1972-2021年江苏省启东市食管癌发病流行趋势分析

Incidence Trends of Esophageal Cancer in Qidong City,Jiangsu Province from 1972 to 2021

[目的]分析江苏省启东市1972-2021年全人群食管癌发病特征及趋势。[方法]基于启东市癌症登记病例数据库,收集整理1972-2021年食管癌发病登记资料及历年人口资料,分析计算食管癌粗发病率、中国人口标化发病率(中标率)、世界人口标化发病率(世标率)、35~64岁截缩率、0~74岁累积发病率、累积发病风险等。应用Joinpoint 4.9.1.0软件进行回归分析,计算食管癌发病率平均年度变化百分比(AAPC)及其95%置信区间。[结果]1972-2021年启东市共报告食管癌发病5762例,占同期全部恶性肿瘤发病总数的3.91%;粗发病率、中标率和世标率分别为10.27/10万、3.60/10万和6.11/10万,35~64岁截缩率与0~74岁累积发病率分别为7.79/10万和0.74%,食管癌累积发病风险为0.74%。男女性粗发病率、中标率及世标率的性别比分别为2.37∶1、3.08∶1及2.97∶1。食管癌的发病平均年龄由1972-1976年的66.18岁上升至2017-2021年的72.28岁,50年间平均发病年龄为69.24岁。1972-2021年0~44岁、45~54岁、55~64岁、65~74岁和75岁及以上年龄组食管癌发病率AAPC分别为-2.03%、-3.11%、-2.29%、-2.08%和-0.70%,除0~44岁外其余年龄组发病率下降趋势均有统计学意义(P均<0.05)。1972-2021年男性、女性及男女合计粗发病率的AAPC分别为1.12%、0.84%及1.02%,上升趋势有统计学意义(P均<0.001);中标率的AAPC分别为-2.03%、-3.00%及-2.15%;世标率的AAPC分别为-1.95%、-2.56%及-2.00%,下降趋势均有统计学意义(P均<0.001)。[结论]1972-2021年启东市全人群食管癌中标率和世标率呈下降趋势,但粗发病率呈上升趋势。随着人口老龄化的加剧及危险因素暴露的累积,食管癌防治工作仍需得到全社会关注。

[Purpose]To analyze the trends of esophageal cancer incidence in Qidong City,Jiangsu Province from 1972 to 2021.[Methods]Based on the cancer registration case database of Qidong City,the incidence registration data of esophageal cancer from 1972 to 2021 and the population data over the years were collected,and the crude rate(CR)of esophageal cancer,age-standardized rates by Chinese standard population(ASRC),age-standardized rates by world standard population(ASRW),truncated rates for 35~64 years old,the cumulative rates for 0~74 years old and the cumulative risk were analyzed and calculated.Joinpoint regression analysis was carried out by using the software Joinpoint 4.9.1.0,and the average annual percentage change(AAPC)of esophageal cancer incidence and its 95%confidence interval were calculated.[Results]From 1972 to 2021,a total of 5762 cases of esophageal cancer were reported in Qidong,accounting for 3.91%of all malignant tumors;CR of esophageal cancer was 10.27/105,ASRC was 3.60/105,ASRW was 6.11/105,truncated rate for 35~64 years old was 7.79/105,cumulative rate for 0~74 years old was 0.74%,and cumulative risk was 0.74%.The male to female ratio in CR,ASRC and ASRW were 2.37∶1,3.08∶1 and 2.97∶1,respectively.The average age of onset of esophageal cancer rose from 66.18 years old during 1972-1976 to 72.28 years old during 2017-2021,with an average onset age of 69.24 years old over the 50-year period.The AAPC of incidence rate in age groups of 0~44,45~54,55~64,65~74 and≥75 years old from 1972 to 2021 were-2.03%,-3.11%,-2.29%,-2.08%and-0.70%,respectively.The downward trend of the incidence rate in all age groups was statistically significant except 0~44 years old(all P<0.05).The AAPC of CR of males,females and both sexes from 1972 to 2021 were 1.12%,0.84%and 1.02%,respectively,and the upward trend was statistically significant(P<0.001).The AAPC of ASRC were-2.03%,-3.00%and-2.15%,respectively;the AAPC of ASRW were-1.95%,-2.56%and-2.00%,respectively,and the downward trend was statistically significant(all P<0.001).[Conclusion]From 1972 to 2021,the ASRC and ASRW of esophageal cancer in Qidong City showed a downward trend,but the crude incidence showed an upward trend.With the aging of the population and the accumulation of risk factors,the prevention and treatment of esophageal cancer still need the attention of the whole society.