2010～2015年重庆市肿瘤登记地区宫颈癌发病与死亡趋势分析

Trend in Incidence and Mortality of Cervical Cancer in Chongqing Cancer Registration Areas from 2010 to 2015

[目的]了解重庆市宫颈癌发病与死亡变化趋势,为开展宫颈癌防治提供建议。[方法]收集整理2010～2015年重庆市11个肿瘤登记点报告的宫颈癌发病、死亡病例（ICD-10编码为C53）。统计分析宫颈癌发病率、死亡率、标化发病率、标化死亡率、截缩率、累积率、累积危险度等指标。率的比较采用χ~2检验,趋势变化年度变化百分比（annual percent change,APC）采用t检验,α=0.05。[结果]重庆市宫颈癌发病率与标化发病率分别由2010年的8.03/10万、7.78/10万上升至2015年的18.29/10万、14.26/10万,APC分别为16.77%与12.30%,变化趋势差异有统计学意义（t值分别为9.99与10.25,P均为0.001）。2012～2014年城市宫颈癌发病率高于农村,差异有统计学意义（P〈0.05）。宫颈癌死亡率与标化死亡率分别由2010年的3.07/10万、3.51/10万上升至2015年的7.84/10万、6.96/10万,APC分别为17.59%与16.30%,变化趋势差异均有统计学意义（P〈0.05）。宫颈癌发病率在30岁前低于10/10万,30岁后呈快速上升,50～岁年龄组达到高峰。宫颈癌死亡率在40岁前低于5/10万,40岁后死亡率呈上升趋势,50～岁年龄组出现第1个小高峰,85＋岁年龄组达到高峰。重庆市宫颈癌截缩发病率、累积发病率与发病累积危险度均呈上升的趋势,分别由2010年的18.38/10万、0.67%、0.67%上升至32.60/10万、1.42%、1.41%（P〈0.05）。宫颈癌截缩死亡率、累积死亡率与死亡累积危险度分别由2010年的6.95/10万、0.27%、0.27%上升至2015年的10.74/10万、0.59%、0.59%（P〈0.05）。[结论]重庆市肿瘤登记地区宫颈癌发病率低于全国平均水平,但死亡率高于全国平均水平,发病率与死亡率均呈逐年上升的趋势,应切实做好宫颈癌三级预防工作。

[Purpose] To analyze the trends in the incidence and mortality of cervical cancer in Chongqing cancer registration areas from 2010 to 2015. [Methods] Cervical cancer cases（ICD-10：C53） from 2010 to 2015 were collected from 11 cancer registries in Chongqing. The crude incidence,crude mortality,age-standardized incidence rate by Chinese standard population（ASIRC）,age-standardized mortality rate by Chinese standard population（ASMRC）,truncated rate of age-standardized incidence and mortality of 35 ～64 years old（TASIR and TASMR）,cumulative incidence and mortality（CI and CM）,cumulative risk of incidence and mortality（CIR and CMR） of cervical cancer were calculated and analyzed. The difference of incidence and mortality between urban and rural areas was compared by Chi-square test（α=0.05）. Annual percent change（APC） was examined by t test. [Results] The crude incidence and ASIRC of cervical cancer in Chongqing were increased significantly from 8.03/105 and 7.78/105 in 2010 to 18.29/105 and 14.26/105 in 2015（t=9.99 and 10.25,P =0.001）;the APC was 16.77% and 12.30%,respectively. The incidence of cervical cancer from 2012 to 2014 in urban areas was higher than that in rural areas（P〈0.05）. The mortality and ASMRC of cervical cancer were significantly increased from 3.07/105 and 3.51/105 in 2010 to7.84/105 and 6.96/105 in 2015（P0.05）;the APC was 17.59% and 16.30%,respectively. The incidence of cervical cancer before 30 years was below 10/105,it increased rapidly after 30 years,and reached the peak at the age group of 50 years,then decreased. The mortality of cervical cancer before 40 years was 5/105;it increased afterwards,reached the first peak in age group of 50 years and reached the second peak in age group of 85 years. The TASIR,CI and CIR of cervical cancer in Chongqing were significantly increased from 18.38/105,0.67%,0.67% in 2010 to 32.60/105,1.42%,1.41% in 2015（P0.05）. The TASMR,CM and CMR were significantly increased from6.95/105,0.27%,0.27% in 2010 to 10.74/105,0.59%,0.59% in 2015（P0.05）. [Conclusion] The incidence of cervical cancer in Chongqing cancer registration areas is lower,but the mortality is higher than the average level in China. However,the incidence and mortality of cervical cancer in Chongqing demonstrates a rising trend over the years,indicating that the primary,secondary and tertiary prevention of cervical cancer should be strengthened in Chongqing.