Trends in the incidence of cancer in Qidong, China, 1978-2002
Trends in the incidence of cancer in Qidong, China, 1978-2002
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DOI：
10.1002/ijc.21952
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发表时间：
2006-09-15
影响因子：
6.4
通讯作者：
Chen, Tao-Yang
中科院分区：
文献类型：
--
作者：
Chen, Jian-Guo;Zhu, Jian;Chen, Tao-Yang
1972年，江苏省启东市中国建立了以人群为基础的癌症登记处，分析了1978年至2002年25年间主要癌症地点的发病率趋势。利用人口规模的年度数据和对人口年龄结构的估计，计算了五年的年龄特异率、粗发病率、世界年龄标化率(ASR)、百分比变化率(PC)和年度百分比变化率(APC)。采用诊断的组织学验证、仅死亡证明和死亡率/发病率等指标评价登记质量。从1978年到2002年，全市共登记癌症病例51,933例，男女性别比为1.9：1。25年间粗发病率显著上升(PC和APC分别为+55.6%和+2.1%)，但ASR略有下降(男性为-0.4%，女性为-0.3%)，表明这主要是人口老龄化所致。位居前五位的肿瘤部位依次为肝癌(平均ASR=50.8/10万)、胃癌(26.7)、肺癌(22.7)、结直肠癌(8.9)、食道(7.4)和乳腺癌(5.4)。研究期间，肝癌、肺癌、结直肠癌和女性乳腺癌的发病率均有所上升，男性的APC(APC)分别为+0.1%、+1.7%和+1.4%，女性为+0.2%、+0.9%、+1.9%和+1.1%，而胃癌(APC：男性-3.2%，女性-2.4%)和宫颈癌(APC：-4.7%)的发病率显著下降。对年龄别发病率的检查显示，年轻一代患肝癌的比例呈下降趋势，但宫颈癌的发病率呈上升趋势。这些结果突出表明，在人口老龄化和社会经济发展和生活方式发生深刻变化的情况下，癌症作为死亡和发病原因的重要性日益增加。中国人口中常见的高致死率癌症(肝癌、胃癌、食道癌)正在显示出一些下降的迹象，至少在年轻一代是这样，但它们仍然是主要问题。与此同时，与经济“发达”社会相关的癌症--肺癌、结肠癌、直肠癌和女性乳腺癌--也呈上升趋势。以人口为基础的癌症登记是为规划和评估所有社会的癌症控制方案提供数据的不可或缺的工具。(C)2006年Wiley-Liss，Inc.
A population-based cancer registry was established in Qidong, Jiangsu Province, China, in 1972, and the trends in incidence rates of the major cancer sites have been analyzed for a 25-year period, 1978-2002. Five-year age-specific rates, crude incidence rates, world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size, and estimates of its age structure. The indices of histological verification of diagnosis, death certificate only and proportion of mortality to incidence were employed for assessing the registration quality. A total of 51,933 incident cases of cancer were registered in Qiaong from years 1978 to 2002, with a male-to-female sex ratio of 1.9:1. Crude incidence increased markedly over the 25-year period (PC and APC of +55.6% and +2.1%, respectively.), but ASR showed a slight decrease (-0.4% in males, and -0.3% in females), indicating that the major part of this is due to population ageing. The leading cancer sites in rank were liver (average ASR = 50.8 per 100,000), stomach (26.7), lung (22.7), colon-rectum (8.9), oesophagus (7.4) and breast (5.4). Cancers of liver, lung, colon-rectum and female breast all showed increases in incidence during the study period, with APCs (ASR) of +0.1%, +1.7% and +1.4% for males, and +0.2%, +0.9%, +1.9% and +1.1% for females, while the cancers of stomach (APC: -3.2% in male, and -2.4% in female) and cervix (APC: -4.7%) showed notable declines. Examination of age-specific rates showed declining trends in the younger generations for liver cancer, but increases for cervix cancer. The results underline the increasing importance of cancer as a cause of mortality and morbidity in a population that is ageing and undergoing profound changes in socioeconomic development and lifestyle. The cancers of high lethality that have been common in the Chinese population (liver, stomach, oesophagus) are showing some evidence of decline, at least in younger generations, but they remain major problems. At the same time, the cancers associated with economically "developed" societies-lung, colon-rectum and female breast - are showing increases. The population -based cancer registry is an indispensable tool for providing data for planning and evaluation of programmes for cancer control in all societies. (c) 2006 Wiley-Liss, Inc.