2000—2022年上海市宝山区甲状腺癌发病趋势分析

doi:10.16150/j.1671-2870.2024.04.005

摘要/Abstract

摘要：

目的：分析2000年至2022年上海市宝山区的甲状腺癌发病特征和变化趋势，为本地区甲状腺癌防控提供依据。方法：利用上海市肿瘤登记报告系统中2000年至2022年甲状腺癌发病资料，分析宝山区户籍人口的甲状腺癌发病情况。采用Excel 2013计算粗发病率、年龄标化发病率（age-standardized incidence rate， ASIR）、0~74岁累积发病率、35~64岁截缩率和性别、年龄别发病率等指标。采用Joinpoint 5.0.2.0软件计算年度变化百分比（annual percentage of change，APC）和平均年度变化百分比（average annual percentage of change, AAPC），并进行趋势分析。结果：2000年至2022年，上海市宝山区甲状腺癌监测核实共计6 877例，年平均发病率为33.38/10万（ASIR为28.77/10万），男性为17.54/10万（ASIR为15.40/10万），女性为49.87/10万（ASIR为43.05/10万）；0~74岁累积发病率为2.16%；35~64岁截缩率为64.07/10万。23年间，甲状腺癌ASIR整体呈上升趋势，AAPC为14.51%（P<0.001），其中2000年至2017年呈现快速上升，APC为20.79%（P<0.001）；2017年至2022年趋于平稳，APC为-4.50%（P=0.146）。甲状腺癌发病率在30~34岁组和55~59岁组达到2个高峰，发病率分别为45.37/10万和52.12/10万。各年龄段发病趋势显示，在20~44岁间平均增速最快，AAPC为17.02%（P<0.001）。结论：上海市宝山区的甲状腺癌发病率呈现出从快速增长向趋于平稳的趋势转变，但仍处于较高水平，应进一步探索甲状腺癌高发的原因；需将30~34岁和55~59岁这2个年龄段的人群作为重点关注人群，并制定针对这些高风险群体的预防策略。

关键词: 甲状腺癌, 发病率, 年度变化百分比, 发病趋势

Abstract:

Objective To provide a scientific basis for the prevention and control of thyroid cancer by analyzing the incidence characteristics and trends of thyroid cancer in Baoshan District, Shanghai from 2000 to 2022. Methods The thyroid cancer incidence data from the Shanghai Cancer Registry Reporting System from 2000 to 2022 were used to analyze the incidence of thyroid cancer among registered residents of Baoshan District. Indices such as crude incidence rate, age-standardized incidence rate (ASIR), cumulative incidence rate for ages 0-74, truncated rate for ages 35-64, and age-specific and gender-specific incidence rates were calculated using Excel 2013.Joinpoint 5.0.2.0 software was used to calculate the annual percentage of change (APC) and average annual percentage of change (AAPC), and to conduct trend analysis. Results Between 2000 and 2022, a total of 6 877cases of thyroid cancer were monitored and recorded in Baoshan District,with an average annual incidence rate of 33.38/100 000(ASIR of 28.77/100 000), among which the incidence rate for males was 17.54/100 000 (ASIR of 15.40/100 000), and for females was 49.87/100 000 (ASIR of 43.05/100 000);the cumulative incidence rate for the 0-74 age group was 2.16%;and the truncated rate for the 35-64 age group was 64.07/100 000. The ASIR of thyroid cancer showed an overall upward trend over the 23 years, with an AAPC of 14.51% (P<0.001). It increased rapidly from 2000 to 2017, with an APC of 20.79% (P<0.001), followed by a stabilization phase from 2017 to 2022, with an APC of -4.50% (P=0.146). The incidence rate of thyroid cancer reached two peaks in in the 30-34 and 55-59 age groups, with the incidence rates of 45.37/100 000 and 52.12/100 000, respectively. The incidence trend of all age groups showed that the average increase rate was the highest between 20 and 44 years old, with an AAPC of 17.02% (P<0.001). Conclusions The incidence of thyroid cancer in Baoshan District of Shanghai presentes a shift from a rapid to a stable trend, yet it remains at a relatively high level. There is a need for further investigation into the causes of the high incidence of thyroid cancer. The age groups of 30-34 and 55-59 should be particularly emphasized as key focus populations, and targeted prevention strategies must be developed to mitigate their risk.

