浙江省肿瘤登记地区2010-2014年宫颈癌发病与死亡分析

目的宫颈癌是常见的妇科恶性肿瘤之一,我国城市肿瘤登记地区宫颈癌发病率在女性肿瘤中位居第6位。本研究分析浙江省肿瘤登记地区宫颈癌发病、死亡及流行趋势,为制定宫颈癌预防控制措施与策略提供依据。方法应用浙江省疾病预防控制中心开发的"浙江省慢病信息管理系统",收集14个(县、市、区)肿瘤登记处上报的2010-2014年宫颈癌发病死亡数据,计算并分析2010-2014年宫颈癌发病率和死亡率及其构成、中国人口标化率(中标率)和世界人口标化率(世标率),年龄组发病(死亡)率以及不同地区宫颈癌的发病(死亡)率、年度变化及其构成等指标。结果 2010-2014年浙江省肿瘤登记地区子宫癌新发病例7 806例,其中宫颈癌5 539例(66.69%),合计发病率为9.46/10万,中标率为7.00/10万,世标率为6.74/10万,占全部癌症发病率2.81%,居各部位癌症发病的第10位。发病率高峰在45岁年龄组为38.19/10万,以后随年龄的增长发病率逐渐下降,35~64岁截缩率为15.77/10万。年度发病率呈上升趋势,年度变化百分比(annual percentage change,APC)为3.67%(95%CI为1.12%~8.70%)。按女性人口算城市地区宫颈癌发病率为20.02/10万,农村地区发病率为16.19/10万,差异无统计学意义(u=0.95,P>0.05),但城市2013-2014年宫颈癌发病率有所下降,而农村则呈逐年上升趋势,APC为11.95%(95%CI为8.86%~156.03%),Z=12.39,P<0.01;2014年城乡发病率两者基本持平。宫颈癌发病率为18.93/10万,居女性癌症发病的第5位,中标率和世标率分别为13.98/10万和14.47/10万,35~64岁截缩率为31.93/10万;2010~2014年宫颈癌死亡995例,死亡率为1.70/10万,中标率1.03/10万,世标率0.98/10万,死亡发病比(M/I)为0.18∶1。结论浙江省宫颈癌发病率总体仍保持平稳,发病主要集中在中老年人群,农村地区发病率有逐年升高趋势,该癌死亡率较低,治疗效果比较满意。今后中老年人群和农村地区宫颈癌防控工作尚需进一步加强。

Analysis of incidence and mortality of cervical cancer in cancer registration area in Zhejiang Province from 2010 to 2014

OBJECTIVE Analysis of the incidence,mortality and epidemic trend of cervical cancer in tumor registration areas of Zhejiang Province providesa basis for the establishment of preventive and control measures and strategies for cervical cancer.METHODS The data were collected from"Information Management System for Chronic Diseases in Zhejiang Province".According to the data reported by 14 cancer registries in Zhejiang Province,indicators were calculated and analyzed including the incidence and mortality rate of cervical cancer and its composition,the age-standardized incidence rate by Chinese standard population(ASIRC)and by world standard population(ASIRW),age-specificand region-based incidence(mortality)rate and its annual change as well as composition.RESULTS There were 7806 new cases of uterine cancer in Zhejiang Province from 2010 to 2014.Among them,5539 cases(66.69%)were cervical cancer,with a total incidence of 9.46/105,ASIRC of 7.00/105 and ASIRW of 6.74/105,accounting for 2.81%of the total cancer incidence,ranking No.10 in all parts regarding the incidence of cancer.The highest incidence rate was 38.19/105 in the 45-year-old age group,and it gradually decreased with the increase of age.The cut-off rate was 15.77/105 for 35-64 years old group with the APC reaching 3.67%(95 CI%=1.12-8.70%).In female population the incidence of cervical cancer in urban areas was 20.02/105,in rural areas was 16.19/105,there was no statistical difference(u=0.95,P>0.05),but the incidence of cervical cancer in urban areas decreased in the last two years,while in rural areas it was increasing year by year,with a APC of 11.95%(95%CI=8.86%-156.03%),Z=12.39,P<0.01.In 2014,the incidence of urban and rural morbidity was basically the same.The incidence of cervical cancer was 18.93/105,ranking fifth among women,with the winning and universal rates of 13.98/105 and 14.47/105,with a cut-off rate of 31.93/105 in 35-64 years;995 cervical cancer deaths in2010-2014,with a mortality rate of 0.17/105,a winning rate of 1.03/105,a universal rate of 0.98/105,and a mortality ratio(M/I)of 0.18∶1.CONCLUSIONS The incidence of cervical cancer in Zhejiang Province remained stable.The incidence of cervical cancer was mainly concentrated in the middle-aged and elderly population.The increasing trend of the incidence was found in rural areas.The mortality rate of the cancer was low and the therapeutic effect was satisfactory.In the future,the prevention and control of cervical cancer in middle-aged and elderly people and in rural areas need to be further strengthened.