中国乳腺癌发病死亡趋势的估计与预测

目的 通过描述20世纪70年代以来中国女性乳腺癌的死亡趋势，对2000年及2005年乳腺癌的发病与死亡状况进行估计和预测，以期为我国妇女乳腺癌临床、基础研究及防治策略的制定提供依据。方法 利用Joinpoint模型对常规监测死亡数据进行趋势分析；结合第二次死因调查结果及部分肿瘤登记处的数据，利用对数线性模型（基于Poisson分布），估计与预测近年中国乳腺癌的发病、死亡状况。结果 尽管20世纪70～90年代初我国女性乳腺癌总死亡率有一定的下降趋势，但中青年妇女年龄别死亡率明显上升，导致了我国城乡妇女乳腺癌在近15年间，发病与死亡的年龄调整率及绝对人数均呈明显上升趋势。2000年至2005年，乳腺癌发病人数将增加4．7万，死亡增加1．3万。结论 由于危险因素、人口增长及老龄化的双重作用，乳腺癌将是我国近年来增长幅度最大的恶性肿瘤之一，其预防与控制，将成为未来中国肿瘤控制计划的制定和实施重点之一。

Time trends, estimates and projects for breast cancer incidence and mortality in China

Objective Using comprehensive available data on women breast cancer in China,to describe the mortality trends from late 1970s,estimate and project the profile in 2000 and 2005,and to aim to provide a reference for clinic,basic research and prevention and control strategy making for breast cancer in China.Methods Using Joinpoint model,the mortality trends were analyzed on the basis of routine surveillance data.Combining with the data from the second national mortality survey and several cancer registries,using the log-linear model(based on Poisson distribution),the breast cancer profile in 2000 and 2005 were estimated and projected.Results Although there was a slight decline in mortality between early 1970s and 1990s,the age-specific mortality rates among young and middle age women increased dramatically which followed a continuing increase trend on both rates and absolute numbers,in both urban and rural areas in recent 15 years.Compared with 2000,there are 470 thousands more new breast cancer cases and 130 thousands more deaths from breast cancer in 2005.Conclusion Due to the double effects of both increasing risk factors and population growth and ageing,breast cancer will be one of the most extensively increasing cancers in Chinese women.The prevention and control of breast cancer will be of great emphasis for future cancer control strategy in China.