2013年至2017年黑龙江省肿瘤登记地区食管癌发病与死亡趋势分析

Analysis of the incidence and mortality trends of esophageal cancer in the cancer registration areas of Heilongjiang province from 2013 to 2017

目的探讨2013年至2017年黑龙江省肿瘤登记地区食管癌发病、死亡情况及随时间变化趋势。方法收集黑龙江省12个肿瘤登记地区上报的食管癌发病、死亡和人口数据,其中11个地区的数据符合审核标准,包括地级以上城市(简称:城市地区)7个,县和县级市(简称:农村地区)4个。计算2013年至2017年黑龙江省11个肿瘤登记地区食管癌的粗发病率、粗死亡率及二者的中国人口标化率(简称:中标率,采用中国2000年人口普查的标准人口构成进行调整)、世界人口标化率(简称:世标率,采用Segi世界标准人口构成进行调整)、0~74岁累积发病率或死亡率(简称:累积发病率或死亡率)。采用Joinpoint回归计算发病率和死亡率年度变化百分比(APC)并进行趋势分析。结果2013年至2017年黑龙江省肿瘤登记地区食管癌粗发病率为6.40/10万,中标发病率为3.63/10万,累积发病率为0.44%。其中,男性食管癌粗发病率(11.61/10万)高于女性(1.27/10万),城市地区食管癌粗发病率(6.27/10万)低于农村地区(6.71/10万)。2013年至2017年黑龙江省肿瘤登记地区食管癌粗死亡率为5.32/10万,中标死亡率为3.01/10万,累积死亡率为0.35%。其中,男性食管癌粗死亡率(9.56/10万)高于女性(1.15/10万),农村地区食管癌粗死亡率(5.13/10万)低于城市地区(5.39/10万)。Joinpoint回归分析显示,2013年至2017年整体和男性食管癌发病率和死亡率均有升高趋势,但差异均无统计学意义(均P>0.05),女性中标发病率有下降趋势,差异有统计学意义(APC=-7.92,95%CI-11.52~-4.21,P<0.01)。结论近年来黑龙江省食管癌发病率和死亡率有升高趋势,疾病负担仍然较重;对于男性人群,更应关注食管癌的一级预防、早发现和早治疗。

Objective To explore the incidence and mortality of esophageal cancer in the cancer registration areas of Heilongjiang province from 2013 to 2017 and their trends of change over time.Methods The esophageal cancer incidence,mortality and population data reported by 12 cancer registration areas of Heilongjiang province were collected.Among them,the data of 11 areas met the check standards,including 7 cities above the prefecture level(abbreviated as urban area),4 counties and county-level cities(abbreviated as rural area).The crude incidence and mortality rates of esophageal cancer in 11 cancer registration areas of Heilongjiang province from 2013 to 2017,and their standardized rates by Chinese population(adjusted according to the standard population composition of the 2000 census of China)and world population(adjusted using Segi world standard population composition),and the cumulative incidence or mortality rate from 0 to 74 years old(abbreviated as cumulative incidence or mortality rate)were calculated.Joinpoint regression was used to calculate the annual percentage change(APC)of the incidence and mortality rates,and the trend analysis was performed.Results From 2013 to 2017,the crude incidence rate of esophageal cancer in the cancer registration areas of Heilongjiang province was 6.40/100000,the standardized incidence rate by Chinese population was 3.63/100000,and the cumulative incidence rate was 0.44%.The crude incidence rate of esophageal cancer in males(11.61/100000)was higher than that in females(1.27/100000).The crude incidence rate of esophageal cancer in rural area(6.27/100000)was lower than that in urban area(6.71/100000).From 2013 to 2017,the crude mortality rate of esophageal cancer in the cancer registration areas of Heilongjiang province was 5.32/100000,the standardized mortality rate by Chinese population was 3.01/100000,and the cumulative mortality rate was 0.35%.The crude mortality rate of esophageal cancer in males(9.56/100000)was higher than that in females(1.15/100000).The crude mortality rate of esophageal cancer in rural area(5.13/100000)was lower than that in urban area(5.39/100000).Joinpoint regression analysis showed that from 2013 to 2017,the incidence and mortality rates of esophageal cancer in the entire population and males had an increasing trend,but the differences were not statistically significant(all P>0.05),and the standardized incidence rate by Chinese population in females had a downward trend,and the difference was statistically significant(APC=-7.92,95%CI-11.52--4.21,P<0.01).Conclusions The incidence and mortality rates of esophageal cancer in Heilongjiang province have been increasing in recent years,and the burden of disease is still heavy.In the male population,the primary prevention,early detection and early treatment of esophageal cancer should be paid more attention.