上海市胃癌发病流行现况与时间趋势分析

目的:表述上海市胃癌的发病流行现况,分析胃癌的时间趋势,探寻病因学研究线索,为预防控制工作提供依据.方法:取材于上海市肿瘤登记报告和随访管理系统收集的胃癌发病资料,以及年度变化百分比对上海市市区1973～2004年男女胃癌发病的时间趋势进行分析.结果:2002～2004年,上海全市共新诊断胃癌16 370例,总发病粗率为40.82/10万,发病标率为22.06/10万.胃癌是上海市男性发病第2位、女性第3位的恶性肿瘤.郊区男性胃癌发病粗率和发病标率均高于市区,郊区女性胃癌发病粗率低于市区而发病标率高于市区.62.79%的病例集中在65岁以上年龄组,80～84岁组发病率最高.1973～2004年,市区男性和女性的发病标率均呈下降趋势.结论:上海市胃癌发病仍居世界高发水平;上海市胃癌的发病特点提示,胃癌高发与人口老龄化有密切关系,而胃癌标化发病率下降则提示上海地区其他导致胃癌发生的危险因素正在逐年下降和(或)保护性因素正在增多,这些因素可能与社会经济、膳食营养和卫生条件的改善有关.     

上海市胆囊癌流行状况和趋势分析

目的 分析上海市胆囊癌的流行病学特征。方法 利用上海市肿瘤登记报告和随访管理系统收集的胆囊癌发病资料,运用年度变化百分比对上海市1973-2006年胆囊癌发病的时间趋势进行分析,并与其他国家的流行病学资料进行比较。结果 2002-2006年,上海全市共新诊断胆囊癌5253例,总粗发病率为7.81/10万,标化发病率为3.80/10万。上海市胆囊癌发病率男性居恶性肿瘤的第15位、女性居第11位,男女发病比为1∶1.77。70岁以下的胆囊癌病例中,郊区病人年龄别发病率略高于市区病人;而70岁以上的病例,市区病人年龄别发病率明显高于郊区病人。75.1%的病例集中在>65岁年龄组,80～84岁组的发病率最高。1973-2006年,上海市区男性和女性的标化发病率分别上升141.1%和137.6%。结论 上海市的胆囊癌发病已明显超过世界中等水平,粗发病率和标化发病率的明显上升与人口老龄化有密切关系。对高发人群的全面筛查是目前预防胆囊癌惟一有效的人群干预方法。     

上海市胰腺癌流行现况、回顾与比较分析

目的：描述上海市胰腺癌的流行特征,分析发病率时间趋势,并与世界其他国家的流行病学资料进行比较。方法：利用上海市肿瘤登记报告和随访管理系统收集的胰腺癌发病资料,运用年度变化百分比对上海市区1973年至2006年胰腺癌发病的时间趋势进行分析。结果：2002年至2006年,上海全市共新诊断胰腺癌8190例,总粗发病率为12．17／10万,标化发病率为6．22／10万。胰腺癌占上海市男性发病的第8位、女性的第7位,男女发病比为1．18：1。郊区男女性发病比明显高于市区。71．06％的病例集中在〉65岁年龄组,80～84岁组的发病率最高。诊断明确的病例中,最主要发生于胰头（75．54％）,诊断时期别多为Ⅳ期（64.41％）。1973年至2006年,上海市区男性和女性的标化发病率分别上升62．20％和75．54％。结论：上海市的胰腺癌发病居世界中等水平;粗发病率的明显上升与人口老龄化有密切关系＋尤其是〉65岁老年人的胰腺癌发病率已达到高发国家水平;标化发病率处于持续缓慢上升过程。而控制吸烟是目前已知预防胰腺癌唯一有效的人群干预方法。     

1988—2015年中国肿瘤登记地区前列腺癌发病趋势分析

目的:探讨1988—2015年中国肿瘤登记地区前列腺癌发病趋势。方法:收集1988—2015年中国肿瘤登记地区覆盖男性人口数量、前列腺癌发病率及世界人口年龄标化发病率数据,计算年均增长率,评估我国前列腺癌发病的变化趋势。结果:中国肿瘤登记地区覆盖男性人口数量由1988年的1 041万增至2015年的16 276万,年均...     

