<b>1993</b>—<b>2017</b>年上海市静安区结直肠癌发病率和死亡率的变化趋势

王妍敏; 熊建菁; 高文君; 尹晓烈; 杨晓明; 曹广文

doi:10.19428/j.cnki.sjpm.2021.21158

1993—2017年上海市静安区结直肠癌发病率和死亡率的变化趋势

Trends in the incidence and mortality of colorectal cancer in Jing'an District of Shanghai from 1993 to 2017

摘要

摘要:
目的阐明上海市静安区结直肠癌发病率和死亡率变化趋势，为其预防和干预措施提供科学依据。
方法采用上海市肿瘤登记报告系统数据，分析1993—2017年静安区结直肠癌流行现况，应用Joinpoint软件分析标化发病率和标化死亡率（ASMR）的时间变化趋势及分年龄段的发病率和死亡率变化趋势，计算年度变化百分比（annual percentage of change， APC）和平均年度变化百分比（average annual percentage of change， AAPC）。
结果1993—2017年静安区结直肠癌新发病例共计13 580例，平均粗发病率为52.94/10万，标化发病率为24.77/10万；死亡病例共计7 572例，平均粗死亡率为29.52/10万，ASMR为12.20/10万。结直肠癌标化发病率总体呈上升趋势，AAPC为1.64%，P<0.001，男性与女性标化发病率均呈上升趋势（男性AAPC为2.10%，女性则为1.04%）；ASMR变化趋势无统计学意义。50~74岁及≥75岁男性居民的结直肠癌发病率均呈上升趋势，AAPC分别为2.07%和3.32%；女性各年龄组的发病率无明显上升趋势。0~49岁男性居民、50~74岁男性与女性居民的死亡率呈下降趋势（AAPC分别为-7.46%，-1.13%和-2.72%）；≥75岁男性居民的死亡率无明显变化趋势，女性居民的死亡率呈上升趋势，AAPC为2.30%。
结论1993—2017年静安区结直肠癌的标化发病率总体呈上升趋势，ASMR变化趋势无统计学意义。≥50岁男性应改善生活方式、加强运动和及时清除息肉等癌前病变以降低结直肠癌发病率，≥75岁女性居民应加强二级预防以降低结直肠癌死亡率。

Abstract:
ObjectiveTo characterize the trends in the incidence and mortality of colorectal cancer in Jing'an District of Shanghai， thus optimizing the prophylactic options for this malignancy.
MethodsData from Shanghai Cancer Registration and Reporting System were used to analyze the colorectal cancer prevalence in Jing'an District from 1993 to 2017. Joinpoint software was used to analyze the trends in the standardized incidence rate and mortality rate by calculating the annual percentage of change （APC） and the average annual percentage of change （AAPC）.
ResultsA total of 13 580 new cases of colorectal cancer were reported in Jing'an District during 1993 and 2017， with an average crude incidence rate of 52.94/10⁵ and a standardized incidence rate of 24.77/10⁵. The total number of deaths was 7 572， with an average crude mortality rate of 29.52/10⁵and a standardized mortality rate of 12.20/10⁵. The standardized incidence rate of colorectal cancer in Jing'an District from 1993 to 2017 showed an increasing trend （AAPC=1.64%，P<0.001）， and the standardized incidence rate of colorectal cancer in both sexes increased （AAPC： 2.10% in men， 1.04% in women）. The age-standardized mortality rate （ASMR） did not change significantly. The incidence rate of colorectal cancer increased in men in both age groups of 50 to 74 years and 75 years and older， with an AAPC of 2.07% and 3.32%， respectively. However， this was not evident in women of all age groups. The mortality rate of colorectal cancer in men aged 0-49 years， as well as in men and women at 50-74 age groups， decreased significantly， with an AAPC of -7.46%，-1.13%， and -2.72%， respectively. The mortality rate of colorectal cancer in men of 75 years or older showed no significant trend， while that in women of 75 years or older increased （AAPC=2.30%）.
ConclusionThe overall standardized incidence rate of colorectal cancer in Jing'an District from 1993 to 2017 was increased， and ASMR did not change significantly. Public health prophylactic options are suggested， including improvement of lifestyle/physical activity and eradication of precancerous lesion polypus in males aged ≥50 years to reduce the incidence of colorectal cancer， and enforcement of second-grade prophylaxis in females aged ≥75 years to decrease the mortality of colorectal cancer.

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