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目的:按照性别、年龄段和发病部位,分析1973年至2007年上海市区结肠直肠癌的发病趋势。方法:数据来源于上海市肿瘤登记报告系统。按照世界标准人口计算结肠直肠癌年龄标化发病率,使用Joinpoint回归模型计算年度变化百分比(annual percentage change,APC)。结果:直肠癌是最常见的结肠直肠癌亚部位,但直肠癌的构成比从1973年至1977年的66.5%,下降至2003年至2007年的44.4%。远端结肠癌标化发病率的APC最高(男性为5.3%,女性为4.9%),其次是近端结肠癌(男性为4.1%,女性为4.2%),直肠癌的APC最低(男性为1.5%,女性为1.1%)。女性远端结肠癌和直肠癌发病率在30~39岁年龄段出现了显著下降的趋势(APC分别为-3.8%和-2.8%),男性直肠癌发病率在30~39岁年龄段也出现了显著下降趋势(APC为-1.9%)。结论:1973年至2007年上海市区结肠直肠癌发病总体呈现上升趋势,其中结肠癌发病上升更为显著,而乙状结肠癌和升结肠癌发病增加是结肠癌构成比上升的最主要因素。在低年龄段人群中,开始出现男性直肠癌、女性直肠癌和远端结肠癌发病下降的趋势。
OBJECTIVE: To analyze the incidence of colorectal cancer in Shanghai from 1973 to 2007 according to sex, age and location. Methods: The data come from Shanghai Tumor Registration Report System. The age-standardized incidence of colorectal cancer was calculated according to the world's standard population, and the annual percentage change (APC) was calculated using the Joinpoint regression model. Results: Rectal cancer was the most common subregion of colorectal cancer, but the proportion of rectal cancer dropped from 66.5% from 1973 to 1977 to 44.4% from 2003 to 2007. The incidence of distal colon cancer was highest in APC (5.3% for males and 4.9% for females), followed by proximal colon cancer (4.1% for males and 4.2% for females) and lowest for colorectal cancer (1.5 for males %, Women 1.1%). The incidence of distal colon cancer and rectal cancer in women showed a significant decrease (30.8% and -2.8%, respectively) in the 30-39 age group, and the incidence of rectal cancer in men also occurred in the 30-39 age group A significant downward trend (APC -1.9%). CONCLUSIONS: The incidence of colorectal cancer in Shanghai showed an overall upward trend from 1973 to 2007, of which the incidence of colon cancer increased more significantly. The increased incidence of sigmoid colon and ascending colon cancer was the most important factor in the increase of colon cancer. In low-age groups, there is a trend toward a decline in the incidence of male rectal cancer, female rectal cancer and distal colon cancer.