宿迁地区女性乳腺癌流行病学及诊治状况调查

Epidemiology, diagnosis and treatment of female breast cancer in Suqian

目的调查宿迁地区女性乳腺癌流行病学及诊治现状，为该地区女性乳腺癌的预防、筛查及精准治疗提供依据。方法收集宿迁地区7 043例乳腺癌患者的病历资料，分析其病理分型、疾病分期、年新发病例数、年死亡例数、城乡发病比例、赴外就诊、经济状况与治疗的关系。结果7 043例乳腺癌患者中，41～50岁2 445例，51～60岁1 349例；城镇乳腺癌4 326例，占7年内新发病例的61.42%；农村乳腺癌2 717例，占7年内新发病例的38.58%；年粗发病率占全地区总人口的10.98/10万～22.83/10万；年粗死亡率占全地区总人口的3.47/10万～11.22/10万；城乡死亡比例为1∶2.18；按照医嘱完成治疗或仍在治疗中者占发病总数的31.48%；未完成治疗或拒绝继续治疗者占发病总数的48.89%；赴外就诊者保乳率为25.74%，本地区就诊者保乳率仅为4.96%；Ⅰ～Ⅱ期患者中，城镇患者占发病总数的28.47%，而农村患者仅占发病总数的15.62%；乳腺癌患者的1年无病生存（DFS）率和总生存（OS）率均为100%，3年DFS和OS分别为78.19%、86.37%，5年DFS和OS分别66.37%、73.16%。结论宿迁地区乳腺癌年粗发病率和年粗死亡率的逐年增长，应引起宿迁地区医务工作者的高度重视，并需要加大一级预防和筛查的力度。城镇患者发病率高于农村患者，但农村患者病死率高于城镇患者，完成治疗例数城镇患者高于农村患者；本地区保乳率很低，宿迁地区从事乳腺癌诊治的医生应加强相关方面的工作。

Objective To investigate epidemiology, diagnosis and treatment of female breast cancer in Suqian, and provide the basis for the prevention, screening and accurate treatment for them. Methods The clinical data of 7 043 patients with breast cancer in Suqian area were collected. The rela- tionships among pathological types, disease stage, annual incidence, annual mortality, incidence ratio of urban to rural areas, left for treatment, economic status and treatment were analyzed. Results In the 7 043 patients with breast cancer, 2 445 cases were from 41 to 50 years old, 1 349 cases were from 51 to 60 years old. 4 326 cases were in urban area, accounting for 61.42% of newly diagnosed cases in 7 years; 2 717 cases were in rural area, accounting for 38.58% of newly diagnosed cases in 7 years. Annual incidence were 10. 98/100 000 to 22. 83/100 000, annual mortality of the total population were 3.47/100 000 to 11.22/100 000, death ratio between urban and rural was 1：2. 18. The rate of patients which completed treatment or was still in treatment was 31.48 % , the rate of patients which did not complete treatment or refused to continue treatment was 48.89%. Breast-conserving treatment rate of left for treatment was 25.74% , and that was 4.96% in Suqian. Patients of Ⅰ-Ⅱ stage breast cancer in urban areas accounted for 28.47% , while those in rural area accounted for only 15.62%. One year disease-free survival （DFS） and overall survival （OS） of all patients were 100%, 3-year DFS and OS were 78.19%, 86.37% respectively; 5-year DFS and OS were 66.37%, 73.16% respectively. Conclusions The increase of annual incidence and mortality of breast cancer should be paid more attention by medical workers in Suqian area and primary prevention and screening need to be strengthened. The incidence of urban patients was higher than that of rural patients, but the mortality in rural areas was higher than that in urban areas. The number of patients in urban area who completed the treatment was higher than that of rural patients. In addition to annual incidence and annual mortality which are not standardized, breast-conserving rate was still very low, so doctors working on breast cancer diagnosis and treatment in Suqian should strengthen related work.