2015-2021年浙江省余姚市结直肠癌发病死亡情况及生存分析

Morbidity,mortality and survival of colorectal cancer in Yuyao,Zhejiang,2015-2021

目的分析2015—2021年浙江省余姚市户籍居民的结直肠癌发病率、死亡率的变化趋势及生存现状。方法收集2015—2021年余姚市户籍居民的结直肠癌发病及死亡监测资料,计算结直肠癌发病和死亡的粗率、年龄别率、0~74岁累积率及35~64岁截缩率,标化率用2010年全国人口普查标准人口构成、Segi's世界标准人口构成计算,各组数据性别差异比较采用四格表χ^(2)检验。利用Joinpoint Regression Program 4.9.0.1软件计算年度变化百分比(APC)和平均年度变化百分比(AAPC),采用Kaplan-Meier法结合Log-Rank检验进行生存分析。结果2015—2021年余姚市结直肠癌新发病例2843例,居发病瘤谱第2位,年均粗发病率为48.58/10万,中标发病率为27.12/10万,世标发病率为20.69/10万,0~74岁累积率为2.48%,35~64岁截缩率为31.94/10万,发病粗率与中标率均呈上升趋势(APC=7.36%、APC=4.00%,均P<0.01);死亡病例1102例,居死亡瘤谱第5位,年均粗死亡率为18.83/10万,中标死亡率为9.87/10万,世标死亡率为7.09/10万,0~74岁累积率为0.67%,35~64岁截缩率为8.11/10万,死亡粗率与中标率变化趋势均不明显(APC=3.71%、APC=0.19%,均P>0.05);所有指标男性均高于女性。发病率和死亡率均随年龄增长呈上升趋势(全局AAPC=7.67%、全局AAPC=8.39%,均P<0.01)。结直肠癌中位生存时间为4.71年,5年生存率为59.12%。结论浙江省余姚市户籍居民结直肠癌发病率和死亡率居高不下,应积极倡导健康生活方式,对重点人群(男性和40岁以上人群)开展结直肠癌早诊早治,以降低结直肠癌发病与死亡风险,提高患者生存率。

Objective To analyze the morbidity rate,mortality rate of colorectal cancer and survival rate of colorectal cancer in Yuyao registered residents from 2015 to 2021.Methods The incidence and death data of colorectal cancer in Yuyao registered residents during 2015−2021 were collected to calculate the crude morbidity and mortality rates,the age-specific morbidity and mortality rates,0−74 years cumulative rate and 35−64 years truncated rate.The standardized rate was calculated based on the Chinese population from the census in 2010 and Segi's standard world population.The gender differences of each group were compared byχ^(2) test.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated by Joinpoint Regression Program 4.9.0.1,and the survival of the cases was analyzed by Kaplan-Meier method combined with Log-Rank test.Results From 2015 to 2021,a total of 2843 new cases of colorectal cancer occurred in Yuyao,ranking second in the cases of tumors,the average annual crude morbidity rate was 48.58/100000,the age-standardized rate by Chinese standard population(ASRC)was 27.12/100000,and the age-standardized rate by world Segi's population(ASRW)was 20.69/100000,the cumulative rate of 0−74 years old was 2.48%,and the truncated rate of 35−64 years old was 31.94/100000.The crude morbidity rate and the ASRC showed upward trends(APC was 7.36%,4.00%,both P<0.01);A total of 1102 deaths of colorectal cancer occurred during this period,ranking the fifth in the deaths of tumors.The average annual crude mortality rate was 18.83/100000,the ASRC was 9.87/100000,and the ASRW was 7.09/100000,the cumulative rate of 0−74 years old was 0.67%,and the truncated rate of 35−64 years old was 8.11/100000.The changes of the crude mortality rate and ASRC were not obvious(APC was 3.71%,0.19%,both P>0.05);All rates were higher in men than in women.The morbidity rate and mortality rate all increased with age(AAPC was 7.67%,8.39%,both P<0.01).The median of survival time of colorectal cancer cases was 4.71 years,and the 5−year survival rate was 59.12%.Conclusion The morbidity and mortality of colorectal cancer remained high in Yuyao.It is necessary to promote healthy lifestyle and carry out early diagnosis and treatment of colorectal cancer in key groups(men and those over 40 years old),in order to reduce the risk of incidence and death of colorectal cancer,and improve the survival of the patients.