上海市长宁区1988～2013年胃癌发病率和死亡率趋势分析

Time Trends of Gastric Cancer Incidence and Mortality in Changning District of Shanghai,1988～2013

[目的]分析1988～2013年上海市长宁区居民胃癌发病与死亡情况及其变化趋势。[方法]利用上海市长宁区1988～2013年恶性肿瘤发病与死亡登记资料,以Segi’s世界标准人口计算胃癌年龄标化发病率和死亡率,采用Joinpoint趋势分析软件估计年均变化百分比。进一步拟合年龄—时期—队列模型(APC model),并评估三者效应对胃癌发病和死亡趋势的影响。[结果] 1988～2013年期间,上海市长宁区男女性胃癌标化发病率分别为29.80/10万和15.45/10万;男女性胃癌标化死亡率分别为22.80/10万和11.20/10万。男性胃癌发病和死亡率以平均每年3.6%和4.0%的幅度下降;女性以平均每年2.6%和4.1%的幅度下降。APC模型结果提示,年龄、时期和出生队列效应对女性胃癌发病风险的影响没有统计学意义;在男性中高年龄组和早期出生队列者其胃癌发病风险较低,但时期效应对发病风险的影响也没有统计学意义。此外,三者对男女性胃癌死亡风险的影响效应均较小。[结论]近25年上海市长宁区男女性胃癌标化发病率和死亡率呈下降趋势,但控制年龄和出生队列因素后,时期效应对胃癌发病和死亡风险无显著影响。

[Purpose]To analyze the long-term trends of gastric cancer incidence and mortality from 1988 to 2013 in Changning district of Shanghai.[Methods]Using the data on cancer incidence and mortality in Changning district of Shanghai,the age-standardized rates(ASRs)were calculated with the Segi’s world standard population.The average annual percent change(AAPC)was used to evaluate the trends of cancer incidence and mortality by the Joinpoint program.Age-period-cohort model was further implemented to assess the contribution of age,period and cohort effects on the trends of incidence and mortality.[Results]During 1988~2013,the age-standardized incidence rates of male and female were 29.80/10~5 and 15.45/10~5.The age-standardized mortality rates were 22.80/10~5 and 11.20/10~5 in males and females.The AAPCs of incidence and mortality were-3.6%and-4.0%in males,while in women those were-2.6%and-4.1%.Age,period and birth cohort effects had no statistical impact on female gastric cancer incidence.Lower incidence risk was observed for the population of old age groups and early birth cohort in males,but no statistical impact of period effect.The results also indicated there was no age,period and birth cohort effects on gastric cancer mortality in both males and females.[Conclusion]The decreased trend of incidence and mortality of gastric cancer in the Changning district has been observed in past 25 years.After controlling for both age and cohort effects,it shows no period effect on incidence and mortality of gastric cancer.