Key words: Thyroid cancer, Incidenc rate, Annual percent change, Incidence trends

中图分类号:

R736.1

张志萍, 蔡世龙, 耿延龙, 刘世友. 2000—2022年上海市宝山区甲状腺癌发病趋势分析[J]. 诊断学理论与实践, 2024, 23(04): 378-384.

ZHANG Zhiping, CAI Shilong, GENG Yanlong, LIU Shiyou. Analysis of incidence trend of thyroid cancer in Baoshan District, Shanghai from 2000 to 2022[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(04): 378-384.

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Gender	case	proportion（%）	Crude rate (1/10⁵)	ASIR(1/10⁵)	Cumulative rate (0-74 years old) (%)	Truncated rate(35-64 years old) (1/10⁵)
Total	6 877	100.00	33.38	28.77	2.16	64.07
Male	1 843	26.80	17.54	15.40	1.13	41.32
Female	5 034	73.20	49.87	43.05	3.30	87.65

Gender	Period	APC				AAPC
Gender	Period	%	95%CI	t vale	P vale	%	95%CI	t vale	P vale
male	2000—2017	21.17	18.58-23.82	18.67	<0.001	15.44	13.09-17.84	13.68	<0.001
	2017—2022	-2.10	-8.11-4.30	-0.70	0.491
female	2000—2018	19.16	16.68-21.68	7.57	<0.001	13.02	10.4-15.70	10.25	<0.001
	2018—2022	-10.91	-19.44-1.47	-2.41	0.027
total	2000—2017	20.79	18.19-23.45	18.21	<0.001	14.51	12.17-16.91	12.83	<0.001
	2017—2022	-4.50	-10.38-1.78	-1.52	0.146

Age/year	APC				AAPC
Age/year	Period	%	95%CI	P vale	%	95%CI	P vale
20-44
Total	2000—2017	23.18	19.57-26.90	<0.001	17.02	13.91-20.20	<0.001
	2017—2022	-1.72	-8.95-6.07	0.638
Male	2000—2016	25.34	20.81-30.05	<0.001	18.40	15.01-21.88	<0.001
	2016—2022	1.69	-4.04-7.76	0.551
Female	2000—2018	21.33	18.16-24.59	<0.001	15.66	12.48-18.93	<0.001
	2018—2022	-6.75	-16.71-4.41	0.210
45-64
Total	2000—2014	22.04	19.39-24.75	<0.001	12.61	9.94-15.25	<0.001
	2014—2020	4.62	0.40-9.03	0.034
	2020—2022	-20.02	-35.12-1.41	0.038
Male	2000—2016	18.53	15.59-21.55	<0.001	13.28	10.64-16.00	<0.001
	2016—2022	-2.88	-9.6-4.34	0.403
Female	2000—2014	22.32	18.85-25.90	<0.001	12.14	8.62-15.77	<0.001
	2014—2020	3.09	-2.27-8.73	0.243
	2020—2022	-21.45	-40.66-3.99	0.087
≥65
Total	2000—2015	23.01	18.94-27.23	<0.001	14.88	11.18-18.71	<0.001
	2015—2019	8.06	-4.47-22.23	0.200
	2019—2022	-11.46	-20.99-0.78	0.038
Male	2000—2018	15.27	9.42-21.43	<0.001	9.93	4.46-15.69	<0.001
	2018—2022	-11.18	-26.46-7.27	0.204
Female	2000—2015	24.05	19.83-28.42	<0.001	15.65	11.78-19.67	<0.001
	2015—2019	7.52	-5.70-22.59	0.257
	2019—2022	-10.21	-20.04-0.82	0.066