1972—2021年江苏省启东市结直肠癌发病流行趋势分析

摘 要：［目的］ 分析江苏省启东市1972—2021年全人群结直肠癌发病流行趋势。［方法］ 基于启东市癌症登记病例数据库，提取1972—2021年结直肠癌发病登记资料，计算粗发病率、中国人口标化率（中标率）、世界人口标化率（世标率）、35~64岁截缩率、0~74岁累积发病率、累积发病风险等。用Joinpoint Regression Program 4.9.1.0软件进行回归分析，计算结直肠癌发病率平均年度变化百分比（average annual percentage change，AAPC）。［结果］ 启东市1972—2021年共计发生结直肠癌11 956例，占同期全部恶性肿瘤发病例数的8.11%；结直肠癌粗发病率为21.31/10万，中标率为8.18/10万，世标率为13.14/10万，35~64岁截缩率为19.34/10万，0~74岁累积发病率为1.55%，结直肠癌累积发病风险为1.54%。其中男性发病6 176例，粗发病率、中标率、世标率分别为22.33/10万、9.18/10万、14.83/10万；女性发病5 780例，粗发病率、中标率、世标率分别为20.33/10万、7.28/10万、11.64/10万。平均发病年龄1972年为60.27岁，1996年为64.52岁，至2021年上升为69.04岁，50年期间平均发病年龄为66.78岁。时间趋势结果显示1972—2021年男女合计、男性及女性粗发病率的AAPC分别为5.703%、6.511%及4.910%，上升趋势均有统计学意义（P均<0.001）；中标率的AAPC分别为2.577%、3.283%及1.819%，上升趋势均有统计学意义（P均<0.001）；世标率的AAPC分别为2.773%、3.470%、2.043%，上升趋势均有统计学意义（P均<0.001）。1972—2021年启东市结直肠癌各年龄组粗发病率随年龄增长而不断升高，45~54岁年龄组粗发病率的AAPC为2.543%（P=0.002），55~64岁年龄组AAPC为 3.278%（P<0.001），65~74岁年龄组AAPC为 2.845%（P<0.001），75岁及以上年龄组AAPC为3.413%（P<0.001），上述各年龄组结直肠癌粗发病率上升趋势均有统计学意义。［结论］ 启东市结直肠癌发病率呈现上升趋势，应针对重点人群做好防控措施，将45岁以上人群作为结直肠癌重点关注对象，推进重点人群结直肠癌筛查项目，提高早诊早治率，并且积极开展全民健康生活方式宣传活动，减少结直肠癌危险因素暴露，以降低启东市结直肠癌的发病水平。

Trends of Colorectal Cancer Incidence in Qidong City of Jiangsu Province from 1972 to 2021

Abstract： ［Purpose］ To analyze the trends of colorectal cancer incidence in Qidong City of Jiangsu Province from 1972 to 2021. ［Methods］ Data of colorectal cancer new cases during 1972 to 2021 were extracted from Qidong cancer registries. The crude rate (CR)， age-standardized rate by Chinese standard population (ASRC) and by world standard population (ASRW)， truncated rate of 35~64 years old， cumulative incidence rate of 0~74 years old and cumulative risk of incidence were calculated. Joinpoint regression analysis was performed using Joinpoint Regression Program 4.9.1.0 software to calculate the average annual percentage change (AAPC) of colorectal cancer incidence. ［Results］ The total number of colorectal cancer cases in Qidong from 1972 to 2021 was 11 956， accounting for 8.11% of all malignant tumor cases. The CR， ASRC， ASRW， the truncated rate of 35~64 years old， cumulative rate of 0~74 years old and cumulative risk of colorectal cancer was 21.31/105， 8.18/105， 13.14/105， 19.34/105， 1.55% and 1.54%， respectively. There were 6 176 male cases and 5 780 female cases. The CR， ASRC and ASRW of males and females were 22.33/105， 9.18/105， 14.83/105； and 20.33/105， 7.28/105， 11.64/105， respectively. The average age of onset was 60.27 years old in 1972， 64.52 years old in 1996， and 69.04 years old in 2021； the average age of onset over a 50-year period was 66.78 years old. Time trend showed that the overall AAPC for the CR of colorectal cancer in both sexes， male and female from 1972 to 2021 were 5.703%， 6.511%， and 4.910%， respectively (all P<0.001)； those in ASRC were 2.577%， 3.283%， and 1.819%， respectively (all P<0.001)； and those in ASRW were 2.773%， 3.470% and 2.043% (all P<0.001). The AAPC was 2.543% in the age group of 45~54 years old (P=0.002)， 3.278% in the age group of 55~64 years old (P<0.001)， 2.845% in the age group of 65~74 years old (P<0.001)， and 3.413% in the age group of above 75 years old (P<0.001). ［Conclusion］ The incidence of colo-rectal cancer in Qidong shows a rising trend from 1972 to 2021. It is necessary to take preventive and control measures for key populations， make people over 45 years of age as the head target of colorectal cancer， promote the colorectal cancer screening program for prominent populations， and improve the rate of early diagnosis and early treatment， carry out the publicity campaign of national healthy lifestyle， reduce the exposure of colorectal cancer risk factors， so as to reduce the incidence level of colorectal cancer in Qidong.