江苏省昆山市2006-2013年宫颈癌发病趋势分析

Temporal trend analysis of cervical cancer incidence during 2006-2013 in Kunshan,Jiangsu Province

目的江苏省昆山市宫颈癌发病情况目前尚未开展研究。本研究分析昆山市宫颈癌发病率和时间趋势，为宫颈癌防治提供流行病学依据。方法收集昆山市2006～2013年肿瘤登记报告的宫颈癌病例资料，计算粗发病率，并使用中国2000年标准人口计算年龄标化发病率（age standardized rate，ASR）；使用Join-point回归计算年度变化百分比（annual percentage change，APC），评价宫颈癌发病率等在年份之间的时间趋势。采用灰色模型（grey model，GM）预测未来年份宫颈癌发病率。结果昆山市宫颈癌粗发病率由2006年的6．34／10万上升到2013年的16．84／10万，APC-13．1％，95％CI为7．8％～18．4％。宫颈癌年龄标化发病率由2006年的4．99／10／万上升到2013年的12．30／10万，APC=12．5％，95％CI为6．9％～18．2％。累积发病率（0～74岁）由2006年的0．43%上升到2013年的1．10％，APC-11．8％，95％CI为6.7％～16．9％。25～45岁是宫颈癌的高发年龄。灰色模型预测结果显示，2014—2016年宫颈癌粗发病率分别为17．94／10万、18．40／10万和18．87／10万，呈现上升趋势。结论昆山市宫颈癌发病呈现持续上升趋势，需要加强相关防治措施，特别是25～45岁的妇女。

OBJECTIVE Little is known about the cervical cancer incidence rate in Kunshan, Jiangsu province. This paper aimed at estimating the incidence rate and time trend of cervical cancer in Kunshan city. METHODS Cervical cancer cases were obtained from Kunshan cancer registry from 2006 to 2013, crude incidence and age-standardized rate were calculated according to the 2000 Chinese standard population and expressed per 100 000 persons. Join-point regression analysis was performed to obtain annual percentage changes （APC） so as to estimate the trend of incidence rates over the year from 2006 to 2013. Grey model was used to forecast future incidence of cervical cancer. RESULTS Crude incidence was 6.34 per 100 000 in 2006 and 16.84 per 100 000 in 2013 with an annual rate of increase of 13.1% （APC=13.1%, 95%CI： 7.8%- 18.4%）. while ASR by Chinese standard population was 4.99 per 100 000 in 2006 and 12. 30 per 100 000 in 2013 （APC= 12.5 %, 95 % CI： 6.9 %- 18.2 % ）. The cumulative incidence rate increased from 0.43 % in 2006 to 1.10% in 2013（APC= 11.8% , 95% CI：6.7%-16.9%）. Significant increase was observed in the age of 25 to 45 years old. Grey model prediction demonstrated that the cervical cancer incidence increasing in the following years, crude incidence rate in the year 2014 to 2016 were 17.94 per 100 000, 18.40 per 100 000, and 18.87 per 100 000, respectively. CONCLUSIONS The cervical cancer incidence increased significantly in Kunshan city, Jiangsu province. More policy attention is needed to strengthen established control and prevention to reduce cervical cancer, especially in those women aged between 25 and 45 years old.