| 黄永迎,相智声,马晶昱,等.2011—2020年福建省肿瘤登记地区上消化道癌流行特征及生存分析[J].中国肿瘤,2024,33(11):886-893. |
| 2011—2020年福建省肿瘤登记地区上消化道癌流行特征及生存分析 |
| Epidemic Characteristics and Survival Trends of Upper Gastrointestinal Cancer in Fujian Cancer Registration Areas from 2011 to 2020 |
| 投稿时间：2024-05-10 |
| DOI：10.11735/j.issn.1004-0242.2024.11.A002 |
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| 中文关键词: 上消化道癌 食管癌 胃癌 发病率 死亡率 生存率 福建 |
| 英文关键词:upper gastrointestinal cancer esophageal cancer gastric cancer incidence rate mortality rate survival rate Fujian |
| 基金项目:福建省自然科学基金项目（2023J011292）；福建省引导性科技计划项目（2022Y0055）；福建省肿瘤医院人才引进项目（2021YNY06） |
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| 中文摘要: |
| 摘 要： ［目的］ 分析福建省肿瘤登记地区2011—2020年上消化道癌流行特征、变化趋势和生存情况。［方法］ 整理分析福建省肿瘤登记数据，计算2011—2020年上消化道癌（包括食管癌和胃癌）发病和死亡粗率、中标率、世标率、累积率，采用 Joinpoint 线性回归模型分析上消化道癌发病和死亡的变化趋势，计算年度变化百分比（annual percentage change，APC）及平均年度变化百分比（average annual percentage change，AAPC）。将诊断时间分成2011—2015年和2016—2020年两个时间段比较上消化道癌的5年相对生存率。［结果］ 2011—2020年，福建省肿瘤登记地区上消化道癌新发病例26 286例，占全部恶性肿瘤的20.28%，粗发病率为56.52/10万，中标率为42.55/10万，世标率为42.75/10万，0~74岁的累积发病率为5.32%，男性上消化道癌发病率高于女性。上消化道癌发病率整体呈下降趋势，中标率的AAPC为-4.7%（95%CI：-6.6%~-2.9%）。其中食管癌新发病例11 680例，粗发病率、中标率、世标率和0~74岁的累积率分别为25.12/10万、18.67/10万、18.97/10万和2.32%；胃癌新发病例14 606例，粗发病率、中标率、世标率和0~74岁的累积率分别为31.41/10万、23.88/10万、 23.78/10万和3.00%。2011—2020年，福建省肿瘤登记地区上消化道癌死亡病例20 133例，占全部恶性肿瘤死亡病例的26.05%，上消化道癌粗死亡率为43.29/10万，中标率为31.95/10万，世标率为31.89/10万，0~74岁的累积死亡率为3.84%，男性上消化道癌死亡率高于女性。上消化道癌死亡率呈现先上升后下降的趋势，2011—2014年的中标率APC为3.5%（95%CI：-0.5%~11.3%），2014—2020年为-5.2%（95%CI：-8.4%~-3.7%）。其中食管癌死亡病例9 643例，粗死亡率、中标率、世标率和0~74岁累积率分别为20.74/10万、15.20/10万、15.35/10万和1.83%；胃癌死亡病例10 490例，粗死亡率、中标率、世标率和0~74岁累积率分别为22.56/10万、16.75/10万、16.54/10万和2.00%。 2011—2015年上消化道癌患者5年相对生存率为24.74%（95%CI：23.92%~25.56%），2016—2020年为25.49%（95%CI：24.65%~26.34%）。2011—2015年和2016—2020年食管癌患者5年相对生存率分别为17.15%（95%CI：16.10%~18.22%）和18.72%（95%CI：17.59%~19.88%）；2011—2015年和2016—2020年胃癌患者的5年相对生存率分别为30.90%（95%CI：29.71%~32.10%）和30.76%（95%CI：29.56%~31.97%）。随着年龄增长，上消化道癌患者5年生存率有所下降，65岁后生存率较低。［结论］ 福建省肿瘤登记地区上消化道癌发病率和死亡率整体呈下降趋势，5年相对生存率略有提升，但上消化道癌的疾病负担依然较重。男性上消化道癌发病率和死亡率均高于女性。老年上消化道癌患者预后较差。应密切关注重点人群，加强上消化道癌的综合防治能力。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the epidemic characteristics and survival trends of upper gastrointestinal cancer in Fujian cancer registration areas from 2011 to 2020. ［Methods］ Cancer regi-stration data in Fujian Province was collected to calculate the crude incidence and mortality rate， age-standardized incidence/mortality rates by Chinese standard population(ASIRC， ASMRC) and by world standard population(ASIRW， ASMRW) and cumulative rate of 0~74 years old of upper gastrointestinal cancer (including esophageal and gastric cancers) as well as the corresponding temporal trends from 2011 to 2020. Using the Joinpoint software to calculate the annual percentage change(APC) and average annual percentage change(AAPC) to analyze the trends. The data were divided into two time periods (2011—2015 and 2016—2020) to compare the 5-year relative survival rates of upper gastrointestinal cancer. ［Results］ From 2011 to 2020， there were 26 286 new cases of upper gastrointestinal cancer in Fujian cancer registration areas， accounting for 20.28% of all malignant tumors. The incidence rate， ASIRC and ASIRW of upper gastrointestinal cancer was 56.52/105， 42.55/105， and 42.75/105， respectively， and