目的：分析2002年至2019年上海市的肺癌发病及死亡情况，并观察其变化趋势。方法：采用上海市疾病预防控制中心建立的人群基础肿瘤登记管理系统和全死因登记系统中2002年至2019年上海市肺癌的发病和死亡资料，按诊断或死亡年份、性别和年龄组等因素分层分析，计算发病人数、构成比、粗率、年龄别率、年龄标准化率（简称标化率）等指标。标化率应用Segi’s 1960年世界标准人口构成调整计算。应用Joinpoint软件对不同分组的标化率、年龄别率和新发病例的部分诊断特征分类构成比，进行年度变化百分比趋势分析。结果：上海市肺癌的年新发病例数从2002年的8 005例，逐年增长到2019年的21 835例，标化发病率从33.73/10万上升至63.82/10万，年死亡人数从6 871人逐年增长到9 573人，标化死亡率从27.90/10万减少至21.75/10万。2019年，上海市肺癌标化发病率为63.82/10万，男性为66.37/10万，女性为62.09/10万；标化死亡率为21.75/10万，男性为33.50/10万，女性为10.95/10万，男女间差异均有统计学意义（P<0.001）。肺癌发病和死亡的年龄别数及率值总体上随着年龄的增长而增加。分性别的趋势分析显示，2002年至2019年，上海市男性肺癌的标化发病率以年均1.39%的增速上升（P=0.006），标化死亡率以年均0.98%的减速下降（P<0.001）；女性肺癌的标化发病率在2002年至2011年间的变化无统计学意义（P=0.717），在2011年至2019年间则以年均15.57%的增速上升（P<0.001），标化死亡率在2002年至2012年间的变化无统计学意义（P=0.779），在2012年至2019年间则以年均2.95%的减速下降（P=0.011）。2002年至2019年上海肺癌新发病例通过病理确诊的占比从44.28%上升至61.88%，通过影像学检查确诊的占比从41.50%下降至7.99%；肺腺癌占比从19.66%上升至41.20%，鳞状细胞癌占比从14.13%下降至6.29%；Ⅰ期患者占比从3.76%上升至22.60%，Ⅱ期至Ⅳ期患者占比下降；但解剖部位、病理组织学分型和诊断时分期不明确的占比仍较高，2019年解剖部位未特指的占比为75.65%，病理组织学分型未特指的占比为45.89%，诊断时分期不明的比例为54.05%。结论：2019年，相比于全球，我国上海市的肺癌标化发病率相对较高，且不同性别、不同年龄间的死亡率呈现出差异较大的流行特征，2002年至2019年间女性肺癌发病率总体呈现上升趋势，2019年女性肺癌的标化发病率随着年龄增长而上升。本研究提示在肺癌的筛查、诊断和生存率提升上仍有较大的空间，为肺癌的进一步研究和预防控制提供了依据。

Objective This study aims to analyze the incidence and mortality of lung cancer in Shanghai from 2002 to 2019 and their variation trends. Methods Data on lung cancer incidence and mortality in Shanghai from 2002 to 2019 were obtained from the population-based cancer registry management system and all-cause mortality registration system established by the Shanghai Municipal Center for Disease Control and Prevention. Stratified analyses were conducted by factors including year of diagnosis or death, sex, and age group, and indicators such as number of cases, constituent ratio, crude rate, age-specific rate, and age-standardized rate (ASR) were calculated. ASRs were calculated using Segi's 1960 world standard population. Joinpoint software was used to analyze annual percentage variation trends in ASRs, age-specific rates, and the constituent ratios of selected diagnostic characteristics of new cases across different groups. Results Annual new lung cancer cases in Shanghai increased from 8 005 in 2002 to 21 835 in 2019, and the age-standardized incidence rate increased from 33.73/10⁵ to 63.82/10⁵. Annual deaths increased from 6 871 to 9 573, while the age-standardized mortality rate decreased from 27.90/10⁵ to 21.75/10⁵. In 2019, the age-standardized incidence rate of lung cancer in Shanghai was 63.82/10⁵, including 66.37/10⁵ in males and 62.09/10⁵ in females, and the sex difference was statistically significant (P<0.001). The age-standardized mortality rate was 21.75/10⁵, with 33.50/10⁵ in males and 10.95/10⁵ in females, and the sex difference was statistically significant (P<0.001). Age-specific numbers and rates of lung cancer incidence and mortality generally increased with age. Sex-stratified trend analysis showed that from 2002 to 2019, the age-standardized incidence rate of lung cancer in males in Shanghai increased at an average annual rate of 1.39% (P=0.006), while the age-standardized mortality rate decreased at an average annual rate of 0.98% (P<0.001). In females, the age-standardized incidence rate showed no significant change from 2002 to 2011 (P=0.717), but increased at an average annual rate of 15.57% from 2011 to 2019 (P<0.001). The age-standardized mortality rate showed no statistically significant change from 2002 to 2012 (P=0.779), but decreased at an average annual rate of 2.95% from 2012 to 2019 (P=0.011). Among newly diagnosed lung cancer cases in Shanghai from 2002 to 2019, the proportion confirmed by pathology increased from 44.28% to 61.88%, while the proportion confirmed by imaging examination decreased from 41.50% to 7.99%. The proportion of adenocarcinoma increased from 19.66% to 41.20%, while that of squamous-cell carcinoma decreased from 14.13% to 6.29%. The proportion of stage Ⅰ patients increased from 3.76% to 22.60%, whereas the combined proportion of stage Ⅱ to stage Ⅳ patients decreased. However, the proportions of cases with unspecified anatomic site, unspecified histological type, and unknown stage at diagnosis remained high, and in 2019, the proportions were 75.65%, 45.89%, and 54.05%, respectively. Conclusions In 2019, compared with the global level, the age-standardized incidence rate of lung cancer in Shanghai, China, was relatively high, and mortality showed distinct epidemiological characteristics across sex and age groups. The incidence rate of lung cancer in females showed an overall upward trend from 2002 to 2019. In 2019, the age-standardized incidence rate of lung cancer in females increased with age. These findings suggest that there is still substantial room for improvement in lung cancer screening, diagnosis, and survival. This study provides a basis for further research and prevention and control strategies for lung cancer.