上海市胃癌发病率和死亡率的变化与预测

分析1980年～1998年上海市胃癌发病率、死亡率变化及其发展趋势,了解胃癌的危害程度,提出胃癌防治策略的建议。方法：收集上海市肿瘤登记和死因登记资料中胃癌发病、死亡资料,计算发病率、死亡率和标化发病率、死亡率,采用线性回归方程拟合分析发病率和死亡率和变化趋势,并预测2005年上海市胃癌发病、死亡情况。结果和结论：目前胃癌居上海市恶性肿瘤发病、死亡第2位,上海市胃癌的发病和死亡近19年来有下降的趋势,60岁以上人群是胃癌发病死亡的高发人群,男性的发病和死亡情况比女性严重。     

年龄-时期-出生队列贝叶斯模型预测中国城市肾癌发病状况的研究

目的 预测全国城市地区肾癌发病情况,为肾癌的病因学研究及防治策略提供依据.方法 根据全国肿瘤登记中心1998-2007年18个城市登记处的肿瘤登记资料,利用年龄-时期-出生队列的贝叶斯模型对发病趋势进行拟合,预测2008-2015年我国城市肾癌发病情况. 结果 1998-2007年我国城市登记地区男性和女性的肾癌发病率均有显著增加,男性从1998年的3.12/10万升至2007年的5.36/10万(标化率),女性从1998年的1.66/10万升至2007年的2.67/10万.不同模型拟合结果显示,肾癌发病率的上升主要由出生队列效应引起(P＜0.001).据预测2015年我国城市地区男性肾癌发病率将达到9.93/10万,女性4.54/10万;预计到2015年城市地区肾癌发病人数为52 259人,其中男性36 616人,女性15 643人. 结论 受年龄和出生队列效应的影响,我国城市地区未来肾癌的疾病负担逐年上升,将成为危害城市地区居民健康的主要癌症之一.应加强对肾癌病因学的研究以及采取有效措施加以预防和控制.     

上海市区乳腺癌流行现状及趋势分析

目的：分析1972－1999年上海市区女性乳腺癌发病情况,并据此预测今后20年上海市乳腺癌的发病趋势,为确定乳腺癌的研究方向和制定防治策略提供依据。方法：收集上海市肿瘤登记资料中乳腺癌发病历史资料, 计算发病率和标化发病率,采用线性回归方程拟合分析发病率的变化趋势,结合人口学资料预测未来20年发病情况。结果：上海市区女性乳腺癌发病率呈明显上升趋势,1999年比1972年上升了180．30％,25岁以上各年龄组女性的发病率均呈明显上升趋势,45－59岁组女性上升速度最快。乳腺癌发病率在地区分布上呈现从城区向郊县由高向低分布的态势。人口学预测结果推算,到2015年全市乳腺癌新发病人将超过6000例。分析结果提示乳腺癌上升趋势可能与相关危险因素变化有关。     

上海市胰腺癌的流行现状和趋势研究

目的：探讨上海市胰腺癌发病和死亡情况以及变化趋势。方法：收集上海市肿瘤登记中胰腺癌的发病和死亡资料，从中计算出发病率和死亡率；用线性回归和非线性回归拟合方法研究胰腺癌的流行趋势以及变化特点。结果：①2000年上海市胰腺癌的标化发病率和死亡率分别为6.0/10万和5.5/10万和5.5/10万；②胰腺癌的发病和死亡病例中50岁以上者约占93%，且发病和死亡粗率随年龄呈指数上升（Y=0.0433 e^1.0116x和Y=0.0247 e^1.0885x）；③无论发病率和死亡率，成年人中男性都高于女性；④市区的发病和死亡率稍高于市郊和郊县；⑤1980年-2000年期间，发病和死亡人数上升趋势非常显著；发病和死亡率上升也较明显；女性标化发病率和死亡率上升斜率较小，但仍有统计学意义。结论：上海市胰腺癌的发病率和死亡率比20世纪70年代上升了50％左右。趋势分析显示上海的胰腺癌发病率和死亡率均呈上升迹象。     

