上海市2016年胃癌发病特征及2002年至2016年胃癌发病趋势分析

doi:10.16150/j.1671-2870.2022.04.008

摘要/Abstract

摘要：

目的：分析上海市2016年的胃癌发病特征及2002年至2016年间的胃癌发病趋势变化。方法：利用上海肿瘤登记处收录的2002年至2016年的胃癌数据,计算胃癌发病粗率、世界人口标化率、年龄别发病率、年度变化百分比。采用Segi′s世界标准人口构成调整计算年龄标化率,构建出生队列并计算出生人群发病率,利用Joinpoint软件进行胃癌发病趋势分析。结果：2016年上海市胃癌新发病例数为5 979例,男女比例为1.92∶1,粗发病率为41.29/10万,标化发病率为15.85/10万,居发病癌谱第4位。男性标化发病率高于女性,分别为21.19/10万和10.84/10万。2002年至2016年,上海市的胃癌标化发病率呈现下降趋势,男、女性胃癌标化发病率平均每年下降2.93%（-3.23%、-2.63%）和2.70%（-2.98%、-2.42%）。胃癌的年龄别发病率均随着年龄的增长而增加,45岁之前较低,发病率低于10/10万,45岁后开始上升,50岁后增长明显,80~84岁组达到高峰。2002年至2016年期间,35岁以上各年龄组的胃癌发病率整体均呈下降趋势,而其中50岁以下各年龄组胃癌发病率的下降趋势更为明显。结论：2016年,上海胃癌标化发病率为15.85/10万,居发病癌谱第4位,2002年至2016年间的胃癌发病率呈现逐年下降趋势。但胃癌仍是上海市居民常见的恶性肿瘤之一,对其发病特征和发病趋势进行分析有助于临床制定适宜的胃癌防治策略。

关键词: 胃癌, 发病率, 流行病学, 时间趋势, 上海

Abstract:

Objective: To investigate the incidence of stomach cancer in 2016 and the trend of incidence during 2002-2016 in Shanghai. Methods: The data on new-diagnosed stomach cancer during 2002-2016 were obtained from population-based cancer registry in Shanghai Municipal Center for Disease Control and Prevention. The incidence of stomach cancer stratified by year of diagnosis, gender, and age-group were analyzed. The number, proportion, crude rate, age-specific rate, age-standardized and annual percentage change were calculated, and the trends of incidence were evaluated. Segi′s World Standard Population in 1960 was used to calculate age-standardized rates of incidence and mortality, and the Joinpoint was used to analyze the trend of incidence of stomach cancer. Results: The new stomach cancer cases in Shanghai were 5 979 in 2016. The crude rate of incidence was 41.29/105 and the age-standardized rate was 15.85/105. The stomach cancer was one the most common cancers and ranked fourth in Shanghai. The age-standardized rate in male (21.19/105) was higher than that in female (10.84/105). The age-standardized rate of stomach cancer decreased during 2002-2016 in both male and female, and the APC was -2.93% (-3.23%, -2.63%) in male and -2.70% (-2.98%, -2.42%) in female, respectively. The morbidity rates of stomach cancer increased with age, which was <10/105 before 45 years, 17.08/105 in male and 13.22/105 in female between 45 and 49 years. After 50 years, the rates increased markedly and reached peak in age group of 80-84 years. While the age-specific incidence rates in all age groups showed decreased trend during 2002 through 2016, especially in the younger age group(<50 years). Conclusions: Population-based incidence data can provide helpful information in prevention of stomach cancer and policy decision.

Key words: Stomach Cancer, Incidence, Epidemiology, Time trend, Shanghai

中图分类号:

R541.7

鲍萍萍, 吴春晓, 顾凯, 庞怡, 王春芳, 施亮, 向詠梅, 龚杨明, 窦剑明, 吴梦吟, 付晨, 施燕. 上海市2016年胃癌发病特征及2002年至2016年胃癌发病趋势分析[J]. 诊断学理论与实践, 2022, 21(04): 462-469.

BAO Pingping, WU Chunxiao, GU Kai, PANG Yi, WANG Chunfang, SHI Liang, XIANG Yongmei, GONG Yangming, DOU Jianming, WU Mengyin, FU Chen, SHI Yan. Analysis on incidence of stomach cancer in 2016 and trend of incidence during 2002-2016 in Shanghai[J]. Journal of Diagnostics Concepts & Practice, 2022, 21(04): 462-469.

