福建省仙游县2011-2012年胃癌死亡及生存状况分析

Analysis on death and survival of patients with gastic cancer in Xianyou county of Fujian in 2011-2012

目的了解仙游县胃癌死亡特征、变化趋势及生存状况。方法分析2011-2012年仙游县18个乡镇的全死因回顾调查中胃癌死亡数据及生存数据,按2000年全国人口普查的标准人口构成对死亡率进行标化。结果仙游县2011-2012年仙游恶性肿瘤粗死亡率为177.93/10万,占死亡总数33.57%,其中胃癌死亡数合计1 176例,占恶性肿瘤死亡的30.43%,是仙游县首位恶性肿瘤。胃癌粗死亡率54.14/10万,标化死亡率49.47/10万,男性高于女性(2.44∶1),胃癌死亡率基本随年龄增长而上升。与1973-1975年仙游县胃癌死亡数据相比,仙游县胃癌粗死亡率(54.14/10万)上升65.11%,而标化死亡率(29.36/10万)下降22.55%。与福建省相比,胃癌死亡率高于2010年福建省监测点(23.38/10万)。不同乡镇间胃癌死亡率差异明显,最高的为西苑乡(69.58/10万)是最低枫亭镇(19.56/10万)的3.56倍,且呈现出从西北到东南随海拔降低胃癌死亡率逐渐降低的现象。仙游县居民胃癌总的减寿年数为11 022.5年,占全死因减寿年数的20.27%,为首位减寿死因。胃癌患者1、3、5年生存率分别为0.46、0.10、0.05,平均生存时间及中位生存时间为657d、365d,经手术治疗比未经手术治疗能增加胃癌患者的生存时间。结论仙游县仍属于胃癌高发区,40年来仙游县胃癌粗死亡率呈上升趋势,标化死亡率呈下降趋势。仙游县胃癌分布呈现较明显地区差异。仙游县胃癌患者生存时间普遍较低,提高高危人群的"三早"率和胃癌患者生存时间以及肿瘤防治是目前工作重点。

Objective To discuss the death and survival of patients with stomach cancer in Xianyou county of Fujian. Methods Death and survival data of patients with gastric cancer from 18 towns were analyzed,and the mortality rate was standardized by national population in 2000. Results The crude mortality rate of all malignant tumors was 177.93 per 100 000 population,accounting for 33.57% of the total number of deaths,and the number of deaths from gastric cancer was 1 176,which contributed to 30.43% of all deaths from malignant tumors.The crude and standardized mortality rates of gastric cancer were 54.14 and 49.47 per 100 000 population,which increased by 65.11% for crude death rate and decreased by 22.55% for standardized rate compared with those from 1973 to 1975.Male patients were 2.44 times more likely to die from gastric cancer than females.The mortality rate varied among patients from different counties with the highest in Xiyuan and the lowest in Fengting,which was 3.56 times higher.The total years of life lost（YLL）of patients with stomach cancer were 11 022.5years,accounting for 20.27% of total YLL and it was the number one cause of YLL.The one-year,three-year,five-year survival rates of patients with gastric cancer were 0.46,0.10,0.05,respectively,the average and median survival time were 657 and 365days,and patients could survive longer after surgery. Conclusions The incidence of gastric cancer is still high in Xianyou and the crude mortality rate keeps climbing up while the standardized one keeps sliding down in recent 40 years.The survival time of patients with stomach cancer is relatively short.Early diagnosis and treatment are critical to decrease the mortality rate of gastric cancer patients.