Colorectal cancer incidence and mortality in Shanghai 2016 and trend analysis 2002—2016

doi:10.16139/j.1007-9610.2021.04.010

Abstract

Abstract:

Objective To investigate the colorectal cancer (CRC) incidence and mortality in 2016 Shanghai and trend change between 2002 and 2016. Methods Data of CRC incidence and death between 2002 and 2016 were collected from the population-based cancer registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention. CRC incidence and mortality including year of incidence and mortality, gender, cancer site and age-group were analyzed. CRC incidence and mortality, and proportion, crude rate, age-specific rate, and age-standardized rate were also calculated. Trends of incidence and death of CRC, crude rate, age-specific rate and age-standardized rate were estimated. Trends of gender-standardized CRC incidence and death and the annual percent change(APC) were estimated by Joinpoint analysis. The incidence and proportion of new CRC cases with selected diagnostic character in different years were also calculated. Age-standardized incidence and mortality were calculated using Segi’s 1960 world standard population. Results CRC incidence and mortality were 9 337 and 4 599 in Shanghai 2016. Crude incidence was 64.48/10⁵, and age-standardized rate was 24.64/10⁵. Crude mortality was 31.76/10⁵, and age-standardized rate was 10.13/10⁵. Age-standar-dized incidence and mortality in males were higher than those in females. Age-specific case number and rate and age-specific death number and rate increased with aging. Age-specific case number and rate reached peak at age group both 60-64 years and 80-84 years, and age-specific death number and rate reached peak at age group more than 85 years. Overall, age-standardized CRC incidence between 2002 and 2016 increased 1.07% per year, and age-standardized CRC mortality was stable. Conclusions The current status and trends of CRC stratified by gender or age-group reflect the changes in risk factors, screening test use, and advances in diagnosis and treatment in Shanghai permanent population. Data of population-based cancer incidence and mortality can be used to decrease cancer burden.

Key words: Colorectal cancer, Incidence, Mortality, Epidemiology, Shanghai

CLC Number:

WU Chunxiao, GONG Yangming, GU Kai, PANG Yi, BAO Pingping, WANG Chunfang, SHI Liang, XIANG Yongmei, DOU Jianming, FU Chen, SHI Yan. Colorectal cancer incidence and mortality in Shanghai 2016 and trend analysis 2002—2016[J]. Journal of Surgery Concepts & Practice, 2021, 26(04): 325-335.

Figures/Tables 9

References 30

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分类	部位	ICD-10	性别	计数	构成比%	粗率/10万	标化率/10万	截缩率/10万	累积率%
分类	部位	ICD-10	性别	计数	构成比%	粗率/10万	标化率/10万	35~64岁	0~64岁	0~74岁	0~84岁
发病	结肠直肠	C18-21	合计	9 337	12.55	64.48	24.64	37.30	1.31	2.90	5.44
			男性	5 441	14.00	75.74	30.03	44.96	1.58	3.56	6.61
			女性	3 896	10.95	53.40	19.52	29.69	1.03	2.24	4.37
	结肠	C18	合计	5 755	7.73	39.74	14.98	21.44	0.75	1.75	3.41
			男性	3 201	8.24	44.56	17.44	24.31	0.85	2.05	3.99
			女性	2 554	7.18	35.00	12.67	18.61	0.65	1.45	2.87
	直肠	C19-20	合计	3 530	4.74	24.38	9.54	15.67	0.55	1.13	2.00
			男性	2 211	5.69	30.78	12.44	20.39	0.71	1.49	2.58
			女性	1 319	3.71	18.08	6.75	10.97	0.38	0.78	1.47
	肛门	C21	合计	52	0.07	0.36	0.12	0.18	0.01	0.01	0.03
			男性	29	0.07	0.40	0.15	0.25	0.01	0.02	0.04
			女性	23	0.06	0.32	0.10	0.11	0	0.01	0.03
死亡	结肠直肠	C18-21	合计	4 599	12.43	31.76	10.13	10.52	0.38	1.00	2.72
			男性	2 684	11.80	37.36	12.94	12.80	0.46	1.28	3.47
			女性	1 915	13.42	26.25	7.64	8.26	0.29	0.71	2.06
	结肠	C18	合计	2 804	7.58	19.36	6.09	5.94	0.21	0.58	1.68
			男性	1 586	6.97	22.08	7.53	6.93	0.25	0.71	2.11
			女性	1 218	8.54	16.69	4.85	4.97	0.18	0.46	1.31
	直肠	C19-20	合计	1 769	4.78	12.22	3.97	4.49	0.16	0.41	1.03
			男性	1 081	4.75	15.05	5.33	5.75	0.21	0.57	1.34
			女性	688	4.82	9.43	2.74	3.22	0.11	0.25	0.74
	肛门	C21	合计	26	0.07	0.18	0.06	0.09	0	0.01	0.01
			男性	17	0.07	0.24	0.08	0.12	0	0.01	0.02
			女性	9	0.06	0.12	0.05	0.06	0	0.01	0.01