启东市1972～2000年前列腺癌流行状况分析

目的了解启东市前列腺癌流行情况，为疾病防治提供依据。方法采用启东市肿瘤防治网收集的肿瘤发病登记报告资料，计算粗发病率、中国人口标化发病率，并对不同时期的发病率做比较。结果启东1972—2000年前列腺癌粗发病率平均为0．70／10万、标化率为0．76／10万。趋势检验中未见29年中发病率的显著升高，但最近10年的发病率已超过1／10万，与前2个时期比较，呈显著的上升趋势。前列腺癌发病率随年龄的增长而升高，但最近10年发病率有向低龄化发展的趋势。结论启东市29年来前列腺癌一直处于较低发病率状态，但发病率似有上升趋势和低龄化趋势，应予重视。     

2016年上海市结肠直肠癌发病和死亡情况与2002—2016年间的变化趋势分析

目的:分析2016年上海市结肠直肠癌发病和死亡的基本情况及其2002—2016年间的变化趋势。方法:采用上海市疾病预防控制中心建立的人群基础肿瘤登记管理系统和死因登记系统收集的2002—2016年结肠直肠癌发病和死亡资料,按诊断或死亡年份、性别、部位和年龄组分层分析,计算数量、构成比、粗率、年龄别率、年龄标准化率(简称:标化率)等指标。分析结肠直肠癌发病和死亡数量、粗率、年龄别率和标化率趋势。按性别划分的结肠癌和直肠癌的发病和死亡标化率也应用Joinpoint软件计算年度变化百分比分析变化趋势。计算不同诊断年份组合的结肠直肠癌新发病例的部分诊断特征指标的数量和构成比。应用Segi 1960年世界标准人口构成调整计算发病和死亡的标化率。结果:2016年上海市结肠直肠癌新发病例数和死亡人数分别为9 337例和4 599人,粗发病率为64.48/10万,标化发病率为24.64/10万,粗死亡率为31.76/10万,标化死亡率为10.13/10万,男性发病和死亡的标化率均高于女性。年龄别发病和死亡的数量和率值随着年龄的增长而增加。年龄别发病的数量和率值分别在60～64岁组和80～84岁组达到高峰,年龄别死亡的数量和率值均在85岁以上组达到高峰。结肠直肠癌的标化发病率在2002—2016年间以年均1.07%的增速上升,标化死亡率维持稳定状态。结论:按性别或年龄组分层的结肠直肠癌现况和趋势反映了上海户籍人口在相关危险因素、筛查技术应用和诊疗水平发展等方面的变化。以人群为基础的癌症发病和死亡资料可用于减少癌症负担。     

Trends in prostate cancer incidence, mortality and survival in England and Wales 1971-1998

OBJECTIVES: To examine trends in prostate cancer incidence and mortality in England and Wales between 1971 and 1998, using a newly developed and validated national cancer database and the national mortality database. METHODS: Age-standardized incidence and death rates were calculated directly and trends in relative survival rates among men with prostate cancer registered during 1971-1990 were examined. RESULTS: The annual number of new cases of prostate cancer registered in England and Wales increased by 179% between 1971 and 1993, from 6174 to 17 210. Directly age-standardized incidence rates increased by 104% between 1971 and 1993, from 29 to 59 per 100 000. The number of deaths from prostate cancer increased by 113% between 1971 and 1998, from 4027 to 8570. Directly age-standardized death rates increased by 49% between 1971 and 1995 and then decreased by 8% between 1995 and 1998, an overall increase of 38% (20 to 27 per 100 000) between 1971 and 1998. The relative survival rate for prostate cancer among men diagnosed during 1986-1990 was 77% at 1 year and 42% at 5 years, compared with 67% and 33%, respectively, for cases diagnosed during 1971-1975. The increase in survival rates was confined to men diagnosed with prostate cancer up to 1985 and no increase was seen for cases diagnosed after 1985. CONCLUSIONS: Prostate cancer is becoming a growing burden on the health service. The explanation for the large increase in prostate cancer incidence and mortality is unclear and needs further investigation. The lack of any improvement in survival rates in cases diagnosed after 1985 is of concern, and suggests that the current management of prostate cancer in both primary and secondary care may need to be reviewed.     

