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摘要:
目的 分析2011—2021年浙江省宁波市恶性肿瘤发病情况及变化趋势。 方法 利用宁波市慢性病协同管理系统中肿瘤发病监测子平台,获取2011—2021年宁波市户籍人口恶性肿瘤发病资料。 参照国际疾病分类(ICD-10),结合人口学资料后计算恶性肿瘤发病率、年龄别发病率、分部位发病率并标化。 中国人口标化率(中标率)根据2010年全国人口普查的标准人口年龄构成计算,世界人口标化率(世标率)根据Segi 1960世界标准人口构成计算。 采用Joinpoint Regression Program 4.9.0.0软件分析恶性肿瘤发病率的变化趋势,根据平均年度变化百分比(AAPC)及95%置信区间衡量上升或下降幅度。 采用频数表法计算平均发病年龄和标化平均发病年龄,采用线性回归模型分析发病年龄的变化趋势。 结果 2011—2021年宁波市恶性肿瘤世标率的上升幅度为3.19%(2.49%~3.90%),其中女性(5.53%)上升幅度高于男性(1.07%),P=0.001;农村地区上升幅度为4.78%,城市地区保持平稳。 分年龄发病情况,20~29岁年龄组发病率上升幅度最高(14.00%);恶性肿瘤经标化平均发病年龄每年平均下降约0.38岁。 分部位发病情况,男性肺癌、结直肠癌、甲状腺癌、前列腺癌、淋巴瘤的世标率呈上升趋势,胃癌、肝癌、食管癌的世标率呈下降趋势;女性肺癌、甲状腺癌、乳腺癌、结直肠癌、子宫体癌的世标率呈上升趋势,胃癌和肝癌的世标率呈下降趋势。 结论 宁波市恶性肿瘤发病率高于全国水平,标化平均发病年龄降低,女性是重点防控人群,农村是重点防控地区,肺癌、结直肠癌、女性乳腺癌是重点防控癌种。 Abstract:Objective To analyze the incidence and trend of incidence of malignant tumors in Ningbo from 2011 to 2021. Methods The incidence data of cancer were collected from the cancer registry system of Ningbo. According to international classification of diseases (ICD10) and data of registered population, the crude incidence rate, age and site specific incidence rate of malignant tumors were calculated, further standardization was performed. The age-standardized rate was adjusted by Chinese standard population in 2010 (ASIRC) and world standard (Segi 1960) population (ASIRW). Software Joinpoint Regression Program 4.9.0.0 was used to analyze the trend of incidence. The average annual percent change (AAPC) was calculated to indicate the incidence change. The trend of average onset age and standard average onset age according to table of frequency distribution was analyzed by a linear regression model. Results The AAPC of age-standardized rate of malignant tumors based on ASIRW in Ningbo was 3.19% (2.49%–3.90%), which was higher in women (5.53%) than in men (1.07%) (P=0.001). The AAPC of age-standardized rate of malignant tumors based on ASIRW was 4.78% in rural area and stable in urban area in Ningbo. The incidence rate increased with age, while the largest AAPC was in 20–29 years old age group. The standard average onset age decreased about 0.38 years. In men, the age-standardized incidence rate of lung cancer, colorectal cancer, thyroid cancer, prostate cancer, lymphoma based on ASIRW increased, while the age-standardized incidence rate of stomach cancer, liver cancer and esophagus cancer based on ASIRW decreased. In women, the age-standardized incidence rate of lung cancer, thyroid cancer, breast cancer, colorectal cancer, uterus cancer based on ASIRW increased, while the age-standardized incidence rate of stomach cancer and liver cancer based on ASIRW decreased. Conclusion The incidence rate of malignant tumors in Ningbo was higher than national average levels. The average age of the cases was young. It is necessary to strengthen the prevention and control of malignant tumors in women and in rural area. Lung cancer, colorectal cancer and breast cancer should be priorities in the prevention and control. -
