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| 2012-2021年福建省厦门市妇科三大癌症的流行情况与变化趋势 |
| The epidemic situation and changing trend of the three major gynecological cancers in Xiamen, Fujian Province from 2012 to 2021 |
| 投稿时间：2025-07-10 修订日期：2026-01-07 |
| DOI： |
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| 中文关键词: 宫颈癌 宫体癌 卵巢癌 发病率 死亡率 相对生存率 中位生存时间 变化趋势 |
| 英文关键词:Cervical cancer Uterine cancer Ovarian cancer Incidence rate Mortality rate Relative survival rate Median survival Trend |
| 基金项目:中华预防医学会老年和重大慢病研究项目（JKCLPJ202501002）；厦门市卫生健康高质量发展科技计划重大科研专项孵育项目（2024GZLZDFY01）；厦门市卫生健康高质量发展科技计划医学创新课题（2024GZL-CX34） |
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| 中文摘要: |
| 目的 分析厦门市妇科三大癌症（宫颈癌、宫体癌和卵巢癌）的流行特征及其变化趋势，为制定妇科癌症防控策略提供依据。方法 通过福建省肿瘤登记信息直报平台和国家人口死亡信息登记系统，连续收集2012—2021年厦门市宫颈癌、宫体癌和卵巢癌的发病和死亡数据，计算粗发病（死亡）率、中国人口标化发病（死亡）率（简称中标率）和世界人口标化发病（死亡）率（简称世标率）、0～74岁累积发病（死亡）率等，运用Joinpoint模型计算年度变化百分比（Annual Percentage Change,APC）和平均年度变化百分比（average annual percentage of change, AAPC）。结果 2012—2021年厦门市宫颈癌、子宫体癌、卵巢癌分别发病1479例、1086例、800例，年龄中位数分别为51.0岁、54.0岁、53.0岁，年均粗发病率分别为12.96 /10万、9.52 /10万、7.01 /10万，中标发病率分别为10.35/10万、7.48/10万、5.66/10万，世标发病率分别为9.72/10万、7.30/10万、5.45/10万，0~74岁累积率分别为1.04%、0.85%、0.56%。10年间宫颈癌和卵巢癌的中标发病率均无明显变化趋势 (AAPC=-1.70%，P＞0.05；AAPC=3.95%，P＞0.05)，而子宫体癌中标发病率呈明显上升趋势 (AAPC=6.81%，P=0.005）。宫颈癌、子宫体癌、卵巢癌分别死亡441例、214例、348例，年龄中位数分别为55.0岁、61.50岁、60.0岁，年均粗死亡率分别为3.87/10万、1.88/10万、3.05/10万，中标死亡率分别为3.01/10万、1.42/10万、2.35/10万，世标死亡率分别为2.90/10万、1.41/10万、2.32/10万，0~74岁累积率分别为0.32%、0.18%、0.32%。10年间宫颈癌、子宫体癌、卵巢癌中标死亡率无明显变化趋势 (AAPC=-1.00%，P＞0.05；AAPC=-0.64%，P＞0.05；AAPC=0.77%，P＞0.05)。但2019-2021 年间宫颈癌和卵巢癌中标死亡率均呈明显下降趋势(APC=-4.14%，P=0.046；APC=-4.91%，P=0.042)。2012—2016年和2017—2021 年宫颈癌患者5年相对生存率分别为66.87%（95%CI：62.96%~70.49%）和76.81%（95%CI：73.24%~79.99%），2012—2016年和2017—2021 年子宫体癌患者5年相对生存率分别为75.81%（95%CI：70.74%~80.19%）和87.93%（95%CI：84.79%~90.53%），2012—2016年和2017—2021 年卵巢癌5年相对生存率分别为48.98%（95%CI：43.33%~54.40%）和60.68%（95%CI：54.86%~66.02%）。从不同年龄组看，宫颈癌、子宫体癌、卵巢癌患者的5年相对生存率随年龄增长均呈下降趋势。宫颈癌、子宫体癌、卵巢癌的中位生存时间分别为17.00(8.00,32.00)月、14.50(5.00,34.00)月、17.00(6.00,35.75)月,宫颈癌和卵巢癌的中位生存时间均呈明显上升趋势（H=34.139，P＜0.001；H=21.980，P=0.009），子宫体癌中位生存时间未见明显变化趋势（H=5.078，P=0.827）。 结论 近年来厦门市宫颈癌和卵巢癌防控初见成效,子宫体癌疾病负担逐年加重。在妇科癌症防治工作中，应重点从子宫体癌的流行特点出发，积极探索适宜防治措施，在不断优化医疗卫生资源配置，提升医疗卫生服务水平的基础上，针对子宫体癌重点高危人群，加强危险因素一级预防，持续做好重点人群健康管理。 |
| 英文摘要: |
| Abstract: Objective Analyze the epidemic characteristics and changing trends of the three major gynecological cancers (cervical cancer, uterine cancer, and ovarian cancer) in Xiamen, and provide a basis for formulating gynecological cancer prevention and control strategies. Methods The incidence and death data of cervical cancer, uterine cancer and ovarian cancer in Xiamen from 2012 to 2021 were continuously collected through the direct reporting platform of tumor registration information in Fujian Province and the national population death information registration system. The crude incidence (death) rate, the standardized incidence (death) rate of Chinese population (hereinafter referred to as the bid winning rate), the standardized incidence (death) rate of world population (hereinafter referred to as the world standard rate), and the cumulative incidence (death) rate from 0 to 74 years old were calculated. The annual percentage change (APC) and the average annual percentage of change (AAPC) were calculated using the joinpoint model. Results From 2012 to 2021, 1479 cases of cervical cancer, 1086 cases of uterine cancer and 800 cases of ovarian cancer occurred