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??Prevalence and temporal trend of gallbladder cancer in Shanghai ZHANG Ming-di*,GONG Wei, ZHENG Ying, et al.*Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092,China
Corresponding author: QUAN Zhi-wei, E-mail:zhiwquan@yahoo.com.cn; GONG Wei, E-mail: gongweius@hotmail.com
Abstract Objective To analyze the epidemiological pattern of gallbladder cancer in Shanghai. Methods The data of gallbladder cancer incidence in Shanghai were collected by the Shanghai cancer registry center and the trend of the incidence in urban Shanghai population from 1973 to 2006 was assessed by using the annual percent change (APC) analysis, which were compared with epidemiological data from other countries. Results A total of 5 253 new cases of gallbladder cancer were diagnosed from 2002 to 2006 with a crude incidence of 7.81 per 100,000 and an age-adjusted incidence of 3.80 per 100,000. Gallbladder cancer ranked the fifteenth among the common cancer in the male and ranked the eleventh in the female. The male/female incidence ratio was 1:1.77. In the age group of below 70 years, incidence is higher in the rural area than that in the urban area. But in the group of over 70 years, that is on the contrary. Of all the patients, 75.1% was over 65 years old and the highest incidence was observed in the age group of 80-84 years. The age-adjusted incidence rates have increased by 141.1% and 137.6% in the male and the female from 1973 to 2006 in urban Shanghai respectively. Conclusions The incidence of gallbladder cancer in the Shanghai area is obviously beyond the middle level of the world. Comprehensive screening of high-risk groups might be the only effective population-based preventive measure of the gallbladder cancer.     

Subtype-specific incidence of testicular cancer in Germany: a pooled analysis of nine population-based cancer registries

Comparisons of incidence estimates of testicular cancer subtypes beyond seminoma and non-seminoma are virtually missing in the epidemiologic literature. We analysed incidence data from population-based German cancer registries to provide subtype-specific incidences of testicular cancer. We pooled data from nine cancer registries from 1998 to 2003. We estimated incidence and mortality time trends of West and East Germany. Incidence and mortality were standardized by the European standard population. The annual percentage incidence change from 1961 through 1989 was 4.9% in East Germany and 3.0% from 1970 through 2004 in Saarland. Incidence increases were the most pronounced among adolescents and young men aged 15–49 years. In 1998–2003, the seminoma incidence rate was 5.1 per 100 000; among non-seminomas, the rates were the highest for malignant teratoma (1.6 per 100 000), followed by embryonal carcinoma (1.2 per 100 000). Testicular lymphomas were rare (0.1 per 100 000). The incidence of testicular cancer among children aged 0–14 years was nearly constant from 1987 through 2004. Majority of these cancers were yolk sac tumours (0.1 per 100 000). In East and West Germany, rates of embryonal carcinoma in the early periods were considerably lower than the rates of malignant teratoma. In the most recent periods, rates of embryonal carcinoma became quite similar to the rates of malignant teratoma. The mortality decline started in West Germany roughly 12 years earlier than in East Germany. The later start of the mortality decline in East Germany may be because of a later introduction of platinum-based chemotherapy compared to West Germany.     

