2009—2020年浙江省海宁市上消化道癌发病与死亡分析

摘 要： ［目的］ 分析2009—2020年海宁市居民上消化道癌（胃癌、食管癌）发病与死亡情况。 ［方法］ 收集海宁市肿瘤登记地区2009—2020年上消化道癌发病、死亡信息，并用Excel 2010和Joinpoint软件分析计算上消化道癌发病（死亡）例数、粗发病率（死亡率）、中标率、年龄别发病率（死亡率）、发病率（死亡率）年度变化百分比（APC）等指标。［结果］ 2009—2020年海宁市上消化道癌新发病例共计2 859例，男女性别比为2.12∶1；上消化道癌死亡病例共计2 041例，男女性别比为2.16∶1。2009—2020年间，上消化道癌粗发病率从2009年的29.67/10万逐渐升至2020年的34.99/10万，粗死亡率从2009年的24.77/10万逐渐降至2020年的19.12/10万。2009—2020年海宁市上消化道癌中标发病率呈下降趋势（APC=-1.66%，95%CI：-2.89%~-0.41%，P<0.05），其中男性上消化道癌中标发病率也呈下降趋势，APC为-2.24%（95%CI：-3.40%~ -1.06%，P<0.05）。2009—2020年海宁市上消化道癌中标死亡率呈下降趋势（APC=-5.35%，95%CI：-6.87%~-3.79%，P<0.05），其中男性和女性上消化道癌中标死亡率也均呈下降趋势，APC分别为-5.73%（95%CI：-7.82%~-3.60%）和-4.93%（95%CI：-8.17%~-1.57%），趋势变化均有统计学意义（P均<0.05）。海宁市2009—2020年上消化道癌年龄别发病率均随着年龄增长而增加，0~34岁处于较低水平，在80~84岁组或85岁及以上组到达高峰。上消化道癌年龄别死亡率增长情况与发病率类似，在0~44岁期间处于较低水平，随后增长急剧，在80~84岁组或85岁及以上组达到高峰。［结论］ 2009—2020年间海宁市居民上消化道癌发病和死亡有下降趋势，男性和中老年群体是上消化道癌防治的重点人群。上消化道癌防治工作取得一定效果，仍需进一步加强。

Incidence and Mortality of Upper Gastrointestinal Cancers in Haining City of Zhejiang Province from 2009 to 2020

Abstract：［Purpose］ To analyze the incidence and mortality of upper gastrointestinal cancers among residents in Haining City of Zhejiang Province from 2009 to 2020. ［Methods］ The data of incidence and mortality of upper gastrointestinal cancers from 2009 to 2020 were collected from Haining cancer registry areas. The crude incidence and mortality rates， age-standardized incidence and mortality by Chinese standard population (ASIRC and ASMRC)， age-specific incidence and mortality rate， and annual percentage change (APC) of incidence and mortality rate were calculated. ［Results］ From 2009 to 2020， the total number of new cases of upper gastrointestinal cancers in Haining City was 2 859， with a male-to-female ratio of 2.12∶1； the total number of deaths of upper gastrointestinal cancers was 2 041， with a male-to-female ratio of 2.16∶1. The crude incidence rate of upper gastrointestinal cancers was rising from 29.67/105 in 2009 to 34.99/105 in 2020， while the crude mortality rate showed a decline from 24.77/105 in 2009 to 19.12/105 in 2020. From 2009 to 2020 the ASIRC showed a decreasing trend from 2009 to 2020 (APC=-1.66%， 95%CI： -2.89%~-0.41%， P<0.05)， and the APC for males was -2.24% (95%CI： -3.40% ~-1.06%， P<0.05). The ASMRC also showed a decreasing trend from 2009 to 2020 (APC=-5.35%，95%CI： -6.87%~-3.79%， P<0.05)， the APC for males and females was -5.73% (95%CI： -7.82%~-3.60%， P<0.05) and -4.93% (95%CI： -8.17%~-1.57%， P<0.05)， respectively. The incidence rates of upper gastrointestinal cancers increased with age， with a lower level in age group of 0~34 years old and reaching a peak in the age group of 80~84 or 85+ years old； the mortality rate was lower between 0 and 44 years of age， and then increased sharply， reaching a peak in the age group of 80~84 or 85+ years old. ［Conclusion］ The incidence and mortality of upper gastrointestinal cancers among residents in Haining City from 2009 to 2020 had a decreasing trend， showing that the prevention and treatment of upper gastrointestinal cancers have achieved certain effect， but still need to be further strengthened. Men， the middle-aged and elderly people are the key groups in the prevention and treatment of upper gastrointestinal cancers.