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| 河北省宫颈癌发病率趋势：基于时期、解剖部位、病理学型及分期的分析 |
| Trends of cervical cancer incidence rates by period, anatomical site, histological subtype, and stage in the North China |
| 投稿时间：2026-01-30 修订日期：2026-04-03 |
| DOI： |
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| 中文关键词: 宫颈癌 鳞状细胞癌 腺癌 解剖部位 分期 中国 |
| 英文关键词:cervical cancer, squamous cell carcinoma, adenocarcinoma, anatomical site, stage, China |
| 基金项目:无 |
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| 摘要点击次数: 48 |
| 全文下载次数: 0 |
| 中文摘要: |
| 摘 要：[目的] 分析河北省宫颈癌发病率随时期、解剖部位、病理学型和分期的变化趋势，旨在促进优化宫颈癌筛查模式，改进治疗方法，推动HPV疫苗接种的规范化和普及，以加速消除河北省宫颈癌。[方法] 收集河北省38个人群肿瘤登记处2009-2020年间上报的所有宫颈癌新发病例数据。同时从国家癌症中心获取2018年中国宫颈癌最新数据。合并分析数据，分别计算不同地区、时期、性别和年龄组的粗发病率及标准化发病率。使用Joinpoint回归模型计算年度变化百分比（AAPC）分析发病趋势。系统分析了河北省及全国宫颈癌的解剖部位、病理学类型和分期分布情况。[结果] 2009-2020年河北省宫颈癌粗发病率为12.98/10万。宫颈癌粗发病率从2009年的14.51/10万下降至2020年的11.93/10万，年均变化百分比（AAPC）为-2.42%。中国人口标化发病率（ASIRC）和世界人口标化发病率（ASIRW）均呈下降趋势，AAPC分别为-3.55%和-3.74%。城市地区粗发病率（12.53/10万）略低于农村地区（13.26/10万）。无论发病率还是病例数，均在50-54岁年龄组达到最高峰。45岁以后，农村地区的发病率显著高于城市地区。在具有明确解剖学亚部位信息的宫颈癌病例中，河北省和全国范围内，宫颈内膜癌占比均超过50%，宫颈外口癌占比均超过35%。鳞状细胞癌是河北省及全国最常见的宫颈癌组织学类型，其次是腺癌。无论是在全国还是河北省，早期（I期）宫颈癌的占比均为最高。全国宫颈癌I期占比已接近60%，河北省接近50%。而晚期（III期和IV期）宫颈癌的比例，在中国及河北省均低于所列的其他国家和地区，分别仅占4.54%和24.37%。[结论] 河北省宫颈癌的发病负担依然沉重。仍需提高HPV疫苗接种覆盖率，扩大筛查地域范围，高度重视50-54岁农村女性高危人群，提高筛查率，实现早发现、早诊断、早治疗，降低晚期宫颈癌诊断比例，提高患者生存率，从而加速河北省宫颈癌的消除。 |
| 英文摘要: |
| Abstract: [Purpose] To analyze the trends of cervical cancer incidence rates by period, anatomical site, histological subtype and stage at diagnosis in the North China to optimize cervical cancer screening mode, improve cervical cancer treatment methods, and promote the standardization and popularization of HPV vaccination, so as to accelerate the elimination of cervical cancer in North China. [Methods] All new cases of cervical cancer in 2009-2020 from 38 cancer registries in Hebei Province were collected. The latest cervical cancer data of China in 2018 were obtained from the National Cancer Center. The data were pooled and analyzed, and the crude incidence and the standardized incidence of different regions, period, gender and age were calculated, respectively. Joinpoint was used to calculate Annual change percentage (APC) to analyze trends in morbidity. The distribution of anatomical site, histological subtype and stage at diagnosis of cervical cancer were analyzed systematically in North China and China. [Results] The crude incidence rate for cervical cancer of North China in 2009-2020 was 12.98/100 000. The crude incidence of cervical cancer was decreased from 14.51/100 000 in 2009 to 11.93/100 000 in 2020, with the AAPC of -2.42%. The ASIRC and the ASIRW decreased, with the AAPC of -3.55% and -3.74%, respectively. The crude incidence rate for cervical cancer in urban areas (12.53/100 000) was slightly lower than that in rural areas(13.26/100 000). Both the incidence rate and the number of cases of cervical cancer were highest at the 50-54 age group. The incidence rates after 45 years old were substantially higher in rural areas than those in urban areas. Among cervical cancer cases with definite subsite information, endocervix accounted for more than 50% and exocervix accounted for more than 35% both in North China and China. The squamous cell carcinoma was the most common histological type of cervical cancer, followed by adenocarcinoma in North China and China. Whether in China or in North China the proportion of early stage cervical cancer was the highest. The proportion of cervical cancer with stage I in China had been close to 60%. In North China, it"s almost 50%. The proportion of advanced stage (stage III and IV) cervical cancer in China and North China was the lowest among these countries and regions, accounting for only 4.54% and 24.37%, respectively.[Conclusions] The incidence burden of cervical cancer remains heavy in North China. It’s still necessary to increase HPV vaccination coverage, expand the scope of screening areas, attach great importance to the high-risk groups of rural women aged 50-54 years old, improve the screening rate, achieve early detection and early diagnosis and treatment, reduce the proportion of advanced cervical cancer diagnosis, and improve the survival rate of cervical cancer patients, so as to accelerate the elimination of cervical cancer in North China. |
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