Key words:
- Malignant tumor /
- Incidence /
- Age of onset /
- Trend analysis /
- Ningbo
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表 1 2011-2021年宁波市恶性肿瘤发病率(/10万)
Table 1. Incidence rate of malignant tumors in Ningbo, 2011−2021 (/100 000)
年份 性别 城乡 总计 男性 女性 城市 农村 粗发
病率中标
率世标
率粗发
病率中标
率世标
率粗发
病率中标
率世标
率粗发
病率中标
率世标
率粗发
病率中标
率世标
率2011 407.13 317.73 246.56 280.66 220.78 170.03 446.48 349.56 270.30 278.42 216.68 167.86 343.87 268.27 207.73 2012 426.38 324.93 253.02 319.98 249.30 193.26 506.42 389.95 302.31 287.63 220.09 171.60 373.10 286.14 222.56 2013 452.71 335.62 259.90 350.72 267.74 206.70 529.64 399.78 308.03 319.08 237.45 184.40 401.59 300.77 232.72 2014 465.06 329.10 254.53 381.51 286.81 220.64 563.96 414.72 319.65 332.00 238.07 183.77 423.12 307.16 236.99 2015 473.97 327.93 253.53 386.14 284.91 218.99 561.19 404.25 311.76 344.21 242.25 186.59 429.82 305.84 235.82 2016 477.31 320.46 248.07 383.57 277.69 214.12 550.34 390.20 300.77 350.86 238.61 184.80 430.14 298.32 230.50 2017 514.92 338.12 261.98 429.62 307.09 237.34 610.53 428.52 331.76 378.91 252.83 195.49 471.94 322.06 249.20 2018 547.09 338.69 264.18 469.70 335.66 260.39 640.03 444.68 347.03 417.34 273.06 211.10 508.05 336.89 262.00 2019 569.08 359.67 279.28 504.61 361.10 280.64 558.92 385.95 300.63 514.77 335.45 259.70 536.51 359.99 279.59 2020 567.23 350.92 273.86 526.89 378.66 294.85 571.34 396.78 309.29 522.60 333.52 260.04 546.82 364.74 284.27 2021 564.26 350.09 272.77 537.49 391.53 303.72 598.39 422.17 328.25 502.74 320.27 249.01 550.69 371.02 288.34 合计 497.84 335.29 260.39 417.71 305.93 236.85 560.40 400.48 310.29 381.68 262.49 203.63 457.50 319.83 248.04 AAPC
( % )
95%置
信区间3.55
( 2.94~
4.17 ) a1.0
( 0.5~
1.5 ) a1.1
( 0.5~
1.6 ) a6.3
( 5.4~
7.2 ) a5.4
( 4.5~
6.4 ) a5.5
( 4.6~
6.5 ) a2.0
( 0.6~
3.5 ) a0.9
( −0.4~
2.1 )1.0
( −0.3~
2.2 )7.0
( 5.6~
8.5 ) a4.7
( 3.2~
6.3 ) a4.8
( 3.2~
6.4 ) a4.8
( 4.1~
5.5 ) a3.1
( 2.5~
3.8 ) a3.2
( 2.5~
3.9 ) a注:AAPC. 平均年度变化百分比;a. P<0.05 表 2 2011-2021年宁波市不同年龄组恶性肿瘤发病率平均年度变化百分比(%)
Table 2. Average annual percent change of age-specific malignant tumor incidence rate in Ningbo 2011−2021
年龄组(岁) 性别 城乡 合计 男性 女性 城市 农村 0~19 −1.7(−4.5~1.3) 3.0(−0.9~7.2) −1.4(−4.7~2.0) 1.2(−1.6~4.1) 0.4(−2.1~3.0) 20~29 11.7(8.7~14.8)a 15.3(13.8~16.8)a 13.2(9.4~17.0)a 15.6(12.5~18.7)a 14.0(12.3~15.7)a 30~39 6.8(4.9~8.7)a 10.8(9.0~12.7)a 7.9(5.8~10.0)a 9.7(5.8~13.8)a 9.5(6.3~12.9)a 40~49 2.5(1.4~3.6)a 6.7(5.2~8.2)a 2.4(1.0~3.8)a 7.0(4.9~9.1)a 5.3(4.1~6.6)a 50~59 −0.8(−1.5~−0.2)a 5.6(4.4~6.9)a 0.2(−1.4~1.8) 4.4(2.9~5.9)a 2.5(1.6~3.3)a 60~69 1.6(1.0~2.2)a 3.7(2.6~4.7)a 0.1(−1.5~1.7) 4.2(2.5~5.8)a 2.3(1.6~3.1)a 70~79 −0.2(−1.1~0.7) 1.0(−0.0~2.1) −2.4(−3.7~−1.1)a 2.2(0.9~3.5)a 0.1(−0.9~1.0) ≥ 80 −0.3(−1.3~0.7) −0.3(−2.4~1.9) −3.2(−5.6~−0.8)a 2.6(1.4~3.8)a −0.3(−2.2~1.6) 注:a. P<0.05;括号内数据表示95%置信区间 表 3 2011-2021年宁波市恶性肿瘤平均发病年龄和标化平均发病年龄(岁)
