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[目的]描述和分析上海市与肥胖相关的恶性肿瘤发病趋势,为完善上海市肿瘤防治决策以及评估有关防治措施的效果提供支持依据。[方法]发病率数据来源于上海市恶性肿瘤登记系统,疾病分类编码采用ICD-10和ICD-O-3。趋势描述和分析采用基于对数线性模型的平均年度变化百分比(AAPC)和年度变化百分比(APC),并采用人群归因危险度(PARP)估计与肥胖相关的恶性肿瘤发病数。[结果]无论是从长期趋势(1973—2008年)还是短期变动(2002—2008年)来看,上海市≥50岁女性乳腺癌发病水平呈持续上升趋势,市区平均每年上升2.34%,郊区每年上升4.00%;无论是全部上海市女性或≥50岁女性的子宫内膜癌发病水平均未表现出明显的变动趋势;上海市除郊区女性外的人群结直肠癌发病水平均表现出明显上升趋势,市区平均每年分别上升2.33%,郊区每年上升2.51%;上海市肾癌发病水平均表现出有波动的明显上升趋势,市区平均每年上升5.20%,郊区每年上升7.57%。短期趋势(2002—2008年)分析表明,上海市除郊区男性外的人群食管及胃贲门腺癌发病水平均表现出明显下降趋势,市区平均每年下降10.49%,郊区每年下降2.94%。2009年上海市上述5类肿瘤中肥胖相关发病数为1 431例,发病贡献比例为11.37%,其中子宫内膜癌的肥胖发病贡献最为突出,占子宫内膜癌发病总数的比例为23.41%。[结论]上海市应推动人群肥胖控制、高危人群筛查等多种策略的综合实施以改变与肥胖相关的主要恶性肿瘤发病不断上升的趋势。
[Objective] To describe and analyze the trend of the incidence of obesity-related malignancies in Shanghai and provide supportive evidence for improving the decision-making of tumor prevention and treatment in Shanghai and evaluating the effect of prevention and treatment measures. [Method] The incidence data come from Shanghai Malignant Tumor Registry. The classification of diseases was ICD-10 and ICD-O-3. Trend description and analysis The average annual percentage change (AAPC) and annual change percentage (APC) based on the log-linear model were used to estimate the incidence of obesity-related malignancies using population-attributable risk (PARP). [Results] The incidence of breast cancer in ≥50-year-old women in Shanghai showed an increasing trend both in the long-term trend (1973-2008) and in the short-term changes (2002-2008), with an average increase of 2.34% Up 4.00% every year. No significant changes were observed in the incidence of endometrial cancer in all Shanghai women or ≥50 years old women. The incidence of colorectal cancer in Shanghai residents except suburban women showed a significant increase Trend, the urban areas rose 2.33% on average each year, the suburbs rose 2.51% per annum; the incidence of renal cell carcinoma in Shanghai showed a clear upward trend in fluctuation, urban areas increased by 5.20% per annum, the suburbs rose 7.57% per annum. The short-term trend (2002-2008) analysis showed that the incidence of esophageal and gastric cardia adenocarcinoma in Shanghai population showed a significant downward trend except suburban men, the average annual decline of 10.49% in urban areas, rural areas fell 2.94% per year. In 2009, the incidence of obesity in these 5 types of tumors in Shanghai was 1 431 cases, with a contribution rate of 11.37%. Among them, the incidence of obesity in endometrial cancer was the most prominent, accounting for 23.41% of the total incidence of endometrial cancer. [Conclusion] Shanghai should promote the implementation of various strategies such as obesity control and high-risk population screening in order to change the rising trend of obesity-related major malignancies.