上海市崇明县1998—2013年女性乳腺癌发病率和死亡率趋势分析

Analysis on the trend for the morbidity and mortality of female breast cancer in Chongming County of Shanghai from 1998 to 2013

目的分析崇明县乳腺癌发病率和死亡率的长期变化趋势。方法利用1998—2013年崇明县户籍居民的肿瘤监测资料,运用年度变化百分比(annual percent change,APC)对崇明女性乳腺癌的发病率和死亡率的时间趋势进行分析。结果乳腺癌位居崇明县女性恶性肿瘤发病首位,1998—2013年女性乳腺癌的粗发病率为36.11/10万,标化发病率为20.69/10万;粗死亡率为11.66/10万,标化死亡率为5.77/10万。发病率持续上升,而死亡率在近10年不仅不再上升,并且呈现显著性下降趋势。55~59岁组发病率最高,85岁及以上组死亡率最高。55岁以下组标化发病率呈现显著增长趋势,而死亡率变化无统计学意义;55岁以上组标化发病率自2002年开始由原先的显著性上升转为稳定,标化死亡率在2003年后不再上升。结论崇明县女性乳腺癌发病率和死亡率相对较低,发病率上升趋势明显。随着诊疗技术提高,标化死亡率出现下降趋势。由于人口老龄化加剧,粗发病率在未来还将增高,乳腺癌将在较长时间内威胁崇明县女性健康和生命。

Objective To analyze the long-term variation trend for the morbidity and mortality of female breast cancer in Chongming County. Methods Based on the cancer registration data for the permanent residents in Chongming County from 1998 to 2013, the annual percent change （APC） model was adopted to analyze the time trends of the morbidity and mortality of female breast cancer. Results Breast cancer was the most common female cancer in Chongming County. From 1998 to 2013, the crude morbidity of female breast cancer there was 36.11/105, the standardized morbidity thereof was 20. 69/105 ; the crude mortality thereof was 11.66/105 , the standardized mortality thereof was 5.77/10s. Although the morbidity of female breast cancer continued to rise in recent 10 years, the mortality rate thereof no longer increased, and showed a significantly downward trend instead. Among all the patients thereof in Chong- ruing County, the age group with the highest morbidity rate was 55-59 age group; the age group with the highest mortality rate was in the age group above 85. The standardized morbidity rate thereof for the age group below 55 showed a significantly upward trend while standardized mortality rate thereof for the same age group had no significant difference. Starting from 2002, the standardized morbidity rate thereof for the age group above 55 turned from a significantly upward trend into a stable trend; the standardized mortality rate thereof for the same age group no longer rose after 2003. Conclusion Although both the morbidity and mortality of female breast cancer are low in Chongming, the morbidity thereof takes on a significantly upward trend. With the improvement of the diagnosis technologies thereof, the standardized mortality there- of showed a downward trend. Owing to the aggravation for the aging of the population, the crude incidence thereof will increase in future, and the female breast cancer will continue to threaten the health and life of women in Chongming County.