2009—2015年甘肃省肿瘤登记地区胆囊癌流行特征及变化趋势分析

Epidemiological characteristics and trend of gallbladder carcinoma in Gansu cancer registration areas from 2009 to 2015

目的分析甘肃省肿瘤登记地区2009—2015年胆囊癌发病与死亡的流行特征,为制定胆囊癌防治策略提供依据。方法按照全国肿瘤登记中心制定的审核方法收集甘肃省11个肿瘤登记点上报的数据作为样本数据,描述甘肃省肿瘤登记地区胆囊癌发病和死亡情况,计算胆囊癌粗发病率(死亡率)、中国人口标化率(中标率)、世界人口标化率(世标率)、累积率(0~74岁)等,采用Joinpoint 4.7.0.0软件计算年度变化百分比(Annual percentage change,APC)。结果2009—2015年甘肃省肿瘤登记地区胆囊癌新发病例1782例,胆囊癌粗发病率为4.70/10万(男性3.91/10万,女性5.54/10万),中标率为4.50/10万,世标率为5.34/10万;死亡病例1123例,胆囊癌粗死亡率为2.96/10万(男性2.38/10万,女性3.59/10万),中标率为2.68/10万,世标率为3.07/10万。城市地区发病和死亡中标率(4.93/10万,2.94/10万)均高于农村地区(1.93/10万,1.66/10万)。胆囊癌发病率和死亡率随着年龄的增长呈上升趋势,在85+岁年龄组达到高峰,呈现出城市高于农村、女性高于男性的特点。甘肃省2009—2015年胆囊癌发病中标率呈下降趋势(APC=-10.9%,t=-3.0,P<0.05),死亡中标率时间变化趋势不明显(APC=-10.6%,t=-0.8,P=0.4)。结论胆囊癌已成为甘肃省常见的恶性肿瘤之一,其中城市老年女性为胆囊癌防治的重点人群,应针对其开展早期筛查、早期诊断和早期治疗工作,提高胆囊癌早期检出率,降低胆囊癌发病率、死亡率和疾病负担。

Objective The aim of this study was to analyze the epidemiological characteristics of gallbladder carcinoma incidence and mortality in cancer registration areas of Gansu province from 2009 to 2015,so as to provide evidence for enacting prevention and treatment strategies of gallbladder carcinoma.Methods According to the auditing method of National Cancer Registration Center,the data reported by 11 cancer registries in Gansu province were collected as sample data to describe the incidence and mortality of gallbladder carcinoma in Gansu province.The incidence and mortality,age-standardized incidence/mortality rate by Chinese standard population(ASR China),age-standardized incidence/mortality rate by World standard population(ASR World)and cumulative rate(0~74 years old)were calculated.The annual percentage change(APC)was calculated using Joinpoint Regression Program 4.7.0.0 software to estimate the variation trend.Results From 2009 to 2015,there were 1782 new cases of gallbladder carcinoma in Gansu cancer registration areas.The crude incidence rate of gallbladder carcinoma was 4.70/100000(3.91/100000 in male,5.54/100000 in female),the ASR China was 4.50/100000,and the ASR World was 5.34/100000;There were 1123 deaths,the crude mortality rate of gallbladder carcinoma was 2.96/100000(2.38/100000 in male,3.59/100000 in female),the ASR China was 2.68/100000,and the ASR World was 3.07/100000.The incidence and mortality by Chinese standard population(ASR China)in urban areas(4.93/100000,2.94/100000)were higher than those in urban areas(1.93/100000,1.66/100000).The incidence and mortality of gallbladder cancer increased with age,and reached the peak in 85+age group,showing the characteristics of urban higher than rural,female higher than male.The incidence of gallbladder cancer by ASR China in Gansu province showed a decreasing trend from 2009 to 2015(APC=-10.9%,t=-3.0,P<0.05),and the time change trend of mortality by ASR China was not obvious(APC=-10.6%,t=-0.8,P=0.4).Conclusion Gallbladder carcinoma has become one of the common malignant tumors in Gansu province,among which the urban elderly women are the key population for the prevention and treatment of gallbladder cancer in Gansu province,it should be targeted to carry out early screening,early diagnosis and early treatment,improve the early detection rate of gallbladder cancer,reduce the incidence,mortality and disease burden of gallbladder cancer.