分类	年龄组（岁）	年龄别率/10万			年龄别率2007—2011/2002—2006			年龄别率2012—2016/2007—2011
分类	年龄组（岁）	2002—2006	2007—2011	2012—2016	比值	Z值	P值	比值	Z值	P值
发病	20-	0.77	0.69	0.91	0.90	0.45	0.649	1.32	1.10	0.272
	25-	1.46	1.72	1.73	1.18	1.01	0.314	1.00	0.03	0.977
	30-	3.49	3.73	4.02	1.07	0.57	0.566	1.08	0.75	0.453
	35-	6.41	5.60	6.27	0.87	1.59	0.113	1.12	1.32	0.185
	40-	11.65	10.61	13.84	0.91	1.67	0.094	1.30	4.45	<0.001
	45-	21.72	21.94	24.34	1.01	0.28	0.776	1.11	2.60	0.009
	50-	39.32	39.72	43.73	1.01	0.38	0.704	1.10	3.66	<0.001
	55-	59.27	62.62	70.42	1.06	2.18	0.029	1.12	5.74	<0.001
	60-	84.50	97.64	100.92	1.16	5.82	<0.001	1.03	1.72	0.085
	65-	127.76	133.73	141.43	1.05	1.99	0.046	1.06	2.78	0.005
	70-	182.15	182.53	187.03	1.00	0.11	0.915	1.02	1.23	0.218
	75-	223.40	240.53	244.05	1.08	3.82	<0.001	1.01	0.79	0.428
	80-	251.11	274.73	279.25	1.09	3.85	<0.001	1.02	0.83	0.409
	≥85	202.62	241.07	249.21	1.19	5.31	<0.001	1.03	1.32	0.187
死亡	20-	0.24	0.31	0.09	1.34	0.76	0.446	0.28	2.42	0.015
	25-	0.56	0.52	0.51	0.93	0.26	0.794	0.98	0.07	0.945
	30-	1.22	1.48	0.98	1.21	1.03	0.305	0.67	2.21	0.027
	35-	1.89	2.14	1.84	1.13	0.83	0.409	0.86	1.01	0.312
	40-	3.85	3.07	3.74	0.80	2.26	0.024	1.22	1.73	0.084
	45-	7.49	6.77	6.50	0.90	1.62	0.106	0.96	0.56	0.574
	50-	12.19	12.55	12.48	1.03	0.61	0.544	0.99	0.12	0.907
	55-	20.59	20.48	21.73	0.99	0.13	0.898	1.06	1.63	0.104
	60-	31.33	35.50	30.54	1.13	3.05	0.002	0.86	4.46	<0.001
	65-	52.13	53.23	51.09	1.02	0.58	0.561	0.96	1.25	0.210
	70-	85.10	92.34	80.82	1.09	2.89	0.004	0.88	4.61	<0.001
	75-	134.82	150.92	144.86	1.12	4.58	<0.001	0.96	1.75	0.080
	80-	195.35	227.51	232.96	1.16	5.86	<0.001	1.02	1.09	0.275
	≥85	230.21	301.62	331.90	1.31	9.06	<0.001	1.10	4.33	<0.001

分类	2002—2006		2007—2011		2012—2016
分类	例数	构成比%	例数	构成比%	例数	构成比%
诊断亚部位（ICD-10编码与名称）
C18.0盲肠/回盲部	1 185	4.14	1 353	3.74	1 376	3.04
C18.1阑尾	129	0.45	141	0.39	296	0.65
C18.2升结肠	3 548	12.41	5 068	14.00	4 954	10.93
C18.3结肠肝曲	694	2.43	787	2.17	688	1.52
C18.4横结肠	1 216	4.25	1 426	3.94	1 653	3.65
C18.5结肠脾曲	224	0.78	241	0.67	208	0.46
C18.6降结肠	997	3.49	1 415	3.91	1 678	3.70
C18.7乙状结肠	4 697	16.43	6 130	16.93	8 322	18.36
C18.8结肠交搭跨越	224	0.78	220	0.61	246	0.54
C18.9未特指的结肠	3 632	12.70	4 631	12.79	7 981	17.61
C19直肠乙状结肠连接处	676	2.36	724	2.00	755	1.67
C20直肠	11 104	38.84	13 806	38.13	16 868	37.22
C21肛门和肛管	263	0.92	265	0.73	297	0.66
病理组织学类型
管状腺癌	4 574	16.00	5 473	15.12	4 490	9.91
神经内分泌癌	202	0.71	370	1.02	693	1.53
乳头状腺癌	851	2.98	396	1.09	224	0.49
绒毛状腺癌	422	1.48	282	0.78	191	0.42
乳头状管状腺癌	532	1.86	896	2.47	865	1.91
黏液腺癌	1 550	5.42	2 080	5.74	2 185	4.82
印戒细胞癌	163	0.57	218	0.60	260	0.57
其他和未分型腺癌	12 751	44.60	18 154	50.14	24 431	53.91
其他分型	239	0.84	243	0.67	254	0.56
未分型	7 305	25.55	8 095	22.36	11 729	25.88
诊断时分期
Ⅰ	1 610	5.63	2 221	6.13	3 988	8.80
Ⅱ	5 153	18.02	6 616	18.27	7 488	16.52
Ⅲ	3 887	13.60	5 883	16.25	6 858	15.13
Ⅳ	3 583	12.53	5 049	13.94	5 811	12.82
不详	14 356	50.22	16 438	45.40	21 177	46.73