2010—2014年河南省儿童和青少年恶性肿瘤生存分析

Relative Survival Rate Among Children and Adolescents’ Cancer Patients Diagnosed During 2010—2014 in Henan Province

[目的]了解河南省2010—2014年儿童和青少年恶性肿瘤患者的生存情况及其特征。[方法]提取河南省肿瘤登记数据库中年龄为0~19岁、诊断日期为2010年1月1日至2014年12月31日期间的所有恶性肿瘤患者数据,采用被动和主动随访方法对所有患者进行随访,按照国际儿童癌症分类第3版的分类标准对肿瘤类型进行重新分类,利用完全队列法估计相对生存率以评估儿童和青少年肿瘤生存情况。[结果]河南省2010—2014年0~14岁儿童恶性肿瘤患者5年生存率为44.4%(95%CI:41.7%~47.1%),15~19岁青少年恶性肿瘤患者5年生存率为52.2%(95%CI:47.7%~56.5%)。城市地区儿童和青少年恶性肿瘤5年生存率(54.6%,95%CI:48.8%~60.1%)均高于农村地区(45.0%,95%CI:42.4%~47.5%),这种城乡差异在不同性别、年龄段以及肿瘤分类的分析中均可以观察到。2013—2014年诊断的儿童和青少年恶性肿瘤的5年生存率(50.5%,95%CI:47.2%~53.7%)高于2010—2012年(42.4%,95%CI:39.1%~45.6%)。从儿童和青少年的主要肿瘤类型来看,白血病、中枢神经系统肿瘤以及骨肿瘤的5年生存率分别为40.1%(95%CI:36.6%~43.5%)、35.2%(29.9%~40.6%)和58.7%(49.2%~67.1%)。[结论]河南省儿童和青少年恶性肿瘤的生存率与全国平均水平以及发达国家水平存在较大差距,需加强其综合防控措施以降低死亡率、提高生存率。

[Purpose] To analyze the survival of childhood and adolescent cancer patients diagnosed in Henan Province between 2010 and 2014. [Methods] Cancer cases aged 0~19 years diagnosed between January 1, 2010 and December 31, 2014 were extracted from the Henan Provincial Cancer Registration Database. All cases were followed up and reclassified with the International Classification of Childhood Cancer, Third Edition(ICCC-3);the relative survival was calculated using the complete cohort method. [Results] In Henan Province, the 5-year relative survival(RS) for children aged 0 to 14 diagnosed between 2010 and 2014 was 44.4%(95% CI:41.7%~47.1%), and for adolescents aged 15 to 19, it was 52.2%(95%CI: 47.7%~56.5%). Children and adolescents had a higher 5-year relative survival rate in urban than that in rural areas(RS: 54.6%, 95%CI: 48.8%~60.1% vs RS: 45.0%, 95%CI: 42.4%~47.5%). When analysis was divided into groups based on gender, age ranges and ICCC-3 categories, the geographic difference was still visible. Children and adolescents diagnosed in the years 2013 and 2014 had a higher 5-year relative survival rate(RS: 50.5%, 95%CI: 47.2%~53.7%) than those diagnosed in the years 2010 and 2012(RS: 42.4%, 95%CI: 39.1%~45.6%). Leukemia, malignant tumors of central nervous system and bone had 5-year relative survival rates of 40.1%(95%CI: 36.6%~43.5%),35.2%(95%CI: 29.9%~40.6%) and 58.7%(95%CI: 49.2%~67.1%), respectively. [Conclusion] In Henan Province, the cancer survival rate for children and adolescents is relatively low;therefore,efforts should be made to lower mortality and raise the survival rate.