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1972—2021年江苏省启东市青少年和年轻成人恶性肿瘤发病趋势分析

Trend of Malignant Tumors Incidence in Adolescents and Young Adults in Qidong City of Jiangsu Province from 1972 to 2021

投稿时间：2025-08-15 修订日期：2025-10-20

DOI：

中文关键词: 恶性肿瘤发病率趋势青少年年轻成人启东

英文关键词:malignant tumor incidence trend adolescents and young adults Qidong

基金项目:南通市“十四五”科教强卫工程（通卫科技【2021】15号）

作者	单位	邮编
王军	启东肝癌防治研究所/启东市人民医院	226200
陈永胜	启东肝癌防治研究所/启东市人民医院	226200
丁璐璐	启东肝癌防治研究所/启东市人民医院	226200
张永辉	启东肝癌防治研究所/启东市人民医院	226200
徐源佑	启东肝癌防治研究所/启东市人民医院	226200
陈建国	启东肝癌防治研究所/启东市人民医院	226200
朱健^*	启东肝癌防治研究所/启东市人民医院	226200
蔡岩坡	启东肝癌防治研究所/启东市人民医院	226200

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中文摘要:

[目的] 分析1972—2021年启东市青少年和年轻成人（adolescents and young adults，AYAs）恶性肿瘤发病情况，为该人群恶性肿瘤精准防控提供科学依据。 [方法] 从启东市肿瘤登记报告系统中提取发病时间为1972年1月1日至2021年12月31日、年龄为15~39岁人群的恶性肿瘤发病资料，计算粗发病率（Crude incidence rate，CR）、中国人口标准化发病率（age-standardized incidence rates by Chinese standard population，ASRC）和世界人口标准化发病率（age-standardized rate by world standard population，ASRW）。采用Joinpoint 5.0.2分析发病率的年度变化百分比（annual percentage change, APC）和年均变化百分比（average annual percentage change, AAPC）。 [结果] 1972—2021年启东市AYAs恶性肿瘤共计发病11 051例（男性6 764例，女性4 287例），CR为53.26/10万（男性65.52/10万，女性41.12/10万），ASRC为41.72/10万（男性66.89/10万，女性41.72/10万），ASRW为46.58/10万（男性57.18/10万，女性36.13/10万）。趋势分析结果显示，1972—2013年ASRW呈下降趋势（APC=-1.53%，t=-11.49，P<0.001），而2013—2021年呈上升趋势（APC=9.39%，t=4.92，P<0.001）。发病率随着年龄的增长而上升，各年龄组时间趋势分段显示除35~39岁年龄组2007—2013年外，其余均呈先降后升趋势（P均<0.05）。其中30~34岁和35~39岁年龄组发病率在近10年增幅最大，APC分别为14.23%（t=3.17，P=0.003）和11.38%（t=4.10，P=0.002）。50年来启东市AYAs的发病癌谱发生了较大的变化，期初1972—1976年前五位恶性肿瘤依次为肝癌、女性乳腺癌、胃癌、白血病和结直肠癌，期末2017—2021年前五位的甲状腺癌、女性乳腺癌、宫颈癌、白血病和肺癌是当前最需关注的重点癌种。主要恶性肿瘤中，肝癌ASRW呈下降趋势（AAPC=-3.62%，t=-5.56，P<0.001），甲状腺癌ASRW上升幅度最高（AAPC=10.87%，t=5.01，P<0.001），女性乳腺癌（AAPC=1.74%，t=2.35，P=0.047）、宫颈癌（AAPC=7.03%，t=4.73，P<0.001）、白血病（AAPC=1.22%，t=5.56，P<0.001）、肺癌（AAPC＝2.41%，t=5.04，P=0.001）和脑及中枢神经系统肿瘤（AAPC＝2.65%，t=10.79，P<0.001）均呈上升趋势，而胃癌、结直肠癌和淋巴瘤ASRW变化趋势无统计学意义（P均>0.05）。 [结论] 50年来启东市AYAs人群恶性肿瘤ASRW以2013年为界，呈先降后升趋势。甲状腺癌、女性乳腺癌、宫颈癌、白血病和肺癌是当前主要癌种且日益加重。未来防控策略应重点关注30~39岁人群，并针对主要癌种制定应对措施。

英文摘要:

[Purpose] To analyze the incidence of malignant tumors among adolescents and young adults (AYAs) in Qidong from 1972 to 2021, and to provide scientific evidence for precise prevention and control strategies in this population. [Methods] Data on malignant tumors among individuals aged 15–39 years from January 1, 1972, to December 31, 2021, were obtained from the Qidong Cancer Registry. Crude incidence rates (CR), age-standardized incidence rates by Chinese standard population (ASRC) and world standard population (ASRW) were calculated. Joinpoint regression (version 5.0.2) was used to estimate annual percentage change (APC) and average annual percentage change (AAPC) in incidence trends. [Results] A total of 11,051 malignant tumors were diagnosed among AYAs in Qidong between 1972 and 2021, including 6,764 cases in males and 4,287 in females. The overall CR was 53.26/105 (65.52/105 in males; 41.12/105 in females), the ASRC was 41.72/105 (66.89/105 in males; 41.72/105 in females), while the ASRW was 46.58/105 (57.18/105 in males; 36.13/105 in females). Incidence increased with age and exhibited a decline-then-rise pattern across all age groups(all P < 0.05), except for individuals aged 35–39 years during 2007–2013. Among those, the most pronounced increases in the past decade were observed in the 30–34 and 35–39 age groups, with APCs of 14.23% (t = 3.17, P = 0.003) and 11.38% (t = 4.10, P = 0.002), respectively. The cancer spectrum shifted substantially over the five decades: in 1972–1976, the top five cancers were liver cancer, female breast cancer, stomach cancer, leukemia, and colorectal cancer; in contrast, during 2017–2021, thyroid cancer, female breast cancer, cervical cancer, leukemia, and lung cancer ranked highest. Among major cancers, liver cancer ASRW showed the greatest decline (AAPC = ?3.62%, t = ?5.56, P < 0.001), while thyroid cancer had the highest upward trend (AAPC = 10.87%, t = 5.01, P < 0.001). Significant upward trends were also observed for female breast cancer (AAPC = 1.74%, t = 2.35, P = 0.047), cervical cancer (AAPC = 7.03%, t = 4.73, P < 0.001), leukemia (AAPC = 1.22%, t = 5.56, P < 0.001), lung cancer (AAPC = 2.41%, t = 5.04, P = 0.001), and tumors of the brain and central nervous system (AAPC = 2.65%, t = 10.79, P < 0.001), whereas changes for gastric cancer, colon and rectal cancer, and lymphoma were not statistically significant (all P > 0.05). [Conclusion] Over the past five decades, ASRW of malignant tumors among AYAs in Qidong City showed a decline before 2013 followed by a significant increase thereafter. Thyroid cancer, female breast cancer, cervical cancer, leukemia, and lung cancer are currently the major cancer types with increasing burden. Future prevention and control strategies should prioritize individuals aged 30–39 years and develop targeted interventions for these key malignancies.

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