目的:分析2016年上海市甲状腺癌发病和死亡的基本情况及其2002—2016年间的变化趋势。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死因登记系统收集2002—2016年甲状腺癌发病和死亡资料。按诊断或死亡年份、性别和年龄组分层分析,计算数量、构成比、粗率、年龄别率、年龄标准化率（简称标化率）等指标。分析甲状腺癌发病和死亡数量、粗率、年龄别率和标化率趋势。应用Joinpoint软件计算标化率年度变化百分比,分析变化趋势。计算不同诊断年份组合的甲状腺癌新发病例部分诊断特征指标的数量和构成比。应用Segi′s 1960年世界标准人口构成调整计算发病和死亡的标化率。结果:2016年上海市甲状腺癌新发病例和死亡人数分别为7 683例和138人,粗发病率为53.06/10万,标化发病率为38.10/10万,粗死亡率为0.95/10万,标化死亡率为0.31/10万。男性发病和死亡的标化率均低于女性。年龄别发病和死亡的数量和率值总体上随着年龄的增长而增多。年龄别发病的数量和率值分别在55~59岁组和50~54岁组达到高峰。年龄别死亡的数量和率值均在85岁及以上组达到高峰。甲状腺癌的标化发病率在2002—2016年间以年均20.40%的增速上升,标化死亡率维持稳定状态。甲状腺癌的病理组织学类型以乳头状癌为主,其中乳头状微小癌比例的增长明显。诊断时分期的比例以Ⅰ期为主,且在不断增长。结论:按性别或年龄组分层的甲状腺癌现况和趋势与全球主要国家的情况相似,反映上海户籍人口在相关危险因素、检测技术应用和诊疗水平发展等方面的变化。加强甲状腺癌监测和研究有助于调整甲状腺癌防治措施,减少负担。

Objective To investigate the thyroid cancer incidence and mortality in Shanghai 2016 and trend change from 2002 to 2016. Methods Cases of thyroid cancer diagnosed, and thyroid cancer deaths during 2002 to 2016 were included from the population-based cancer registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention. Both incidence and mortality of thyroid cancer were stratified based on the year when diagnosed or died, and on gender and age, and were analyzed. Both case number and death number, and crude rate, age-specific rate, age-standardized and other rate were calculated. Changing trends in incidence and mortality, crude rate, age-specific rate and age-standardized rate were estimated. The annual percent change(APC) of age-standardized rates of both incidence and mortality was estimated by Joinpoint analysis. The case number and proportion of thyroid cancer in different diagnosis years with some diagnostic character were also calculated. Age-standardized rates of incidence and mortality were adjusted and calculated using Segi′s 1960 world standard population. Results Cases number 7 683 diagnosed as thyroid cancer and death number 138 due to thyroid cancer was in Shanghai 2016. The crude rate of incidence was 53.06/10⁵ and the age-standardized rate 38.10/10⁵. The crude rate of mortality was 0.95/10⁵ and the age-standardized rate 0.31/10⁵. The age-standardized rates of both incidence and mortality in males were lower than those in females. The age-specific both case and death and rates of incidence and mortality increased with aging. The age-specific case number and rate of incidence reached the peak at the age group of both 55-59 years and 50-54 years, respectively. The age-specific death number and rate of mortality reached the peak at the age group of more than 85 years. The age-standardized rate of incidence increased 20.40% per year between 2002 and 2016, however, that of mortality was stable. Papillary thyroid cancer was the dominant histopathological type when the proportion of papillary microcarcinoma increased. The ratio of stage of thyroid cancer was most at stage Ⅰ and increased continually. Conclusions The current status and changing trend of thyroid cancer stratified based on both gender and age were similar to those in most countries of the world, which indicate the risk factors, methods of detection, levels of both diagnosis and treatment improved in Shanghai. Development of the survey and research on thyroid cancer will help to promote more efficient control and prevention strategies, and decrease cancer burden.