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。

Incidence of pancreatic cancer in shanghai: a current, retrospective and comparative exploration

Objective To describe the epidemiological pattern of pancreatic cancer in Shanghai, and to analyze the trend of incidence from 1973 to 2006 in the Shanghai urban area. Methods The data of pancreatic 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. Results A total of 8 190 new cases of pancreatic cancer were diagnosed from 2002 to 2006 with a crude incidence of 12.17 per 100 000 and an age-adjusted incidence of 6.22 per 100 000. Pancreatic cancer ranked the eighth among the common cancer in the male and ranked the seventh in the female. The male/female incidence ratio was 1.18：1, and it was higher in the rural area than that in the urban area. Of all the patients, 71.06% were over 65 years old and the highest incidence was observed in the age group of 80-84 years. Among the definitely diagnosed cases, the most common site was located in the head of pancreas （75.54%）, and almost 2/3 cases （64.41%） were diagnosed in stage Ⅳ. The age-adjusted incidence rates have been increasing constantly both in the male and the female in urban Shanghai from 1973 to 2006, Conclusions The incidence of pancreatic cancer in the Shanghai area is on the middle level in the world. The increasing crude incidence is related to aging. It is noticed that the incidence of the age group over 65 reached the high level in the world, Age-adjusted incidence also increases persistently. Prohibition of smoking might be the only effective population-based preventive measure of the pancreatic cancer.