目的：分析2002—2021年上海市女性乳腺癌发病和死亡的流行病学特征及其变化趋势。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收集的2002—2021年上海市女性乳腺癌的新发病和死亡资料，按诊断或死亡年份和年龄组等因素分层分析，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。标化率应用Segi’s 1960年世界标准人口构成调整计算。应用Joinpoint分析软件对女性乳腺癌不同分组的标化年度变化百分比趋势、年龄别率和新发病例的部分诊断特征分类构成比进行分析。结果：上海市女性乳腺癌年新发病例数从2002年3 341例逐年增长到2021年7 086例，标化发病率从30.87/10万增长至46.62/10万，2002—2021年间以年均2.25%的增速上升（P<0.001）；年死亡人数从881人逐年增长到1 328人，标化死亡率从7.71/10万减少至5.98/10万，2002—2010年间以年均1.66%的增速上升（P=0.029），2010—2021年间以年均2.44%的减速下降（P<0.001）。2021年上海市女性乳腺癌粗发病率为94.24/10万，标化发病率为46.62/10万；粗死亡率为17.66/10万，标化死亡率为5.98/10万。年龄别发病率和死亡率随着年龄的增长而上升，年龄别发病率在60~64岁组达到顶峰，为160.63/10万，70~74岁之后迅速下降；年龄别死亡率在85岁及以上组达到顶峰，为99.35/10万。年龄特征趋势分析显示，上海市女性乳腺癌发病的中位年龄和平均年龄均有增长，大部分年龄组的年龄别发病率呈上升趋势，而年龄别死亡率则呈现下降趋势。新发病例通过病理确诊（MV）的占比上升，但组织学类型不详组的占比也在上升。诊断时Ⅰ期和未分期的占比均呈上升趋势。结论：上海市女性乳腺癌标化发病率相对较高，标化死亡率已显著降低，发病年龄特征呈现明显的老龄化趋势。上海在乳腺癌早期发现和诊疗方面的提升，可能对其发病特征带来影响，通过提高生存率而降低死亡率，但在乳腺癌的筛查、诊断和生存率提高上仍有较大的空间。本研究为乳腺癌的进一步研究和预防控制提供了科学依据。

Objective To analyze the epidemiological characteristics and trends of the incidence and mortality of female breast cancer in Shanghai from 2002 to 2021. Methods Data on new cases and deaths of female breast cancer from 2002 to 2021 were obtained from the Population-based Cancer Registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention. Cases or deaths, proportion, crude rate, age-specific rate, age-standardized rate (ASR) and others were calculated stratified by year of diagnosis or death and age-group. ASRs were calculated using Segi’ s 1960 world standard population. Trends of the annual percent change (APC) of ASRs, age-specific rates and proportions of new cases with selected diagnostic character of female breast cancer stratified by different groups were analyzed by Joinpoint analysis software. Results Annual new cases increased from 3 341 in 2002 to 7 086 in 2021, with ASR of incidence changing from 30.87/10⁵ to 46.62/10⁵. The trend of ASRs of incidence increased at an average annual rate of 2.25% (P<0.001) from 2002 to 2021. Annual deaths increased from 881 to 1 328, with ASR of mortality decreased from 7.71/10⁵ to 5.98/10⁵. The trend of ASRs of mortality increased at an average annual rate of 1.66% from 2002 to 2010 (P=0.029), followed by a decelerating decline at an average annual rate of 2.44% from 2010 to 2021 (P<0.001). In 2021, the crude rate of incidence of female breast cancer was 94.24/10⁵ in Shanghai, and the ASR was 46.62/10⁵. The crude rate of mortality was 17.66/10⁵, and the ASR was 5.98/10⁵. Age-specific rates of incidence and mortality generally increased with aging. The age-specific incidence rate peaked in the 60-64 years old (160.63/10⁵), followed by a marked decline after the 70-74 years old. The age-specific mortality rate peaked in the ≥85 years old (99.35/10⁵). The analysis on age-specific trends showed increases of both the median and mean ages at onset of female breast cancer. Increasing trends in age-specific incidence rates were observed across the majority of age groups, whereas age-specific mortality rates showed declining trends. The proportion of morphological verification (MV) increased; however, the proportion of cases with unspecified histological type also increased. The proportions of cases diagnosed at Stage Ⅰ and unknown stage showed increasing trends. Conclusions The ASR of female breast cancer incidence in Shanghai remains relatively high, whereas the ASR of mortality has declined. The age-specific characteristics at onset showed a pronounced trend toward aging. Improvements in early detection and clinical management of breast cancer may have influenced these epidemiological features, contributing to reduced mortality through improved survival rates in Shanghai. Nevertheless, considerable scope remains for further advancements in screening, diagnosis, and survival improvement for breast cancer. This study provided a scientific basis for further research, prevention and control for breast cancer.