Colorectal cancer incidence trends by subsite in urban Shanghai, 1972-1994.
Colorectal cancer incidence trends by subsite in urban Shanghai, 1972-1994.
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发表时间：
1998-08
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通讯作者：
B. Ji;S. Devesa;W. Chow;F. Jin;Yu-Tang Gao
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作者：
B. Ji;S. Devesa;W. Chow;F. Jin;Yu-Tang Gao
结直肠癌的流行病学特征可能因解剖部位不同而不同，提示不同部位的结直肠癌可能代表不同的疾病实体。这项研究按性别和年龄组探讨了23年间不同亚组结直肠癌发病率的时间趋势。有关结直肠癌发病率的数据来自中华人民共和国中国上海市的一个基于人群的癌症登记。1972至1994年间，上海市肿瘤登记处登记了30693例结直肠癌患者。从1972-1977到1990-1994，总体调整年龄的结直肠癌发病率增加了50%，即每年2%，男性从14/10万增加到22/10万，女性从12/100,000增加到19/10万。与直肠癌相比，结肠癌的发病率增加得更快，几乎翻了一番。在整个研究期间，近端结肠癌比远端结肠癌更常见，而这两种癌症的发病率以相似的年度百分比变化(每年5%)上升，几乎在所有年龄组中都是如此。近端结肠癌的估计年增长率从35-44岁的2%上升到75-84岁的7%，但远端结肠癌的估计年增长率更一致(每年5%-6%)。经年龄调整和特定年龄的直肠癌发病率变化不大。1990-1994年，男性与女性的结直肠癌年龄调整比率为1.19。这一比例随着时间的推移而增加，并随子部位的不同而不同，从近端结肠到远端结肠和直肠的比例都在增加。此外，55岁及以上的男性远端结肠癌和直肠癌的发病率高于女性，而女性在较年轻时这两种癌症的发病率高于男性。男性：女性近端结肠癌的比率并不随年龄的变化而显著变化。这项研究的结果表明，结直肠癌特定部位的发病率因性别、年龄和时间趋势而异。发生在近端结肠、远端结肠和直肠的癌症可能有一些不同的病因。
Epidemiological characteristics of colorectal cancer may differ by particular anatomical subsite, suggesting that the subsite-specific colorectal cancers may represent different disease entities. This study explored the time trends over a 23-year period in colorectal cancer incidence at various subsites by sex and age group. Data on the incidence of colorectal cancer were obtained from a population-based cancer registry in Shanghai, People's Republic of China. Between 1972 and 1994, 30,693 patients with colorectal cancer were registered at the Shanghai Cancer Registry. The overall age-adjusted colorectal cancer incidence rates increased > 50%, or 2% per year from 1972-1977 to 1990-1994, from 14 to 22 per 100,000 among men and from 12 to 19 per 100,000 among women. The increases in rates were considerably more rapid for colon cancer, with rates approximately doubling, than they were for rectal cancer. Proximal colon cancer was more common than distal colon cancer over the whole study period, whereas rates for both cancers rose with similar annual percentage changes (> 5% per year) and across virtually all age groups. The estimated annual increases rose from 2% at ages 35-44 years to 7% at ages 75-84 years for proximal colon cancer, but they were more uniform for distal colon cancer (5-6% per year). Age-adjusted and age-specific rectal cancer rates changed little. The male:female age-adjusted rate ratio for colorectal cancer was 1.19 in 1990-1994. The ratios increased over time and varied by subsites, with ratios increasing from the proximal colon to the distal colon and to the rectum. Furthermore, men had higher rates than women for distal colon and rectal cancers at ages 55 and older, whereas women had higher rates than men at younger ages for these two cancers. Male:female rate ratios for proximal colon cancer did not vary substantially with age. The findings from this study indicate that subsite-specific incidence rates of colorectal cancer differ by sex and age and in their time trends. Cancers arising in the proximal colon, distal colon, and rectum may have somewhat different disease etiologies.