2002-2012年上海市杨浦区社区人群前列腺癌的发病和生存情况分析

目的 阐明上海市杨浦区2002-2012年间前列腺癌（prostate cancer， PCa）发病率和死亡率。 方法 系统整理2002年1月至2012年12月杨浦区男性户籍人群PCa发病和死亡资料，应用年均变化百分比（APC）模型分析患者发病率和死亡率的时间变化趋势，应用Kaplan-Meier模型结合Log-rank检验进行生存分析。采用2000年全国人口普查的标准男性人口年龄构成进行标化。 结果 2002-2012年间PCa新发病例1 578人，占同期全区男性新发恶性肿瘤的6.36%（1 578/24 800）。PCa年均粗发病率为25.87/10⁵，标化发病率为10.60/10⁵。2002-2012年间PCa粗发病率（APC=10.11，P<0.01）和标化发病率（APC=7.27，P<0.01）逐年增长。60岁以后PCa发病率迅速增加。因PCa死亡716例。年均粗死亡率为11.74/10⁵，标化死亡率为3.92/10⁵。65岁之后PCa死亡率明显上升。PCa患者的5年生存率为57.59%，其中手术治疗组5年生存率为67.56%，显著高于非手术治疗组50.40%（P<0.01）。 结论 年龄是PCa发病率升高的主要因素，PCa死亡率明显低于发病率，手术治疗是影响患者生存的一个重要因素。

Incidence and survival analysis of prostate cancer patients among permanent residents in Yangpu district of Shanghai during 2002-2012

Objective To investigate the incidence and mortality of prostate cancer (PCa) among male permanent residents in Yangpu district of Shanghai during 2002-2012. Methods The data of PCa patients among male permanent residents of Yangpu district from January 2002 to December 2012 were obtained. Changes in the incidence and mortality of PCa was assessed using annual percent change (APC) model. Kaplan-Meier analysis with log-rank test was applied to estimate the survival. The incidence and mortality were standardized with age composition of standard male population from a nationwide census of 2000. Results A total of 1 578 cases of PCa were newly diagnosed between 2002 and 2012,accounting for 6.36% (1 578/24 800) of total male cases with malignant diseases during the period in Yangpu district, Shanghai. The annual crude incidence of PCa was 25.87/10⁵ and the standardized incidence was 10.60/10⁵. The crude incidence of PCa increased consecutively (APC=10.11, P<0.01) from 2002 to 2012; the same was true for the standardized incidence (APC=7.27, P<0.01). The incidence of PCa was increased rapidly above 60 years old. A total of 716 cases died of PCa in this period, with the annual crude mortality being 11.74/10⁵ and the standardized one being 3.92/10⁵. The mortality was increased greatly in those above 65 years old. The overall 5-year survival of the PCa patients was 57.59%. The 5-year survival rate of patients receiving operation was significantly higher than that of patients receiving no operation (67.56% vs 50.40%, P<0.01). Conclusion Age is the major reason for increased incidence of PCa in Yangpu district of Shanghai. The mortality of PCa is apparently lower than the incidence, and surgical treatment is an important factor influencing the survival of PCa patients.