in Xiamen, with the median age of 51.0 years old, 54.0 years old and 53.0 years old, respectively. The average annual crude incidence rate was 12.96 /105, 9.52 /105 and 7.01 /105, respectively. The bid winning rate was 10.35 /105, 7.48/105,and 5.66 /105, respectively. The world standard rate was 9.72 /105, 7.30/105and 5.45 /105,respectively. The cumulative rate of 0-74 years old was 1.04%, 0.85% and 0.56%, respectively. The standardized incidence rate of cervical cancer and ovarian cancer had no significant change trend in the past 10 years (AAPC=-1.70%, P>0.05; AAPC=3.95%, P>0.05), while the standardized incidence rate of uterine body cancer showed a significant upward trend (AAPC=6.81%, P=0.005). There were 441 deaths from cervical cancer, 214 deaths from uterine body cancer, and 348 deaths from ovarian cancer, with median ages of 55.0 years, 61.50 years, and 60.0 years, respectively. The average annual crude mortality rates were 3.87/105, 1.88 /105, and 3.05 /105, respectively. The winning rates were 3.01 /105, 1.42 /105, and 2.35 /105, respectively. The world standard rates were 2.90 /105, 1.41 /105, and 2.32 /105, respectively. The cumulative rates from 0 to 74 years old were 0.32%, 0.18%, and 0.32%, respectively. Over the past 10 years, there has been no significant trend in standardized mortality rates for cervical cancer, uterine body cancer, and ovarian cancer (AAPC=-1.00%, P>0.05; AAPC=-0.64%, P>0.05; AAPC=0.77%, P>0.05). However, the standardized mortality rates of cervical cancer and ovarian cancer showed a significant downward trend from 2019 to 2021 (APC=-4.14%, P=0.046; APC=-4.91%, P=0.042). The 5-year relative survival rates of patients with cervical cancer in 2012-2016 and 2017-2021 were 66.87% (95% CI: 62.96% -70.49%) and 76.81% (95% CI: 73.24% -79.99%). The 5-year relative survival rates of patients with uterine body cancer in 2012-2016 and 2017-2021 were 75.81% (95% CI: 70.74% -80.19%) and 87.93% (95% CI: 84.79% -90.53%). The 5-year relative survival rates of patients with ovarian cancer in 2012-2016 and 2017-2021 were 48.98% (95% CI: 43.33% -54.40%) and 60.68% (95% CI: 54.86%~66.02%). From different age groups, the 5-year relative survival rate of patients with cervical cancer, uterine body cancer and ovarian cancer showed a downward trend with age.The median survival time for cervical cancer, uterine body cancer, and ovarian cancer were 17.00 (8.00, 32.00) months, 14.50 (5.00, 34.00) months, and 17.00 (6.00, 35.75) months, respectively. The median survival time for cervical cancer and ovarian cancer showed a significant upward trend (H=34.139, P<0.001; H=21.980, P=0.009), while the median survival time for uterine body cancer showed no significant change trend (H=5.078, P=0.827). Conclusions In recent years, the prevention and control of cervical and ovarian cancer in Xiamen have shown initial results, and the burden of uterine body cancer has been increasing year by year. In the prevention and treatment of gynecological tumors, it is important to focus on the epidemiological characteristics of uterine body cancer, actively explore appropriate prevention and treatment measures, continuously optimize the allocation of medical and health resources, improve the level of medical and health services, strengthen primary prevention of risk factors for key high-risk groups of uterine body cancer, and continuously manage the health of key populations. |
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