| 李安琪,李 灿,邹艳花,等.2022年湖南省肿瘤登记地区食管癌流行特征及2018—2022年变化趋势分析[J].中国肿瘤,2026,35(7):515-521. |
| 2022年湖南省肿瘤登记地区食管癌流行特征及2018—2022年变化趋势分析 |
| Epidemiological Characteristics of Esophageal Cancer in Cancer Registration Areas of Hunan Province in 2022 and Trends from 2018 to 2022 |
| 投稿时间：2026-05-08 |
| DOI：10.11735/j.issn.1004-0242.2026.07.A003 |
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| 中文关键词: 食管癌 发病率 死亡率 变化趋势 湖南 |
| 英文关键词:esophageal cancer incidence mortality temporal trend Hunan |
| 基金项目:湖南省肿瘤医院医院高层次人才五年支持计划（20250811-1101） |
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| 中文摘要: |
| 摘 要：［目的］ 分析2022年湖南省肿瘤登记地区食管癌的流行现状及2018—2022年的趋势特征。［方法］ 收集湖南省质控合格的肿瘤登记处2018—2022年食管癌的发病与死亡监测资料，人口数据来源于公安部门发布的各辖区对应年度户籍人口统计数据。计算 2022年食管癌的发病和死亡粗率、标化率及累积率等指标。应用Joinpoint回归模型进行对数线性回归拟合，通过平均年度变化百分比（average annual percentage change，AAPC）分析其变化趋势。［结果］ 2022年湖南省肿瘤登记地区食管癌粗发病率为5.63/10万（男性9.28/10万，女性1.73/10万），中标发病率为2.98/10万；粗死亡率为4.77/10万（男性7.75/10万，女性1.58/10万），中标死亡率为2.42/10万，男性的发病与死亡风险均远高于女性。年龄分布特征显示，发病与死亡风险分别在40岁和45岁后快速攀升，均在80~84岁组达到峰值（分别为29.04/10万和32.32/10万）。趋势分析显示，2018—2022年食管癌粗发病率和中标发病率分别由2018年的6.72/10万和3.90/10万降至 2022年的5.63/10万和2.98/10万，AAPC 分别为-4.45%和-6.92%（P=0.008；P=0.006）；中标死亡率同样呈现下降趋势（AAPC=-4.04%，P=0.017），粗死亡率的变化趋势无统计学意义。性别分层分析显示，男性与女性的食管癌中标发病率均表现为下降趋势，其AAPC分别为-6.64%和-7.80%（P=0.006；P=0.024），男性中标死亡率总体呈现下降趋势（AAPC=-3.91%，P=0.033），而女性中标死亡率趋势检验未见统计学意义。年龄分层分析提示，44岁及以下人群的发病率整体变化趋势无统计学意义，其中男性发病率呈现下降趋势（AAPC=-11.83%，P=0.035），而女性则未见明显趋势变化；45~64岁、65岁及以上人群中标发病率AAPC分别为-10.69%、-3.63%，45~64岁组人群中标死亡率AAPC为-8.75%，趋势变化均有统计学意义（P均＜0.05）。 ［结论］ 湖南省肿瘤登记地区食管癌发病率和死亡率低于全国平均水平且呈下降趋势，性别差异显著，男性及高龄人群为防控重点。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the current epidemic status of esophageal cancer in the cancer registration areas of Hunan Province in 2022 and to evaluate the temporal trends from 2018 to 2022. ［Methods］ Surveillance data on esophageal cancer incidence and mortality were collected from qualified cancer registries in Hunan Province from 2018 to 2022. Demographic data were obtained from the annual household registration statistics provided by public security departments. Calculate the crude incidence and mortality rates， age-standardized rates， cumulative rates， and other indicators for esophageal cancer in 2022. Joinpoint regression models were employed to fit log-linear regressions， and temporal trends were analyzed using the average annual percentage change (AAPC). ［Results］ In 2022， the crude incidence rate of esophageal cancer in the cancer registration areas of Hunan Province was 5.63/105 (9.28/105 in males and 1.73/105 in females)， and the age-standardized incidence rate by Chinese standard population (ASIRC) was 2.98/105； the crude mortality rate was 4.77/105 (7.75/105 in males and 1.58/105 in females)， and the age-standardized mortality rate by Chinese standard population(ASMRC) was 2.42/105. The risk of incidence and mortality in males was much higher than that in females. Age distribution characteristics showed that the incidence and mortality risks increased rapidly after 40 and 45 years old respectively， and both peaked in the 80-84 years old group (29.04/105 and 32.32/105 respectively). Trend analysis showed that from 2018 to 2022， the crude incidence rate and ASIRC of esophageal cancer decreased from 6.72/105 and 3.90/105 in 2018 to 5.63/105 and 2.98/105 in 2022， with AAPC of -4.45% and -6.92% respectively (P=0.008； P=0.006)； the ASMRC also showed a downward trend (AAPC=-4.04%， P=0.017)， while the change trend of crude mortality rate was not statistically significant. Stratified analysis by sex showed that the ASIRC of esophageal cancer in both males and females showed a downward trend， with AAPC of -6.64% and -7.80% respectively (P=0.006； P=0.024). The overall ASMRC in males showed a downward trend (AAPC=-3.91%， P=0.033)， while the trend test of ASMRC in females was not statistically significant. Stratified analysis by age indicated that the overall change trend of incidence rate in the population aged ≤44 years old was not statistically significant， among which the incidence rate in males showed a downward trend(AAPC=-11.83%， P=0.035)， while no obvious trend change was observed in females. The AAPC of ASIRC in the population aged 45-64 years old and ≥65 years old was -10.69% and -3.63% respectively， and the AAPC of ASMRC in the 45-64 years old group was -8.75%， with statistically significant trend changes (all P<0.05). ［Conclusion］ Esophageal cancer incidence and mortality across Hunan’s cancer registries stay below national benchmarks， displaying a clear downward trend. Given the prominent gender differences， prevention and control efforts should prioritize males and the elderly population. |
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