2010—2016年河南省食管癌发病与死亡情况趋势分析

Changing trend of incidence and mortality of esophageal cancer during 2010-2016 in Henan Province,China

目的根据河南省肿瘤登记数据估算河南省2016年食管癌发病和死亡情况,分析2010—2016年食管癌发病和死亡变化趋势。方法按照《中国肿瘤登记手册》以及国际癌症研究中心的登记质量标准评估2016年河南省肿瘤登记数据的完整性、有效性和可靠性,按照国际疾病分类10编码(C15)提取食管癌数据,并分城乡、性别、年龄组计算登记人群食管癌发病率和死亡率,结合2016年全省人口数据估算河南省食管癌发病、死亡情况。人口标准化率按照2000年中国标准人口结构(中标率)和Segi′s世界标准人口结构(世标率)进行计算。采用Joinpoint模型估计食管癌中标发病率和中标死亡率年度变化百分比(APC)。结果2016年河南省食管癌新发病例数为4.01万例,占河南省全部恶性肿瘤新发病例的13.46%,位于全部恶性肿瘤发病的第3位。食管癌粗发病率为37.21/10万,中标率为26.74/10万,世标率为27.12/10万;男性发病率高于女性,男性和女性中标率分别为34.53/10万和19.19/10万;农村地区发病率高于城市地区,中标率分别为28.13/10万和20.90/10万。河南省2016年食管癌死亡病例数为2.93万例,占河南省全部恶性肿瘤死亡的15.61%,位于全部恶性肿瘤死亡的第3位。食管癌粗死亡率为27.14/10万,中标率为18.74/10万,世标率为18.78/10万;男性死亡率高于女性,中标率分别为24.78/10万和13.12/10万;农村地区高于城市地区,食管癌中标死亡率分别为19.48/10万和15.73/10万。2010—2016年间,河南省食管癌中标发病率(APC=-3.12%,95%CI:-5.30%~-0.90%,P=0.015)和中标死亡率(APC=-2.47%,95%CI:-4.70%~-0.20%,P=0.039)平均每年分别下降3.12%和2.47%;不同地区变化趋势不同,农村地区中标发病率和死亡率均呈现下降趋势,而城市地区变化趋势无统计学意义;男性和女性中标发病率和死亡率变化趋势相同,均呈现下降趋势。结论近年来河南省食管癌发病和死亡呈下降趋势,但是其疾病负担仍然较重,农村地区为食管癌高发区,应坚持"以预防为主"和"以农村为重点"的原则,开展食管癌防控工作。

Objective To estimate the incidence and mortality of esophageal cancer in 2016 and their changing trend during 2010-2016 according to the cancer registration data in Henan province.Methods The data quality including completeness,validity,and reliability of local registries which submitted the cancer registration data of 2016 were assessed according to the criteria of Guideline on Cancer Registration in China and IARC/IACR.Esophageal cancer cases(ICD10:C15)were extracted from the database,and the incidence and mortality stratified by gender,age,and areas(urban/rural)were calculated,the incidence and mortality of provincial cancer were estimated combined with provincial population data.China′s 2000 census population and Segi′s population were used to calculate the age-standardized rate.Joinpoint model was used to estimate the changing trend of age standardized incidence and mortality along with the calendar year.Results Approximately 40.10 thousand new esophageal cancer cases were diagnosed in Henan in 2016,accounting for 13.46%of all new cancer cases,and it ranked the third among cancer of all sites.The crude incidence of esophageal cancer was 37.21/100000 with an age-standardized incidence rate by China standard population(ASIRC)of 26.74/100000 and an age-standardized incidence rate by world standard population(ASIRW)of 27.12/100000.The incidence of esophageal cancer in males was higher than that in females,with the ASIRC of 34.53/100000 and 19.19/100000,respectively.It was higher in rural areas than that in urban areas,with the ASIRC of 28.13/100000 and 20.90/100000,respectively.About 29.30 thousand deaths of esophageal cancer in Henan in 2016,accounting for 15.61%of all cancer deaths in Henan,which ranked the third among cancer of all sites.The crude mortality rate was 27.14/100000 with an age-standardized mortality rate by China standard population(ASMRC)of 18.74/100000 and an age-standardized mortality rate by world standard population(ASMRW)of 18.78/100000.The mortality in males was higher than that in females,with the ASMRC of 24.78/100000 and 13.12/100000,respectively.It was also higher in rural areas than that in urban areas,with the ASMRC of 19.48/100000 and 15.73/100000,respectively.The ASIRC and ASMRC were declining with annual percent change(APC)of 3.12%(APC=-3.12%;95%CI:-5.30%,-0.90%;P=0.015)and 2.47%(APC=-2.47%;95%CI:-4.70%,-0.20%;P=0.039)during 2010-2016.However,the significant declining trend was only observed in rural areas in Henan,and the changing trend was same between males and females.Conclusions The incidence and mortality of esophageal cancer are declining since 2010,however,the disease burden remains large in Henan.Therefore,comprehensive prevention and control efforts should be strengthened according to its epidemic characteristics and risk factors.