2005—2013年中国肿瘤登记地区鼻咽癌发病和死亡分析

Incidence and mortality of nasopharyngeal carcinoma in China’s tumor registration areas, 2005-2013

目的根据2005—2013年《中国肿瘤登记年报》登记的鼻咽癌资料,分析中国鼻咽癌的发病和死亡情况,为制定中国鼻咽癌防控策略提供科学依据。方法整理收集2005—2013年中国鼻咽癌发病和死亡数据,利用Joinpoint回归模型分析鼻咽癌标化发病和死亡率的时间变化趋势,以及年龄别趋势。结果鼻咽癌发病率整体来说呈下降趋势,在2009—2010年出现明显转折,其中城市在2009年前呈上升趋势(APC=2.97%,P=0.30),2009年后呈下降趋势(APC=-5.75%,P<0.05);而农村在2009年前鼻咽癌发病率呈快速下降趋势(APC=-17.64%,P=0.20),2009年后呈缓慢上升趋势(APC=4.24%,P=0.60),城乡差距逐渐缩小;中国男性鼻咽癌标化发病率一直高于女性,为女性的2.30~2.45倍,随时间发展男女性发病率整体呈下降趋势(APC<0,P<0.05);0~25岁人群鼻咽癌年龄别发病率趋势较平缓且较低,25~60岁人群随着年龄递增发病率逐渐升高,且各年份鼻咽癌发病率峰值均出现在50~60岁年龄组。鼻咽癌死亡率在2009—2010年出现明显转折,其中城市在2009年前呈上升趋势(APC=3.09%,P=0.20),2009年后呈下降趋势(APC=-7.27%,P<0.05);2009年前农村鼻咽癌死亡率呈快速下降趋势(APC=-22.81%,P=0.10),2009年后呈缓慢上升趋势(APC=3.60%,P=0.60),城乡差距逐渐缩小;中国男性鼻咽癌标化死亡率一直高于女性,为女性的2.54~3.09倍,随时间发展男女性死亡率整体呈下降趋势(APC<0,P<0.05);整体而言,0~25岁人群鼻咽癌年龄别死亡率趋势较平缓且较低,25岁以后各年份随年龄增长呈上升趋势。结论 2005—2013年间中国鼻咽癌发病和死亡率整体呈下降趋势,无论是发病或死亡均存在明显的年龄、性别差异,城市农村差距逐渐缩小,25岁以后呈现增长趋势且保持较高的发病率和死亡率水平,需重点关注25岁以上男性的鼻咽癌防治情况。

Objective To analyze the incidence and mortality of nasopharyngeal carcinoma in China according to the registered information of nasopharyngeal carcinoma in China Cancer Registry Annual Reports in 2005-2013,and to provide a scientific basis for formulating nasopharyngeal carcinoma prevention and control strategies in China.Methods We collected the data about the incidence and mortality of nasopharyngeal carcinoma in China from 2005 to 2013.The Joinpoint regression model was used to analyze the temporal changing trends of standardized morbidity and mortality of nasopharyngeal carcinoma and the trends of the age-specific incidence.Results The incidence rates of nasopharyngeal carcinoma showed an overall downward trend.There was a significant turning point in the incidence in 2009-2010.The incidence rate of nasopharyngeal carcinoma in cities showed an upward trend before 2009(APC=2.97%,P=0.30)but a downward trend after 2009(APC=-5.75%,P<0.05).The incidence rate of nasopharyngeal carcinoma in rural areas showed a rapid decreasing trend before 2009(APC=-17.64%,P=0.20)but a slow upward trend after 2009(APC=4.24%,P=0.60).The gap between urban and rural areas was gradually narrowing.The standardized incidence rates of nasopharyngeal carcinoma in Chinese males in 2005-2013 were all higher than those in Chinese females,which were 2.30-2.45 times those of Chinese females.The incidence rates of males and females presented an overall decreasing trend with time(APC<0,P<0.05).The age-specific incidence rate of nasopharyngeal carcinoma in population aged 0-25 years was milder and lower,and the incidence rate in population aged 25-60 years gradually increased with age,and the peak incidence in each year during 2005-2013 was found in the age group of 50-60 years.The mortality rates of nasopharyngeal carcinoma in 2009-2010 displayed a significant turning point,of which the mortality rate in cities showed an upward trend before 2009(APC=3.09%,P=0.20)but a downward trend after 2009(APC=-7.27%,P<0.05).The mortality rate of nasopharyngeal carcinoma in rural areas showed a rapid decreasing trend before 2009(APC=-22.81%,P=0.10)but a slow upward trend after 2009(APC=3.60%,P=0.60).The gap between urban and rural areas was gradually narrowing.The standardized mortality rates of nasopharyngeal carcinoma in Chinese males in 2005-2013 were all higher than those in Chinese females,which were 2.54-3.09 times those of Chinese females.The mortality rates of male and female patients displayed an overall decreasing trend with time(APC<0,P<0.05).The trends of age-specific mortality rates of nasopharyngeal carcinoma in population aged 0-25 years were relatively flat and low in generally,but the age-specific mortality rate in population above 25 years old in each year displayed an upward trend with age.Conclusions The incidence rates and mortality rates of nasopharyngeal carcinoma in China in 2005-2013 showed a downward trend in general.There were obvious age and gender differences in the morbidity and mortality.The urban-rural gap gradually narrowed.The incidence and mortality rates in population above 25 years old showed an upward trend and maintained a high level.Special attention should be paid to prevention and treatment situation of nasopharyngeal cancer in males over 25 years of age.