1972-2021年江苏省启东市甲状腺癌发病趋势及年龄-时期-队列模型分析

Trends and Age-Period-Cohort Analysis of Thyroid Cancer Incidence in Qidong City of Jiangsu Province from 1972 to 2021

[目的]分析启东市1972-2021年甲状腺癌发病流行特征及变化趋势。[方法]从启东市癌症登记病例数据库中提取1972-2021年甲状腺癌发病登记资料,计算粗发病率、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岁累积率、累积风险;应用Joinpoint统计软件分析甲状腺癌粗发病率、中标率、世标率的平均年度变化百分比(AAPC);利用年龄-时期-队列模型分析年龄、时期和出生队列对甲状腺癌患者发病趋势变化的影响。[结果]1972-2021年启东市甲状腺癌发病2592例,占全部癌症发病的1.76%,粗发病率为4.62/10万,中标率为3.84/10万,世标率为3.52/10万,35~64岁截缩发病率为8.53/10万,0~74岁累积发病率为0.36%,累积风险为0.36%。男性发病501例,粗发病率、中标率、世标率分别为1.81/10万、1.49/10万、1.38/10万;女性发病2091例,粗发病率、中标率、世标率分别为7.35/10万、6.12/10万、5.60/10万。1972-2021年甲状腺癌中标率的AAPC为11.84%(男性9.12%,女性12.84%)(P均<0.05)。年龄-时期-队列模型分析显示,所有年龄组甲状腺癌发病率的净漂移值为5.39%(95%CI:4.25%~6.55%),局部漂移值在30~34岁组达到最大值8.70%(95%CI:7.54%~9.88%)。年龄效应中发病风险随年龄的增长而增加。随着时期的推移,甲状腺癌发病风险逐渐增加,以1992-1996年时期组为对照组[率比(RR)=1.00],发病风险RR在1972-1976年时期组为1.76,2017-2021年时期组为28.34。与较早出生的队列相比,较晚出生的队列甲状腺癌发病风险更高,以1952-1956年出生队列为对照组(RR=1.00),发病风险RR由1892-1896年出生队列组的0.26上升到2017-2021年出生队列组的5.37。[结论]50年来,启东市甲状腺癌的发病率呈上升趋势,且随年龄增长而升高,甲状腺癌发病风险的时期、队列效应均呈上升趋势,需进一步开展针对甲状腺癌相关危险因素的研究。

[Purpose]To investigate trends of thyroid cancer incidence in Qidong City of Jiangsu Province between 1972 and 2021.[Methods]The registry data of thyroid cancer incidence in Qidong from 1972 to 2021 were collected.Crude incidence rate(CR),age-standardized rate by Chinese standard population(ASRC),age-standardized rate by world standard population(ASRW),the truncated incidence rate(35~64 years old),the cumulative incidence rate(0~74 years old)and the cumulative risk were calculated.The average annual change percentage(AAPC)was calculated with Joinpoint software.Age-period-cohort(APC)model was used to analyze the influence of age,period and birth cohort on the incidence trend of thyroid cancer.[Results]From 1972 to 2021,there were 2592 new cases of thyroid cancer in Qidong,accounting for 1.76%of all cancer new cases.CR of thyroid cancer was 4.62/105,ASRC was 3.84/105,ASRW was 3.52/105,the truncated incidence rate(35~64 years old)was 8.53/105,the cumulative incidence rate(0~74 years old)was 0.36%,the cumulative risk was 0.36%.There were 501 male patients,the CR,ASRC and ASRW were 1.81/105,1.49/105 and 1.38/105,respectively.There were 2091 female patients,the CR,ASRC and ASRW were 7.35/105,6.12/105 and 5.60/105,respectively.Temporal trends indicated significant upward trends in ASRC among both sexes,males and females with AAPC values of 11.84%(P<0.05),9.12%(P<0.05),and 12.84%(P<0.05),respectively.The results of the APC model showed that the average net drift value of thyroid cancer incidence in all age groups was 5.39%(95%CI:4.25%~6.55%).The highest value of local drift was 8.70%(95%CI:7.54%~9.88%)in the age group of 30~34 years old.The incidence of thyroid cancer increased with age.The risk of thyroid cancer incidence increased over time:compared with the relative rate(RR=1.00)in 1992—1996,the RR of thyroid cancer incidence was 1.76 in 1972—1976,and 28.34 in 2017—2021.The later the cohort was born,the greater the risk of thyroid cancer incidence:compared with the relative risk(RR=1.00)in 1952—1956 cohort,the RR of thyroid cancer incidence increased from 0.26 in the 1892—1896 cohort to 5.37 in the 2017—2021 cohort.[Conclusion]The incidence of thyroid cancer has presented a rising trend in the past 50 years.Thyroid cancer incidence is increased with age,and the period and cohort effects on the risk of incidence are increased.Further research is needed on risk factors related to thyroid cancer.