广东地区近20年大肠癌临床特征的变化趋势

目的了解近20年来广东地区大肠癌临床流行病学特征的变化规律和趋势。方法总结分析广州南方医院和广东惠州市中心人民医院1985-2004年经病理确诊的大肠癌3870例资料。将20年资料按每5年为一时期进行统计分析。结果1985-1989年段与2000-2004年段比较，大肠癌收治率增加102．0％，平均每年上升5．1％；发病中位年龄从50．2岁上升至58．6岁，上升了8．4岁；男女比例逐渐下降，从1．50下降到1．35；发病部位直肠癌比例从64．8％下降到49．7％，右半结肠癌比例则从18．0％上升到28．7％；组织学类型中，中高分化者占的比例从70．1％上升到80．6％，低未分化者比例则从29．9％下降到19．4％；诊断Dukes A期的大肠癌比例从3．2％上升到9．8％。结论近20年来广东地区大肠癌的发病率上升；发病中位年龄上升；男女比例下降；直肠癌比例下降，右半结肠癌上升；组织学类型高中分化者占的比例上升，低未分化者下降；诊断Dukes A期的比例上升。

The trend of clinical characteristics of colorectal cancer during the past 20 years in Guangdong province

OBJECTIVE: To study the trend of clinical characteristics of colorectal cancer during the past 20 years in Gaungdong province. METHODS: The clinical data of 3870 cases of colorectal cancers confirmed pathologically who were hospitalized to Nanfang Hospital and Huizhou Municipal Hospital, Guangdong province, 1985 - 2004 were divided into 5-year groups and analyzed. RESULTS: The hospitalization number of colorectal cancer in the 2000 - 20004 5-year period was 102%, higher than that of the 1985 - 1989 period with an annual increase of 5.1%. The median age of incidence 2000 - 2004 was 58.6 years, 8.4 years higher than that in 1985 - 1989. The male to female ratio of the 3870 patients was 1.42:1. The male to female ratio 2000 - 2004 was 1.35:1, lower than that 1985 - 1989 (1.50:1). The proportion of rectal cancer 2000 - 2004 was 49.7%, significantly lower than that in 1985 - 1989 (64.8%), while the proportion of right hemi-colon cancer 2000 - 2004 was 28.7%, significantly higher than that in 1985 - 1989 (18.0%). The proportion of moderately and well differentiated cancer 2000 - 2004 was 80.6%, higher than that in 1985 - 1989 (70.1%), and the proportion of poorly differentiated cancer 2000 - 2004 was 19.4%, lower than that in 1985 - 1989 (29.9%). The proportion of colorectal cancer at Dukes A stage 2000 - 2004 was 9.8%, higher than that in 1985 - 1989 (3.2%). CONCLUSION: In the past 20 years, the incidence of colorectal cancer has increased in Guangdong province with a n increase of median age of incidence, The male to female ratio has decreased, and the incidence of right hemi-colon cancer, the rates of higher differentiated cancer and Dukes A stage cancer have increased.