Rising incidence of breast cancer in Papua New Guinea

Background : Three previous reports have shown the incidence of breast cancer in Papua New Guinea (PNG) to have risen in the 30 years between 1958 and 1987. In the present report the incidence and pathology of breast cancer in the decade 1989–1998 are described. Methods : This was a retrospective review of all histopathology specimens in PNG from 1989 to 1998. During this period the female population grew from 1 640 000 to more than 2 000 000. Results : There were 790 cases of breast cancer. The age of the patient was not known in 221 cases (26%). The age‐standardized incidence was 6.9 per 100 000. The incidence of breast cancer has been steadily rising in the 40 years since cancers were recorded in PNG. The incidence has risen in all four regions, most notably in the islands. The peak incidence was in the 45–54‐year‐old age group (18.4/100 000); 83.9% of women with breast cancer were aged 54 or less. Fifteen per cent were under 35 years old and 55.7% were under 45. The incidence fell in the elderly. The tumours tended to be advanced. The actual size was recorded in only 163 cases (20.7%) but there were only three T₁ tumours in this group. Clinical signs of advanced breast cancer were recorded in 206 cases: ulceration of skin (91 cases), peau d’ orange (69 cases), nipple retraction (43 cases) and lymphoedema of the upper extremity (three cases). Axillary nodes were positive in 185 of 247 patients (75%) in whom they were sampled. Conclusions : The incidence of breast cancer in PNG women has steadily risen over the past 40 years and the highest age‐specific incidence occurs in the 35–54 age group. Tumours present late at an advanced stage. Clinical information on pathology request forms is poor and a prospective clinical audit is needed. Strategies need to be developed to detect breast cancer earlier in this population of women.     

A POPULATION‐BASED STUDY OF THE INCIDENCE,MORTALITY AND OUTCOMES IN PATIENTS FOLLOWING SURGERY FOR COLORECTAL CANCER IN WESTERN AUSTRALIA

Background : The literature contains many reports on the management of colorectal cancer from single institutions or groups of specialist surgeons. But there are few data on community‐wide patterns of treatment or the outcomes of colorectal surgery. The aim of the present study was to use a population‐based linked database to assess the trends in colorectal cancer incidence and mortality in Western Australia (WA) in the period 1982–95, and to evaluate the outcomes following surgical care. Methods : A population‐based linked database was used to relate the cancer registry, hospitalization and mortality records of all patients with a diagnosis of colorectal cancer in WA during 1982–95. Data on surgical treatment and postoperative morbidity and mortality in this group of patients were available only in 1988–95. Patient records were selected using the international classification for diagnosis and procedure codes pertaining to colorectal cancer and surgery. Incidence and mortality trends in colon and rectal cancers were estimated by Poisson regression of age‐standardized rates, and relative survival analysis was used to compare patient survival with the general population. Results : During the 14‐year period, 9673 patients presented with a diagnosis of colorectal cancer. The sex distribution of patients with colon cancer was evenly divided, but rectal cancer was more common in men (ratio 1:4). The mean age at diagnosis was 67.8 years (SD: 12.7). During the study period there was a significant increase in the standardized incidence rate of rectal cancer in men, and in the mortality rates from colon cancer in women. The overall crude 5‐year survival was 57%. Large bowel resections were performed on 71% of patients with an in‐hospital postoperative mortality of 4.2%. Conclusion : Colorectal cancer is a continuing major cause of morbidity and mortality in WA. The present study demonstrated increases in the incidence rate of rectal cancer in men and in the mortality rate from colon cancer in women in the period 1982–95.     

Epidemiology of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan

The goal of this study was to determine the incidence of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan. Kaohsiung City is the industrial and commercial center of southern Taiwan, with a population of 1 433 621 in 1996. The number of individuals over 65 years of age accounted for 6.2% of the total population. Data from the archives of reimbursement of the National Health Insurance program were used to investigate the incidence of fractures of the proximal femur. This study detected 580 cervical and trochanteric fractures (40.5 fractures per 100 000 population per year) in 261 males (35.8 fractures per 100 000 men per year) and 319 females (45.3 fractures per 100 000 women per year), with 420 (72%) of these fractures occurring in individuals over 65 years of age. The age-specific incidences of cervical and trochanteric fractures increased exponentially with age in both genders. The overall ratio of cervical to trochanteric fractures was 1 : 1.04. The mean ages of women with cervical or trochanteric fractures (71.6 and 74.0 years, respectively) were significantly higher than those of males (59.9 and 64.8 years, respectively; P < 0.01). The age-adjusted incidences of fractures of the proximal femur in Kaohsiung City were higher than in other Asian countries, but were lower than in Western countries such as the United States and Norway. The urban lifestyle and low daily calcium intake may be responsible for this increased incidence of proximal femoral fractures in Kaohsiung City. Received: Dec. 22, 1998 / Accepted: July 6, 1999     

