risk of LC increased constantly above 35 y（P〈0. 001）,the group of 2001--2005 and 2006--2010 were obviously increased（P〈0. 001） ,for those cohorts who born after 1941 ,the risk of LC decreased gradu- ally（P〈0.05）. The age risk of LC for males was higher than females,the group and cohorts risks for females were higher than males. CONCLUSIONS For males and females,the rising LC of CRs were closely related with the ageing of popula tion. The rising LC of WASRs for females pointed out there may be the effect of specific risk factors.