Incidence and survival of non-small cell lung cancer in Shanghai: a population-based cohort study.
Incidence and survival of non-small cell lung cancer in Shanghai: a population-based cohort study.
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DOI：
10.1136/bmjopen-2015-009419
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发表时间：
2015-12-23
期刊：
影响因子：
2.9
通讯作者：
Zhao NQ
中科院分区：
文献类型：
--
作者：
Fan H;Shao ZY;Xiao YY;Xie ZH;Chen W;Xie H;Qin GY;Zhao NQ
中国大陆缺乏关于非小细胞肺癌（NSCLC）发病率和结局的大规模人群研究。本研究旨在了解上海地区非小细胞肺癌的发病率、人口学特征、生存率及影响生存的因素。前瞻性观察性队列研究。基线信息来源于上海市卫生信息网，该信息网基于上海市所有具有肿瘤诊断资格的综合医院和专科医院的卫生信息系统。招募了2011年至2013年期间从数据库中识别的所有NSCLC病例（15020例患者）。 NSCLC的粗发病率和年龄校正发病率分别为54.20/100 000人（男性55.90/100 000，女性52.39/100 000）和39.05/100 000人（男性41.43/100 000，女性37.13/100 000）。 中位生存时间为22.7个月（95%CI 21.8至24.2个月），总1年生存率为71.8%（95%CI 69.8%至73.8%）。 1年生存率为96.5%（95% CI 94.0%-98.6%），I期NSCLC患者中，89.1%（95% CI 83.3%-94.9%），IIIa期NSCLC患者为78.8%（95% CI 74.1%至83.5%），IIIb/IV期NSCLC患者为58.9%（95% CI 56.1%至61.7%）。多因素分析显示，手术切除（HR=0.607，95% CI 0.511至0.722）和化疗（HR=0.838，95% CI 0.709至0.991）显著改善生存率。与低生存率相关的因素包括年龄大、男性、肿瘤较大、淋巴结转移、远处转移和鳞状细胞癌。与既往发表的研究相比，发现NSCLC患者的发生率更高，生存率更好，这可能为中国NSCLC的发生率和生存率提供证据。
Large population-based studies on the incidence and outcome of non-small cell lung cancer (NSCLC) are lacking in mainland China. This study aimed to investigate the NSCLC incidence, demographic features and survival as well as factors affecting survival of patients with NSCLC in Shanghai. Prospective observational cohort study. Baseline information was collected from Shanghai Health Information Network, which is based on the Health Information Systems from all the comprehensive hospitals and specialist hospitals qualified for cancer diagnosis in the Shanghai metropolitan area. All NSCLC cases identified from the database between 2011 and 2013 were recruited (15 020 patients). The crude and age-adjusted incidences of NSCLC were 54.20 per 100 000 people (55.90 per 100 000 for men, 52.39 per 100 000 for women) and 39.05 per 100 000 people (41.43 per 100 000 for men and 37.13 per 100 000 for women), respectively. The median survival time was 22.7 months (95% CI 21.8 to 24.2 months) with an overall 1-year survival rate of 71.8% (95% CI 69.8% to 73.8%). The 1-year survival rate was 96.5% (95% CI 94.0% to 98.6%) in patients with stage I NSCLC, 89.1% (95% CI 83.3% to 94.9%) in patients with stage II NSCLC, 78.8% (95% CI 74.1% to 83.5%) in patients with stage IIIa NSCLC and 58.9% (95% CI 56.1% to 61.7%) in patients with stage IIIb/IV NSCLC. Multivariate analysis showed surgical resection (HR=0.607, 95% CI 0.511 to 0.722) and chemotherapy (HR=0.838, 95% CI 0.709 to 0.991) significantly improved survival. Factors associated with poor survival included older age, male sex, larger tumour size, lymph node metastasis, distant metastasis and squamous cell carcinoma. A higher incidence and better survival rates for patients with NSCLC were identified when compared with previously published studies, which may provide evidence on the incidence and survival of NSCLC in China.