Trends in colon cancer surgery in Ontario: 2002–2009

Aim The safety and efficacy of laparoscopic surgery for colon cancer is well established but its uptake in the province has not been previously explored. We report an investigation of the trends of open and laparoscopic surgery for colon cancer in Ontario, Canada. Method A retrospective cross‐sectional time‐series analysis examining population‐based rates of elective surgery for colon cancer among 10.5 million adults in Ontario was conducted from 1 April 2002 to 31 March 2009. Databases were linked to assess quarterly elective procedure rates over time. Results During the study period, 3950 laparoscopic and 13 048 open elective colon cancer operations were performed in Ontario. The overall quarterly rate of colon cancer surgery remained stable at an average of 5.8 per 100 000 population (P = 0.10). From the first and last quarter, the rate of laparoscopic operations increased nearly threefold from 0.8 to 2.2 per 100 000 population with a notable increase after 2005 (P < 0.01). In contrast, open surgery decreased by more than 30% from 5.3 to 3.5 per 100 000 population (P < 0.01). If current trends continue, the projected proportion of laparoscopic colon operations is estimated to reach 41% by 2015. Patients receiving open surgery had a significantly higher preoperative comorbidity (Charlson comorbidity score ≥ 3) than those having laparoscopy (47.8%vs 39.1%, standardized difference 0.26). Conclusion Trends in Ontario of laparoscopic colon cancer surgery show an increase between 2002 and 2009, but the incidence remains lower than for open surgery.     

Changes in Hip Fracture Epidemiology: Redistribution Between Ages, Genders and Fracture Types

After several reports of increasing hip fracture incidence some studies have suggested a trend-break. In a previous study of hip fractures we forecast a 70% increase in the total number of fractures from 1985 up to year 2000. We therefore studied the incidence trend for the last 15 years and supply a new prognosis up to year 2010. We recorded all incident hip fractures treated in the county of ?sterg?tland, Sweden (≈ 400 000 inhabitants) 1982–96. A total of 11 517 hip fractures in men and women aged 50 years and above were included in the study after cross-validation between a computerized register of radiologic investigations and the hospital records. The projected number of fractures up to year 2010 was estimated by a Poisson regression model, considering both age and year of fracture in every single year 1982–96 for the respective fracture type and gender, and applied to the projected population. The annual number of hip fractures increased by 39% in men and 25% in women during the study period. Amongst men, the age-adjusted incidence of cervical fractures increased from 188 to 220/100 000 and of trochanteric fractures from 138 to 170/100 000. In women the incidence of cervical fractures decreased from 462/100 000 to 418/100 000 and of trochanteric fractures from 407/100 000 to 361/100 000. Cervical/trochanteric fracture incidence rate ratio leveled off, and also the female/male fracture rate ratio declined. A prognosis assuming that the incidence development will continue as during 1982–96, and a population in agreement with the forecast, predicts that the total age- and sex-adjusted number of hip fractures will decrease by 11% up to year 2010 compared with 1996. In women and men, however, a decrease of 19% and an increase of 7% respectively were projected. If the age- and sex-specific incidence remains at the same level as at the end of the study period, no significant change in the total numbers will occur. A trend-break was thus found in hip fracture incidence for women but not for men. Whether this is due to therapeutic and/or preventive measures in women is unknown. According to the most probable scenario a substantial increase in male trochanteric fractures (36%) is expected up to 2010, while all other hip fractures in both genders will decrease by 4–32% resulting in a total reduction of 11%. Received: 17 November 2000 / Accepted: 2 July 2001