Breast cancer in a transitional society over 18 years: trends and present status in Shanghai, China
Breast cancer in a transitional society over 18 years: trends and present status in Shanghai, China
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DOI：
10.1007/s10549-008-0303-z
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发表时间：
2009-09-01
影响因子：
3.8
通讯作者：
Shao, Zhi-Ming
中科院分区：
文献类型：
--
作者：
Fan, Lei;Zheng, Ying;Shao, Zhi-Ming
作为一个在过去三十年中社会和经济快速发展的大都会，上海的乳腺癌发病率超过了中国所有其他癌症登记。为探讨上海市城区女性乳腺癌发病的变化规律，对1975 ~ 2004年上海市城区女性乳腺癌发病资料进行了分析。此外，回顾性分析了1990年1月至2007年7月期间接受手术治疗的7，443例女性乳腺癌患者的一家医院住院患者数据库。我们观察到，乳腺癌发病率在过去30年中急剧增加，并记录了以中年组（45-59岁）为代表的发病率高峰，该高峰出现在过去20年中。发病高峰由前20年的40-44岁组移至最近10年的50-54岁组。上海的中位诊断年龄早于西方国家，尽管从1990年的47.5岁增加到2007年的50岁。据观察，生殖风险因素的暴露程度高得多，依赖生殖系统的病例相对较少。通过筛查发现的无症状病例比例逐渐增加，早期病例（从1990年的78.6%增加到2007年的93.3%）和原位癌（2007年为14.7%）的比例也逐渐增加。手术治疗模式的分析表明，微创选择的趋势。发病高峰年龄和诊断时的中位年龄均随时间而增加，这表明未来将观察到发病率随年龄增加而沿着增加的趋势。因此，具体的筛查方案应加以完善，以考虑出生队列。
As a metropolis with rapid social and economic development over the past three decades, Shanghai has a breast cancer incidence that surpasses all other cancer registries in China. In order to estimate the regular changing patterns of female breast cancer in urban Shanghai, population-based incidence data from 1975 to 2004 were studied. In addition, a one-hospital-based in-patient database of 7,443 female breast cancer patients treated surgically between January-1990 and July-2007 were reviewed, retrospectively. We observed that breast cancer incidence increased dramatically over the past 30 years and documented a peak incidence represented by the middle-age group (45-59 years), which emerged in the last 20 years. The incidence peak moved from the 40-44 year group in the previous two decades to the 50-54 year group in the most recent decade. Median age at diagnosis was earlier in Shanghai than in the western countries, although it increased from 47.5-year in 1990 to 50-year in 2007. Considerably higher exposure to reproductive risk factors and relatively fewer hormone-dependent cases were observed. The proportion of asymptomatic cases detected by screening gradually increased, as well as that of early-stage cases (from 78.6% in 1990 to 93.3% in 2007) and carcinoma in situ (14.7% in 2007). Analysis of surgical treatment patterns suggested a trend of less-invasive options. Both age of peak incidence and median age at diagnosis increase with time, which suggests that increased incidence trending along with increasing age, will be observed in the future. Consequently, specific screening protocol should be refined to consider birth cohorts.