2003—2012年食管癌高发区林州市不同病理类型食管癌发病及生存状况分析

Incidence and survival of esophageal cancer with different histological types in Linzhou between 2003 and 2012

目的 分析2003—2012年林州市不同病理类型食管癌发病及生存状况,了解当地食管癌发病趋势和疾病负担.方法 从林州市肿瘤登记处抽取2003—2012年全部食管癌发病个案记录和人口数据,计算不同性别、病理类型的食管癌发病率.按世界标准人口（Segi＇s）年龄构成计算世界人口结构标化发病率（世标率）;根据2000年中国人口普查的人口构成计算中国人口结构标化发病率（中标率）.采用JoinPoint回归模型对2003—2012年食管癌的世标率进行分析,计算世标率的估计年度变化百分比（EAPC）;应用Kaplan-Meier方法计算5年生存率.结果 2003—2012年间,林州市食管癌新发病例8229例,年均发病率为80.08/10万（8229/10276481）,其中鳞癌新发病例7019例,占85.3%（7019/8229）.2003年林州市食管癌中标率为80.92/10万,世标率为81.85/10万,2012年中标率、世标率分别为67.97/10万和68.63/10万.JoinPoint模型回归分析结果显示,其他和不明病理类型食管癌发病率在2003—2012年间EAPC为-12.9%（95%CI：-16.4%--9.1%）.食管癌世标率在2007—2012年间EAPC为-5.5%（95%CI：-9.2%--1.6%）,女性食管癌世标率在2006—2012年间EAPC为-5.4%（95%CI：-7.0%--3.9%）,鳞癌世标率在2007—2012年间EAPC为-4.9%（95%CI：-9.5%--0.1%）.食管癌5年患病率为215.49/10万（2337/1084493）,发病后5年内死亡5489例,5年生存率为34.6%（95%CI：33.5%-35.6%）.结论 林州市食管癌的发病率呈下降趋势,生存率较以往有所提高,食管癌疾病负担依然较重.食管癌主要病理类型为鳞癌,发病趋势与总体相同.

Objective To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012. Methods All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi＇s population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change （EAPC） was calculated. 5-year survival rate was calculated with Kaplan-Meier model. Results There were 8229 esophageal cancer cases in Linzhou during 2003- 2012. The average annual incidence rate was 80.08/100000 （8229/10276481）. Among all esophageal cancer cases, 7019 （85.3%） were diagnosed as esophageal squamous cell carcinoma （ESCC）. In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100000 and 81.85/100000 in 2003, 67.97/100000 and 68.63/100000 in 2012. JoinPoint regression model showed that EAPC was-12.9%（95%CI：-16.4%--9.1%） for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5%（95%CI：-9.2%--1.6%） for esophageal cancer between 2007 and 2012,-5.4%（95%CI：-7.0%--3.9%） for esophageal cancer in female between 2006 and 2012,-4.9% （95%CI：-9.5%--0.1%） for ESCC between 2007 and 2012. The 5-year＆amp;nbsp;prevalence of esophageal cancer was 215.49 per 100000 （2337/1084493）, and 5489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6%（95%CI：33.5%-35.6%）. Conclusion Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.