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目的探讨汉中地区单中心乳腺癌临床流行病学特征,为乳腺癌的防治提供流行病学依据。方法收集2009年至2013年西安交通大学医学院附属汉中三二0一医院确诊的住院684例乳腺癌病例的临床资料,分析其发病特点、病员县域及城乡分布、所接受的治疗方法、费用支付方式及可能的高危因素等。结果在684例乳腺癌患者中,发病年龄主要集中于41~60岁,中位年龄47岁;组织类型以浸润性导管癌为主;从年度变化趋势来看,各类患者绝对人数均有增长;2009年与2013年相比放疗构成比显著升高;费用形式方面农保支付构成比逐年增高、自费构成比逐年下降,差异有统计学意义(P<0.05,P<0.01);平原县妇女乳腺癌发病构成比2012、2013年度显著高于山区县(P<0.05,P<0.01),且平原县妇女乳腺癌发病构成比2013年高于2009年(P<0.05);山区县及农村乳腺癌患者伴发乳腺良性疾病比例低于城镇及平原县妇女(P均<0.01)。结论该地区女性乳腺癌发病情况处于全国中等水平,41~60岁为最高发病年龄段,必须加强综合防治措施;当地居民的生活习惯及母乳喂养程度等因素可能与女性乳腺癌发病有相关性;全民医保覆盖工作需进一步加强。
Objective To explore the clinical epidemiological characteristics of single center breast cancer in Hanzhong area and to provide epidemiological evidence for the prevention and treatment of breast cancer. Methods The clinical data of 684 cases of inpatients diagnosed as breast cancer in Hanzhong Hospital of Medical Center of Xi'an Jiaotong University between 2009 and 2013 were collected and analyzed. The characteristics of the disease, the distribution of the patients, the distribution of urban and rural areas, the treatment methods accepted and the payment of costs Ways and possible risk factors. Results Among the 684 breast cancer patients, the age of onset was mainly between 41 and 60 years old, with a median age of 47 years. The type of tissue was mainly invasive ductal carcinoma. From the perspective of annual change, the absolute number of all kinds of patients increased ; Compared with 2013, the composition ratio of radiotherapy increased significantly in 2009; in terms of cost form, the proportion of payment for rural social security increased year by year, while the composition of self-payment declined year by year with a statistically significant difference (P <0.05, P <0.01) The incidence of breast cancer was significantly higher than that in mountainous counties in 2012 and 2013 (P <0.05, P <0.01), and the incidence of breast cancer in plain counties was higher than that in 2013 (P <0.05) The proportion of cancer patients with breast benign disease was lower than that in urban and plain counties (all P <0.01). Conclusion The prevalence of breast cancer in women in this area is at the middle level in the country, with the highest incidence in 41-60 years of age. Comprehensive prevention and control measures should be strengthened. Factors such as the living habits of local residents and the degree of breastfeeding may be related to the incidence of breast cancer in women. Universal coverage of health insurance needs to be further strengthened.