the cumulative incidence rate (0~74 years old) was 5.32%. Incidence of upper gastrointestinal cancer was higher in men than that in women. The incidence of upper gastrointestinal cancer showed an decreasing trend from 2011 to 2020， with an AAPC of ASIRC of -4.7% (95%CI：-6.6%~-2.9%). There were 11 680 new cases of esophageal cancer in Fujian cancer registration areas， the crude incidence， ASIRC， ASIRW and cumulative incidence (0~74 years old) of esophageal cancer were 25.12/105， 18.67/105， 18.97/105， and 2.32%， respectively. There were 14 606 gastric cancer new cases in Fujian cancer registration areas during 2011—2020， the crude mortality， ASMRC， ASIRW and cumulative mortality (0~74 years old) of gastric cancer were 31.41/105， 23.88/105， 23.78/105， and 3.00%， respectively. There were 20 133 upper gastrointestinal cancer deaths during 2011—2020 in Fujian cancer registration areas， accounting for 26.05% of all cancer deaths. The crude mortality， ASMRC and ASMRW of upper gastrointestinal cancer was 43.29/105， 31.95/105， and 31.89/105， respectively， the cumulative mortality rate (0~74 years old) was 3.84%. The mortality of upper gastrointestinal cancer was higher in men than that in women. The mortality rate of upper gastrointestinal cancer showed a trend of first increase and then decrease， with an APC of 3.5% (95%CI：-0.5%~11.3%) from 2011 to 2014 and -5.2% (95%CI：-8.4%~3.7%) from 2014 to 2020. There were 9 643 deaths of esophageal cancer during 2011—2020 in Fujian cancer registration areas. The crude mortality， ASMRC， ASMRW and cumulative mortality rate (0~74 years old) of esophageal cancer was 20.74/105， 15.20/105， 15.35/105， and 1.83%， respectively. There were 10 490 deaths of gastric cancer during 2011—2020 in Fujian cancer registration areas. The crude mortality， ASMRC， ASMRW and cumulative mortality rate (0~74 years old) of gastric cancer was 22.56/105， 16.75/105， 16.54/105， and 2.00%， respectively. The 5-year relative survival rate for upper gastrointestinal cancer patients during 2011—2015 and 2016—2020 were 24.74% (95%CI：23.92%~25.56%) and 25.49% (95%CI：24.65%~26.34%)， respectively. The 5-year relative survival rate for esophageal cancer patients during 2011—2015 and 2016—2020 were 17.15% (95%CI：16.10%~18.22%) and 18.72% (95%CI：17.59%~19.88%)， respectively. The 5-year relative survival rate for gastric cancer patients during 2011—2015 and 2016—2020 were 30.90% (95%CI：29.71%~32.10%) and 30.76% (95%CI：29.56%~31.97%)， respectively. There was a decreasing trend in 5-year survival of upper gastrointestinal patients with increasing age， with lower survival rate in patients over 65 years old. ［Conclusion］ The incidence and mortality of upper gastrointestinal cancer in Fujian cancer registration areas showed an overall decreasing trend， and the 5-year relative survival rate improved slightly， while the disease burden of upper gastrointestinal cancer remains heavy. Incidence and mortality of upper gastrointestinal cancer of men were higher than those of women， and the elderly patients with upper gastrointestinal cancer had a poorer prognosis. Fujian should pay close attention to the prevention and control of gastric cancer among key groups， and strengthen its comprehensive prevention and control ability of upper gastrointestinal cancer. |
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