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性别	例数（n）	构成比（%）	粗率/10万	标化率/10万	截缩率/10万	累积率%			顺位
性别	例数（n）	构成比（%）	粗率/10万	标化率/10万	35~64岁	0~64岁	0~74岁	0~84岁	顺位
合计	5 979	8.03	41.29	15.85	23.41	0.84	1.83	3.53	4
男性	3 933	10.12	54.75	21.19	29.54	1.06	2.50	4.91	3
女性	2 046	5.75	28.04	10.84	17.33	0.62	1.16	2.28	5

年龄分组	年份	男		女
年龄分组	年份	APC（%）	95%CI	APC（%）	95%CI
30~34岁	2002-2016	-3.82	-1.79,0.81	-0.11	-2.64,2.49
35~39岁	2002-2016	-3.83^*	-6.82,-0.74	-2.72^*	-4.80,-0.59
40~44岁	2002-2016	-5.43^*	-6.44,-4.42	-2.26^*	-4.10,-0.39
45~49岁	2002-2016	-4.85^*	-6.17,-3.51	-3.42^*	-4.65,-2.17
50~54岁	2002-2016	-2.74^*	-3.89,-1.57	-1.57^*	-3.04,-0.08
	2002-2007	-2.87^*	-5.55,-0.11
	2007-2012	1.03	-2.90,5.11
	2012-2016	-10.53^*	-14.00,-6.91
55~59岁	2002-2016	-1.69^*	-2.52,-0.86	-1.36^*	-2.44,-0.26
60~64岁	2002-2016	-2.16^*	-2.97,-1.34	-3.00^*	-4.30,-1.69
65~69岁	2002-2016	-2.54^*	-3.23,-1.85	-3.71^*	-4.39,-3.03
70~74岁	2002-2016	-3.58^*	-4.08,-3.08	-3.96^*	-4.88,-3.03
75~79岁	2002-2016	-3.27^*	-3.81,-2.73	-3.16^*	-3.81,-2.51
	2002-2006	-6.03^*	-8.78,-3.20
	2006-2016	-2.51^*	-3.21,-1.79
80~84岁		-3.55^*	-4.05,-3.05	-2.86^*	-3.89,-1.81
≥85岁		-2.86^*	-3.68,-2.03	-1.47^*	-2.17,-0.77
合计^**		-2.93^*	-3.23,-2.63	-2.70^*	-2.98,-2.42

分类	2002年至2006年		2007年至2011年		2012年至2016年
分类	例数（n）	构成比（%）	例数（n）	构成比（%）	例数（n）	构成比（%）
诊断亚部位（ICD-10编码与名称）
贲门 C16.0	3 257	11.60	2 673	9.12	2 110	7.07
胃底 C16.1	393	1.40	480	1.64	473	1.58
胃体 C16.2	2 215	7.89	2 592	8.85	2 174	7.28
胃窦 C16.3	6 158	21.94	6 272	21.40	5 361	17.96
幽门 C16.4	262	0.93	166	0.57	133	0.45
胃小弯 C16.5	2 002	7.13	2 528	8.63	2 027	6.79
胃大弯 C16.6	150	0.53	100	0.34	74	0.25
胃交搭跨越 C16.8	786	2.80	661	2.26	697	2.34
胃NOS C16.9	12 844	45.76	13 830	47.20	16 794	56.27
病理组织学类型
鳞癌	187	0.67	190	0.65	134	0.45
管状和乳头状腺癌	1 402	4.99	1 443	4.93	1 141	3.82
黏液腺癌	810	2.89	829	2.83	658	2.20
印戒细胞癌	1 930	6.88	2 339	7.98	2 385	7.99
类癌	44	0.16	38	0.13	16	0.05
神经内分泌癌	17	0.06	64	0.22	142	0.48
其他和未分型腺癌	14 324	51.04	15 968	54.49	15 915	53.33
腺鳞癌	37	0.13	26	0.09	27	0.09
胃肠道间质肉瘤	422	1.50	691	2.36	821	2.75
其他和未分型	8 894	31.69	7 714	26.33	8 604	28.83
诊断时分期
Ⅰ期	1 508	5.37	1 915	6.54	2 194	7.35
Ⅱ期	2 466	8.79	2 453	8.37	2 074	6.95
Ⅲ期	3 242	11.55	3 578	12.21	3 221	10.79
Ⅳ期	3 989	14.21	4 769	16.28	4 440	14.88
不详	16 862	60.08	16 587	56.61	17 914	60.03