20042019年上海市普陀区女性乳腺癌的过早死亡及趋势

Premature death of female breast cancer patients and its trend in Putuo District of Shanghai from 2004 to 2019

  • 摘要:
    目的 了解上海市普陀区女性乳腺癌患者的发病、死亡及乳腺癌所致过早死亡的情况,以降低乳腺癌的发病率、死亡率及早死概率,为实现主要慢性病早死概率控制目标提供参考。
    方法 采用上海市人群基础肿瘤登记管理系统收集2004—2019年上海市普陀区女性户籍居民乳腺癌患者的发病、死亡资料,计算乳腺癌粗发病率、标化发病率、粗死亡率、标化死亡率、年龄别发病率、年龄别死亡率等指标,运用Joinpoint回归模型计算乳腺癌发病率、死亡率、早死概率的年度变化百分比(APC)和平均年度变化百分比(AAPC),分析变化趋势。
    结果 2004—2019年上海市普陀区乳腺癌粗发病率从75.76/10万上升至95.77/10万(APC=2.26%,t=6.05,P<0.01),标化发病率在2004—2008年未呈现明显下降趋势(APC=-4.83%,t=-1.81,P=0.10),2008年后呈上升趋势(APC=1.67%,t=2.84,P=0.02)。粗死亡率从18.52/10万变化至21.63/10万(APC=1.51%,t=1.52,P=0.15),标化死亡率从9.91/10万下降至7.44/10万(APC=-1.46%,t=-2.43,P=0.03)。30~69岁年龄别发病率从98.39/10万上升至111.75/10万(APC=1.14%,t=3.05,P=0.01),死亡率从16.13/10万变化至19.30/10万(APC=0.48%,t=0.84,P=0.41)。≥70岁年龄别发病率从165.68/10万变化至139.53/10万(APC=1.54%,t=1.25,P=0.23),死亡率从85.08/10万变化至56.64/10万(APC=-0.18%,t=-0.08,P=0.94)。乳腺癌早死概率从7.73‰下降至6.61‰(APC=-1.56%,t=-2.30,P=0.04)。
    结论 女性乳腺癌发病、死亡风险仍不容忽视,由此导致早死概率的控制压力仍然较大。应重点关注30~69岁年龄组,采取进一步控制措施,控制发病率的升高、降低死亡率,从而降低女性乳腺癌早死概率,促进早死概率总体控制目标的实现。

     

    Abstract:
    Objective To understand the incidence and death of female breast cancer patients and the premature death caused by breast cancer in Putuo District of Shanghai, and to reduce the incidence of breast cancer, mortality and the probability of early death, and to provide reference for realizing the control target of the probability of early death of major chronic diseases.
    Methods The incidence and death data of the registered female residents with breast cancer in Putuo District of Shanghai from 2004 to 2019 were collected using Shanghai Population-based tumor registration management system. The crude incidence rate, standardized incidence rate, crude mortality rate, standardized mortality rate, age-specific incidence rate, age-specific mortality rate and other indicators were calculated. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) of breast cancer incidence, mortality and premature death probability, and to analyze the changing trend.
    Results From 2004 to 2019, the crude incidence of breast cancer in Putuo District of Shanghai increased from 75.76/105 to 95.77/105 (APC=2.26%, t=6.05, P<0.01), while the standardized incidence did not decrease significantly during 2004‒2008 (APC=-4.83%, t=-1.81, P=0.10) and showed an upward trend after 2008 (APC=1.67%, t=2.84, P=0.02). The crude mortality rate changed from 18.52 per 105 to 21.63 per 105 (APC= 1.51%, t=1.52, P=0.15), and the standardized mortality rate decreased from 9.91/105 to 7.44/105 (APC=-1.46%, t=-2.43, P=0.03). The incidence rate in the group of 30‒69 years increased from 98.39/105 to 111.75/105 (APC=1.14%, t=3.05, P=0.01), and the mortality rate increased from 16.13/105 to 19.30/105 (APC=0.48%, t=0.84, P=0.41). The incidence rate of patients aged ≥70 years varied from 165.68/105 to 139.53/105 (APC=1.54%, t=1.25, P=0.23), and the mortality rate changed from 85.08/105 to 56.64/105 (APC=-0.18%, t=-0.08, P=0.94). The probability of premature death from breast cancer decreased from 7.73‰ to 6.61‰ (APC=-1.56%, t=-2.30, P=0.04).
    Conclusion The risk of female breast cancer morbidity and death can not be ignored, and the control pressure of premature death probability is still large. Attention should be paid to the age group of 30‒69 years old, and further measures should be taken to control the increase of incidence and to reduce mortality, so as to reduce the probability of premature death of female breast cancer, and promote the realization of the overall control goal of premature death probability.

     

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