江苏省启东市1977-2016年卵巢癌生存率趋势分析

Analysis of the survival trend of ovary cancer in Qidong City,Jiangsu Province from 1977 to 2016

目的:对江苏省启东市近40年全人群卵巢癌发病病例进行生存率分析,为预后评价及防治提供依据。方法:基于启东市癌症登记病例资料,采用SURV3.01软件中Hakulinen方法一计算观察生存率(observed survival rate, OS)和相对生存率(relative survival rate, RS),应用Hakulinen氏似然比检验法进行统计学检验。年龄标化RS采用国际癌症生存标准年龄结构(International Cancer Survival Standard, ICSS)进行标化。用Joinpoint 4.7.0.0软件进行Joinpoint回归分析,计算卵巢癌生存率年度变化百分比(annual percentage change, APC)。结果:启东市卵巢癌1-RS从1977-1981年的31.02%上升至2012-2016年的78.81%,3-RS从1977-1981年的18.50%上升至2012-2016年的57.91%,5-RS从1977-1981年的19.47%上升至2012-2016年的49.54%。统计检验显示,RS的总体上升趋势有统计学意义(χ^(2)=56.09,P<0.001)。经年龄标化后1-RS从1977-1981年的35.35%上升至2012-2016年的65.96%,3-RS从1977-1981年的20.59%上升至2012-2016年的45.27%,5-RS从1977-1981年的24.61%上升至2012-2016年的38.66%。15~24岁、25~34岁、35~44岁、45~54岁、55~64岁、65~74岁和75岁及以上各年龄组的5年RS分别为47.71%、43.03%、52.66%、49.35%、33.77%、34.48%和24.24%,各年龄组之间RS差异有统计学意义(χ^(2)=61.00,P<0.001)。1977-2016年分8个时段的1-OS、3-OS及5-OS的APC值分别为1.57%(t=4.189,P=0.006)、2.19%(t=6.142,P=0.001)、1.63%(t=3.170,P=0.019),1-RS、3-RS及5-RS的APC值分别为1.57%(t=4.230,P=0.005)、2.18%(t=6.389,P=0.001)、1.61%(t=3.304,P=0.016),标化后1-RS、3-RS及5-RS的APC值分别为1.52%(t=6.770,P=0.001)、1.99%(t=4.7 6 1,P=0.0 0 3)、1.3 1%(t=2.481,P=0.048),上升趋势均有统计学意义。结论:近40年来启东地区卵巢癌生存率得到一定的提升,但仍有上升空间,应当继续重视卵巢癌的诊治。

Objective:To analyze the survival rate of ovary cancer cases in the whole population of Qidong City,Jiangsu Province in the past 40 years,to provide a basis for prognosis evaluation and prevention.Methods:Based on the cancer registration case data in Qidong City,the observed survival rate(OS)and relative survival rate(RS)was calculated using the Hakulinen method in SURV3.01 software,and statistical test was performed using Hakulinen's likelihood ratio test.Age-standardized relative survival rate was calculated using International Cancer Survival Standard(ICSS).Joinpoint regression analysis was performed with Joinpoint 4.7.0.0 software to calculate the annual percentage change(APC)of ovary cancer survival.Results:1-RS increased from 31.02%in 1977-1981 to 78.81%in 2012-2016,3-RS increased from 18.50%in 1977-1981 to 57.91%in 2012-2016,5-RS increased from 19.47%in 1977-1981 to 49.54%in 2012-2016.The upward trend of RS was statistically significant(χ^(2)=56.09,P<0.001).Age-standardized 1-RS increased from 35.35%in 1977-1981 to 65.96%in 2012-2016.Age-standardized 3-RS increased from 20.59%in 1977-1981 to 45.27%in 2012-2016.Age-standardized 5-RS increased from 24.61%in 1977-1981 to 38.66%in 2012-2016.The 5-RS for the age groups of 15~24,25~34,35~44,45~54,55~64,65~74,and over 75 years old were 47.71%,43.03%,52.66%,49.35%,33.77%,34.48%and 24.24%,respectively.There was statistically significant difference among different age groups(χ^(2)=61.00,P<0.001).The overall APC of 1-OS,3-OS,5-OS from 1977 to 2016 was 1.57%(t=4.189,P=0.006),2.19%(t=6.142,P=0.001),1.63%(t=3.170,P=0.019),and the overall APC of 1-RS,3-RS,5-RS from 1977 to 2016 was 1.57%(t=4.230,P=0.005),2.18%(t=6.389,P=0.001),1.61%(t=3.304,P=0.016),and the overall APC of age-standardized 1-RS,3-RS,5-RS from 1977 to 2016 was 1.52%(t=6.770,P=0.001),1.99%(t=4.761,P=0.003),1.31%(t=2.481,P=0.048),with statistically significant upward trend.Conclusion:The survival rate of ovary cancer in Qidong has been improved to a certain extent in the past 40 years recent years,but there is still a proportion for improvement.We should continue to pay attention to the diagnosis and treatment of ovary cancer.