启东市15~39岁人群恶性肿瘤生存率趋势分析

Trend of survival rate of malignant tumor among 15~39-year-old population in Qidong

目的:分析1972-2016年启东市15~39岁人群恶性肿瘤生存情况,为该人群恶性肿瘤患者预后评价及防治提供依据。方法:恶性肿瘤资料来源于启东癌症登记报告系统,随访时间截至2021年12月31日。采用SURV3.01软件计算观察生存率(observed survival rate,OSR)和相对生存率(relative survival rate,RSR),并用Hakulinen氏似然比检验法进行统计检验。Joinpoint 4.7.0.0分析生存率年度变化百分比(annual percentage change,APC)。结果:1972-2016年启东市15~39岁人群恶性肿瘤患者1、5、10年OSR分别为32.75%、18.95%及16.30%,1、5、10年RSR分别为32.82%、19.19%及16.80%。将1972-2016年分为9个时期,5-RSR从1972-1976年13.65%升至2012-2016年56.47%,9个时期的RSR上升趋势有统计学意义(χ2=869.73,P<0.001)。1972-2016年5-OSR和5-RSR的APC分别为4.25%和4.22%,均呈明显上升趋势(均P<0.05)。男性和女性5-OSR分别为10.57%及33.83%,5-RSR分别为10.74%及34.05%;女性生存率高于男性,男女性RSR差异有统计学意义(χ2=957.32,P<0.001)。15~19岁、20~24岁、25~29岁、30~34岁及35~39岁年龄组5-RSR分别为19.69%、21.93%、19.53%、19.14%和18.67%。各年龄组之间RSR差异无统计学意义(χ2=50.34,P=0.127)。时间趋势显示,15~19岁、20~24岁、25~29岁、30~34岁及35~39岁年龄组5-RSR的APC分别为2.99%、3.51%、4.82%、4.73%和4.07%,各年龄组5-RSR上升趋势均有统计学意义(均P<0.05)。发病前十位恶性肿瘤中,5-RSR最高的是甲状腺癌(97.80%),其次是宫颈癌(74.61%)和女性乳腺癌(68.22%);5-RSR最低的是肝癌(4.54%),其次是肺癌(12.28%)和白血病(12.75%)。1972-2016年启东市15~39岁人群恶性肿瘤中肝癌占全部恶性肿瘤55.07%,其5-RSR从1972-1986年2.87%上升至2002-2016年9.13%。结论:45年来启东市15~39岁人群总体生存率上升趋势明显,但仍有一定上升空间。应当加强重视15~39岁人群恶性肿瘤的早诊早治及健康宣教,从而提高其恶性肿瘤生存率。

Objective:To analyze the survival of cancer among 15~39-year-old population in Qidong from 1972 to 2016,and provide a basis for the prognosis evaluation and prevention of cancer among 15~39-year-old patients.Methods:The data of cancer was obtained from the Qidong Cancer Registration and Reporting System,and the follow-up was up to December 31,2021.Observed survival rate(OSR)and relative survival rate(RSR)were calculated by SURV3.01 software,and Hakulinen's likelihood ratio test was used for statistical difference comparison.Joinpoint 4.7.0.0 software was used to conduct the annual percentage change(APC)of cancer survival rate among 15~39-year-old population.Results:During 1972 to 2016,the OSR of cancer among 15~39-year-old at 1,5 and 10 years were 32.75%,18.95%and 16.30%,and the RSR at 1,5 and 10 years were 32.82%,19.19%and 16.80%,respectively.Dividing 1972-2016 into 9 periods,the 5-RSR increased from 13.65%in 1972-1976 to 56.47%in 2012-2016.The uptrends of RSR in the nine periods were statistically significant(χ2=869.73,P<0.001).The APC of 5-OSR and 5-RSR were 4.25%and 4.22%from 1972 to 2016 in Qidong,the upward trend was statistically significant in both 5-OSR and 5-RSR(both P<0.05).The 5-OSR and 5-RSR for male were 10.57%and 10.74%,and for female were 33.83%and 34.05%.The survival rate of female was higher than that of male,there was a statistically significant difference in RSR between male and female(χ2=957.32,P<0.001).The 5-RSR for the age groups of 15~19,20~24,25~29,30~34,and 35~39 years old were 19.69%,21.93%,19.53%,19.14%and 18.67%,respectively.There was no significant difference in RSR among different age groups(χ2=50.34,P=0.127).Moreover,the APC of 5-RSR among 15~19,20~24,25~29,30~34,and 35~39 years old were 2.99%,3.51%,4.82%,4.73%and 4.07%,respectively.The increasing trend of 5-RSR in each age group was statistically significant(all P<0.05).Among the top ten cancer,the highest 5-RSR was thyroid cancer(97.80%),followed by cervical cancer(74.61%)and female breast cancer(68.22%),the lowest 5-RSR was liver cancer(4.54%),and followed by lung cancer(12.28%)and leukemia(12.75%).From 1972 to 2016,liver cancer accounted for 55.07%of all cancer among 15~39-year-old in Qidong,and its 5-RSR increased from 2.87%in 1972-1986 to 9.13%in 2002-2016.Conclusion:Over the past 45 years,the overall survival rate of cancer among 15~39-year-old in Qidong has been on the rise,but there's still a certain room for improvement.It is necessary to pay more attention to the early diagnosis,early treatment and health education of 15~39-year-old population,so as to improve the survival rate of cancer among 15~39-year-old.