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| 江苏省启东市1972-2021年结直肠癌发病流行趋势分析 |
| Trends of Colorectal Cancer Incidence in Qidong City, Jiangsu Province from 1972 to 2021 |
| 投稿时间：2023-11-28 修订日期：2024-03-16 |
| DOI： |
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| 中文关键词: 结直肠癌 发病率 趋势 流行病学 启东 |
| 英文关键词:colorectal cancer incidence trend epidemiology Qidong |
| 基金项目:2023年度南通市卫生健康委科研项目（MS2023121）；南通市“十四五”科教强卫工程（通卫科技[2021]15号） |
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| 中文摘要: |
| [目的] 分析江苏省启东市1972-2021年全人群结直肠癌发病流行趋势，为结直肠癌预防控制提供依据。 [方法] 基于启东市癌症登记病例数据库，提取1972-2021年结直肠癌发病登记资料，结合相应人口资料，计算粗发病率、中国人口标化率（中标率）、世界人口标化率（世标率）、35~64岁截缩率、0~74岁累积发病率、累积发病风险等。用Joinpoint Regression Program 4.9.1.0软件进行Joinpoint 回归分析，计算结直肠癌发病率平均年度变化百分比（average annual percentage change，AAPC）。[结果] 启东市1972-2021年50年期间共计发生结直肠癌11 956例，占同期全部恶性肿瘤发病例数的8.11%；结直肠癌粗发病率为21.31/10万，中标率为8.18/10万，世标率为13.14/10万，35~64岁截缩率为19.34/10万，0~74岁累积发病率为1.55%，结直肠癌累积发病风险为1.54%。其中男性发病6 176例，男性粗发病率、中标率、世标率分别为22.33/10万、9.18/10万、14.83/10万；女性发病5 780例，女性粗发病率、中标率、世标率分别为20.33/10万、7.28/10万、11.64/10万。1972-2021年启东市结直肠癌各年龄组发病率随年龄增加而不断升高，45 ~54岁年龄组AAPC值为2.543%，55~64岁年龄组AAPC值为 3.278%，65~74岁年龄组AAPC值为 2.845%，75岁及以上年龄组发病率AAPC值为3.413%,上述各年龄组结直肠癌发病率上升趋势均有统计学意义。平均发病年龄1972年为60.27岁，1996年为64.52岁，至2021年上升为69.04岁，50年期间平均发病年龄为66.78岁。时间趋势结果显示1972-2021年男女合计、男性及女性粗发病率的总体AAPC值分别为5.703%、6.511%及4.910%（均P < 0.001），上升趋势均有统计学意义；中国标化发病率的总体AAPC值分别为2.577%、3.283%及1.819%（均P < 0.001），上升趋势均有统计学意义；世界标化发病率的总体AAPC值分别为2.773%、3.470%、2.043%（均P < 0.001），上升趋势均有统计学意义。[结论] 启东市结直肠癌发病率呈现上升趋势，应针对重点人群做好防控措施，将45 岁以上人群作为结直肠癌重点关注对象，推进重点人群结直肠癌筛查项目，提高早诊早治率，以降低启东市结直肠癌的发病水平。 |
| 英文摘要: |
| Abstract: [ Objective] To analyze the trend of colorectal cancer incidence in the whole population of Qidong City, Jiangsu Province, from 1972 to 2021, and provide a basis for the prevention and control of colorectal cancer. [Methods] Based on the database of registered cancer cases in Qidong, colorectal cancer incidence registration data were extracted from 1972 to 2021, the crude incidence rate (CR), age-standardized rate by Chinese population (ASR-C) and by Segi’s world standard population (ASR-W), 35-64-year-old truncated rate, 0-74-year-old cumulative incidence rate and cumulative risk of incidence were calculated. Joinpoint regression analysis was performed using Joinpoint Regression Program 4.9.1.0 software to calculate the average annual percentage change (AAPC) in colorectal cancer incidence. [Results] The total number of colorectal cancer cases in Qidong during the 50-year period from 1972 to 2021 was 11,956, accounting for 8.11% of all malignant tumor cases during the same period. The CR, ASR-C, ASR-W, the truncated rate of 35-64, cumulative rate of 0-74 and cumulative risk of colorectal cancer was 21.31/105, 8.18/105, 13.14/105, 19.34/105, 1.55% and 1.54%, respectively. There were 6,176 cases in male, and the CR, ASR-C and ASW were 22.33/105, 9.18/105, and 14.83/105, respectively. While in female, there were 5,780 cases, and the CR, ASR-C and ASW were 20.33/105, 7.28/105, and 11.64/105, respectively. From 1972 to 2021, the incidence of colorectal cancer in Qidong in all age groups increased with age, and the AAPC was 2.543% in the age group of 45-54 years old, 3.278% in 55-64 years old, 2.845% in 65-74 years old, and 3.413% in 75 years old and above, and the increasing trend of colorectal cancer incidence in the age groups was statistically significant. The average age of incidence was 60.27 years old in 1972, 64.52 years in 1996, rising to 69.04 years by 2021, and 66.78 years over a 50-year period. Time trend showed that the overall AAPC for the CR in both gender, male and female from 1972 to 2021 were 5.703%, 6.511%, and 4.910%, respectively (all P < 0.001), with a statistically significant upward trend. The AAPC for ASR-C were 2.577%, 3.283%, and 1.819%, respectively (all P < 0.001), all with statistically significant upward trends. Moreover, the AAPC in ASR-W were 2.773%, 3.470% and 2.043% (all P < 0.001), all with statistically significant upward trends. [Conclusions] The incidence of colorectal cancer in Qidong shows a rising trend, and it is necessary to take preventive and control measures for key populations, make people over 45 years of age as the head target of colorectal cancer, promote the colorectal cancer screening program for prominent populations, and improve the rate of early diagnosis and early treatment, so as to reduce the incidence level of colorectal cancer in Qidong. |
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