关键词: 小肠癌, 发病, 死亡, 生存, 流行病学, 上海

Abstract: Objective: To investigate the incidence, mortality and survival of small intestine cancer in Shanghai from 2002 to 2016. Methods: Data of new small intestine cancer cases and deaths from 2002 to 2016 were obtained from the population?based cancer registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Pre?vention. The incidence and mortality of small intestine cancer stratified by year of diagnosis or death, gender and age?group were analyzed. Cases or deaths, proportion, crude rate, age?specific rate, age?standardized rate and others were calculated. Trends of cases or deaths, crude rate, age?specific rate and age?standardized rate of incidence and mortality with follow?up information were estimated. The annual percent change (APC) of age?standardized rates of incidence and mortality was estimated by Joinpoint analysis. The new cases and proportions with selected diagnostic character of small intestine cancer in different diagnosis years were also calculated. Age ? standardized rates were calculated using Segi’s 1960 world standard population. The 1? to 5?year observed survival rates were calculated based on the life table. The probabilities of surviving from 0 to 99 years old were estimated according to the Elandt ?Johnson model, and then the cumulative expected survival rates were calculated according to the Ederer Ⅱ method. Finally, the 1? to 5?year relative survival rates were calculated. Results: The age?standardized rates of incidence and mortality of small intestine cancer were stable in Shanghai from 2002 to 2016. The new average cases and deaths of small intestine cancer were 280 and 174 per year in Shanghai. The crude rate of incidence was 2.02/105 , and the age?standardized rate was 0.96/105 . The crude rate of mortality was 1.25/105 , and the age?standardized rate was 0.54/105 . The age?standardized rates of incidence and mortality in males were higher than those in females. The age?specific cases or deaths and rates of incidence and mortality increased with aging.Duodenum cancer was the dominant anatomical site. Adenocarcinoma was the most histopathological type, and the proportion of gastrointestinal stromal tumors was increasing. The 5?year observed survival rate of small intestine cancer diagnosed from 2002 to 2013 was 36.34% in Shanghai, and the 5?year relative survival rate was 39.98%. All survival rates of male were lower than those of female. The 5? year observed and relative survival rates were stable. And those decreased with the increase of diagnostic years and stages. Relative to other sites, the rates of the duodenum cancer were the lowest. Relative to other histopathological types, those of gastrointestinal stromal tumors were the highest. Conclusions: The diagnostic level of small intestine cancer has been improved in Shanghai, continuously. But the survival rates have not been improved with the times. The proportion of stage Ⅰ was low and without improvement for a long time. This study provides useful information to further research, control and prevention of small intestine cancer. Improvement of the surveillance and research on small intestine cancer will help to promote more efficient control and prevention strategies then decrease cancer burden.

Key words: Small intestine cancer, Incidence, Mortality, Survival, Epidemiology, Shanghai