Table 3. Trend of average onset age and standardized average onset age of malignant tumor in Ningbo, 2011−2021
年份 平均发病年龄 标化平均发病年龄a 男性 女性 城市 农村 合计 男性 女性 城市 农村 合计 2011 64.13 59.98 62.20 62.68 62.44 62.04 57.23 59.77 60.19 59.95 2012 64.40 59.37 62.06 62.45 62.24 61.81 56.15 59.18 59.35 59.24 2013 64.47 59.33 62.02 62.43 62.22 61.85 55.92 58.90 59.35 59.11 2014 64.75 58.95 61.51 62.79 62.12 61.99 54.99 58.01 59.33 58.63 2015 64.96 59.40 62.13 62.78 62.45 61.76 55.08 58.04 59.15 58.56 2016 65.35 59.80 62.35 63.39 62.86 62.06 55.28 58.17 59.49 58.80 2017 65.21 59.76 62.32 63.14 62.71 61.46 54.82 57.88 58.63 58.19 2018 65.55 59.56 62.40 63.13 62.76 60.94 53.64 57.46 58.26 57.19 2019 65.34 59.37 62.09 62.94 62.51 60.86 53.41 56.44 57.67 57.01 2020 65.49 59.07 61.64 63.14 62.36 60.47 52.81 55.64 57.28 56.37 2021 65.32 58.44 61.01 62.99 61.91 60.09 52.11 54.89 56.95 55.74 β值 0.13 −0.07 −0.05 0.06 0.01 −0.19 −0.45 −0.43 −0.29 −0.38 t值 6.63 −1.74 −1.26 2.82 0.08 −5.96 −11.94 −9.79 −8.36 −10.96 P值 < 0.001 0.117 0.239 0.020 0.942 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 注:a. 采用Segi 1960世界标准人口构成标化 表 4 2011-2021年宁波市恶性肿瘤发病率前10位平均年度变化百分比
Table 4. Average annual percent change of top 10 cancer incidences in Ningbo, 2011−2021
性别 部位 趋势1 趋势2 2011-2021年
平均年度变化百分比(%)
(95% 置信区间)年份 平均年度变化百分比(%)
(95% 置信区间)年份 平均年度变化百分比(%)
(95% 置信区间)男性 肺 2011-2021 2.1(1.6~2.6)a − − 2.1(1.6~2.6)a 结直肠 2011-2021 3.7(3.0~4.5)a − − 3.7(3.0~4.5)a 胃 2011-2021 −3.3(−4.0~−2.6)a − − −3.3(−4.0~−2.6)a 甲状腺 2011-2021 17.3(14.2~20.4)a − − 17.3(14.2~20.4)a 前列腺 2011-2021 6.7(4.9~8.5)a 6.7(4.9~8.5)a 肝脏 2011-2019 −4.4(−5.3~−3.5)a 2019-2021 −12.4(−20.4~−3.6)a −6.0(−7.6~−4.5)a 食管 2011-2021 −3.9(−4.8~−3.0)a − − −3.9(−4.8~−3.0)a 膀胱 2011-2021 −0.5(−1.8~0.7) − − −0.5(−1.8~0.7) 胰腺 2011-2021 0.2(−1.1~1.6) − − 0.2(−1.1~1.6) 淋巴瘤 2011-2021 1.8(0.3~3.2)a − − 1.8(0.3~3.2)a 女性 肺 2011-2016 8.5(5.0~12.1)a 2016-2021 17.8(15.2~20.4)a 13.1(11.3~14.9)a 甲状腺 2011-2021 12.4(8.7~16.2)a − − 12.4(8.7~16.2)a 乳腺 2011-2019 5.3(4.1~6.5)a 2019-2021 −3.4(−11.8~5.7) 3.5(1.8-5.2)a 结直肠 2011-2021 1.1(0.5~1.8)a − − 1.1(0.5~1.8)a 胃 2011-2021 −3.2(−4.6~−1.8)a − − −3.2(−4.6~−1.8)a 子宫颈 2011-2019 1.6(−0.4~3.6) 2019-2021 −12.6(−27.4~5.3) −1.4(−4.6~1.8) 肝脏 2011-2021 −5.9(−7.0~−4.8)a − − −5.9(−7.0~−4.8)a 子宫体 2011-2021 2.2(1.0~3.5)a − − 2.2(1.0~3.5)a 胰腺 2011-2021 0.6(−1.4~2.6) − − 0.6(−1.4~2.6) 淋巴瘤 2011-2021 3.1(1.6~4.7)a − − 3.1(1.6~4.7)a 卵巢 2011-2021 1.3(−0.4~3.1) − − 1.3(−0.4~3.1) 注:2011-2021年女性恶性肿瘤发病率排至前10位的癌种共11种;a. P<0.05 -
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