上海市长宁区1973—2013年女性乳腺癌发病和死亡趋势分析

Incidence and mortality trends of female breast cancer in Changning District of Shanghai, 1973-2013

目的:分析上海市长宁区1973—2013年女性乳腺癌的发病和死亡趋势。方法:根据上海市肿瘤登记系统收集的长宁区1973—2013年女性乳腺癌发病和死亡资料,以及公安局提供的人口资料,计算女性乳腺癌粗发病率、粗死亡率及其世界人口标化率等指标。应用Joinpoint软件分析趋势变化,计算年均变化百分比。同时构建年龄-时期-队列模型,分析患者年龄、诊断时间和出生队列对趋势变化的影响。结果:1973—2013年,上海市长宁区女性乳腺癌新发病例5 365例,粗发病率为49.98/10万;死亡1 589例,粗死亡率为14.80/10万。41年间女性乳腺癌发病率和死亡率均呈上升趋势(P值均<0.05),年均分别升高2.69%和1.39%。时期和队列对发病率的变化均有影响(P值均<0.01),而死亡率的升高是由队列效应引起(P <0.01)。结论:1973—2013年上海长宁区女性乳腺癌的发病率和死亡率均呈上升趋势。因此,女性乳腺癌的预防和治疗需引起重视,并且有关卫生部门应大力倡导健康的生活方式。

Objective: To explore the long-term trends in the incidence and mortality of female breast cancer in Changning District of Shanghai from 1973 to 2013.Methods: Using the data of female breast cancer which were obtained from the Shanghai Cancer Registry and the population data which were obtained from the Changning District Bureau of Public Security,the crude rates and the world population-standardized rates of incidence and mortality of female breast cancer were calculated.Joinpoint analysis was conducted to analyze the trend changes and to estimate the annual percent changes of incidence and mortality rates. Furthermore, the age-period-cohort model was performed to further investigate the effects of age, diagnosis period and birth cohort on the secular trends of breast cancer incidence and mortality.Results: From 1973 to 2013, 5 365 female cases were newly diagnosed with breast cancer in Changning District of Shanghai, the crude incidence rate was 49.98/100 000;at the same time,1 589 female cases were dead of breast cancer, the crude mortality rate was 14.80/100 000.For age-standardized rates, the significant increasing trends of incidence and mortality rates of female breast cancer were observed(both P < 0.05). The annual percent changes of agestandardized incidence and mortality rates were 2.69% and 1.39%. Both the diagnosis period and birth cohort had impacts on the incidence trend of female breast cancer in Changning District of Shanghai(both P < 0.01), and the change of mortality trend was almost attributed to the effect of birth cohort(P < 0.01).Conclusion: The incidence and mortality of female breast cancer in Changning District of Shanghai from 1973 to 2013 showed an upward trend. So the prevention and treatment of female breast cancer should be strengthened, and the healthy life style should be advocated by the related health department.