河北省40年结直肠癌发病和死亡分析

Analysis of colorectal cancer incidence and mortality rates during the last 40 years in Hebei Province

背景与目的:结直肠癌是常见的消化道肿瘤之一,2012年全球约有136万结直肠癌新发病例,是世界第3高发恶性肿瘤,居恶性肿瘤死亡第4位,严重威胁着人类健康。该研究通过肿瘤登记地区结直肠癌发病死亡情况估计河北省结直肠癌疾病负担,与河北省三次全死因回顾调查资料比较,分析结直肠癌死亡率的时间变化趋势。方法:河北省肿瘤登记办公室收集到9个肿瘤登记处上报的2010—2012年恶性肿瘤发病和死亡资料。数据分性别、年龄别(0、1~4、5~9、10~14……80以上)计算恶性肿瘤发病率、死亡率和构成;采用2000年中国标准化人口构成和Segi’s世界人口构成分别计算中国和世界人口年龄标准化发病率和死亡率。整理分析河北省1973—1975年、1990—1992年和2004—2005年三次全死因回顾调查的结直肠癌数据。采用Joinpoint回归模型分析磁县肿瘤登记处1988—2012年和涉县肿瘤登记处2000—2012年结直肠癌发病和死亡趋势。结果:河北省肿瘤登记地区2010—2012年结直肠癌新发病例2 303例,死亡1 229例。结直肠癌发病率为16.48/10万(男性18.12/10万,女性14.77/10万),中国人口标准化发病率为13.74/10万;结直肠癌死亡率为8.79/10万(男性10.23/10万,女性7.31/10万),中国人口标准化死亡率7.59/10万。河北省2010—2012年结直肠癌死亡率较1973—1975年升高了28.03%。磁县1988—2012年男性结直肠癌发病率年度平均变化百分比(annual percentage changes,APC)为3.55,死亡率APC为1.64。涉县2000—2012年男性结直肠癌发病率APC为4.68,女性为9.17。涉县2000—2012年男性结直肠癌死亡率APC为5.61。结论:河北省近40年结直肠癌发病与死亡呈现上升趋势。加强结直肠癌筛查,降低结直肠癌发病率和死亡率是河北省一项重要任务。

Background and purpose： Colorectal cancer is one of the most common gastrointestinal cancers. There were about 1.36 million new cases of colorectal cancer, which was the third highest incidence of malignant tu- mors of the world in 2012. It was the fourth leading cause of cancer death and became a serious threat to human health. The aim of the study was to estimate the colorectal cancer burden in Hebei Province with the data of cancer registries areas and analyze the trend of colorectal cancer mortality rates with three of the Hebei Province death retrospective surveys. Methods： Nine cancer registries in Hebei Province submitted cancer registry data from 2010 to 2012 to the Hebei Provincial Cancer Registry Center. The pooled data were stratified by gender and age （0, 1-4, 5-9, 10-14...80＋）. Proportions and incidence/mortality rates for colorectal cancer were calculated. Incidence and mortality rates were age-standardized to Chinese population census in 2000 and world Segi＇s population standard. Colorectal cancer mortal- ity data during the periods 1973-1975, 1990-1992 and 2004-2005 were extracted from the death retrospective surveys and analyzed. Mortality and incidence rate data from Cixian County from 1988 to 2012 and Shexian County from 2000 to 2012 were obtained in each county and analyzed using Joinpoint regression model. Results： The estimated number of newly diagnosed colorectal cancer cases and deaths from 2010 to 2012 in cancer registry areas of Hebei Provinc were 2 303 and 1 229, respectively. The crude incidence rate of colorectal cancer was 16.48/100 000 （male 18.12/100 000 and female 14.77/100 000）. The age-standardized incidence rate by Chinese population census （ASRC） in 2000 was 13.74/100 000. The colorectal cancer mortality rate was 8.79/100 000 （male 10.23/100 000 and female 7.31/100 000）. The age-standardized mortality rate by Chinese population census （ASRC） in 2000 was 7.59/100 000. The mortality rates of colorectal cancer displayed a significant increasing trend in Hebei Province from 1973-1975 to 2010-2012, with an increased rate of 28.03%. In Cixian County, the annual percentage change （APC） of colorectal cancer incidence rate was 3.55, while the APC of colorectal cancer mortality rate was 1.64 for males from 1988 to 2012. In Shexian County, the APC ofcolorectal cancer incidence rates were 4.68 and 9.17 for males and females from 2000 to 2012, respectively; the APC of colorectal cancer mortality was 5.61 for males in Shexian County. Conclusion： The incidence and mortality rates of colorectal cancer showed an increasing trend in Hebei Province over the past 40 years. It is an important task that colorectal cancer screening is strengthened to reduce morbidity and mortality of the colorectal cancer in Hebei Province.