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目的分析1973-2004年上海市区胃癌发病的时间趋势,探讨近年来上海市区胃癌发病的新特点。方法全部资料来源于上海市恶性肿瘤登记报告系统。分别按粗率和标准化率逐年统计1973-2004年市区男性和女性户籍居民的胃癌发病率,用对数线性回归法计算其年度变化百分比(APC),对上海市区近32年的胃癌发病趋势进行估计。对已全部计算机化的2002-2004年上海市区胃癌发病资料,从性别、年龄、诊断分期、病理类型、发病部位等角度进行独立或联合分析,以探讨近年来上海市区胃癌发病的新特点。上海市区的人口资料来自上海市公安局。率的标准化采用世界标准人口。构成比的比较采用X~2检验。统计分析采用SPSS 10.0软件包。结果1973-2004年上海市区男性和女性居民的胃癌标化发病率均呈现显著而持续的下降趋势,其中男性下降了54.4%,女性下降了37.6%。2002-2004年上海市区共登记报告新发胃癌7630例,男性和女性胃癌的标化发病率分别为27.4/10万和14.0/10万。40岁以下人群的胃癌发病率较低,男女性无明显差异。40岁以卜人群的胃癌发病率明显上升且男性逐渐高于女性。在诊断分期上。46.1%的病例具有详细的诊断分期记录,其中Ⅳ期胃癌比例最多,Ⅰ期最少。74.1%的病例为病理诊断,71.7%的病例具有详细的病理类型记录,其中腺癌占76.8%,印戒细胞癌占9.4%。男性腺癌和管状腺癌的比例高于女性,而女性印戒细胞癌的比例高于男性。肠型胃癌仍占主导地位且男性多于女性,而女性弥漫型胃癌的比例高于男性。发病部位以胃窦癌最为常见且女性比例高于男性,而贲门癌男性明显高于女性。远端胃癌中女性的比例高于男性,而近端胃癌中男性明显高于女性。结论上海市区胃癌发病率在1973- 2004年间呈现显著而持续的下降趋势。且近年来在性别、年龄、诊断分期、病理类型、发病部位等方面表现出一些有意义的发病特点。
Objective To analyze the time trend of gastric cancer incidence in Shanghai during 1973-2004 and to explore the new features of gastric cancer incidence in Shanghai in recent years. Methods All data from the Shanghai Cancer Registry System. The incidence rates of gastric cancer in urban and rural areas from 1973 to 2004 were calculated respectively according to the crude rate and standardization rate. The annual percentage change (APC) was calculated by logarithmic linear regression and the incidence of gastric cancer in Shanghai in the recent 32 years Make an estimate. In order to explore the new features of gastric cancer in Shanghai in recent years, the computerized data of gastric cancer incidence in Shanghai from 2002 to 2004 were analyzed independently or jointly from the aspects of gender, age, diagnosis stage, pathological type, . Shanghai’s population data from the Shanghai Public Security Bureau. The rate of standardization using the world’s standard population. Composition ratio comparison using X ~ 2 test. Statistical analysis using SPSS 10.0 software package. Results During 1973-2004, the incidence of gastric cancer was significantly and continuously decreased in both urban and rural areas in Shanghai, with a drop of 54.4% for males and 37.6% for females. Between 2002 and 2004, a total of 7630 newly diagnosed gastric cancers were reported in Shanghai. The standardized incidence of gastric cancer in men and women was 27.4 / 100,000 and 14.0 / 100,000, respectively. People under the age of 40 have a lower incidence of gastric cancer and no significant difference between men and women. The incidence of gastric cancer in 40-year-old population increased significantly and the male gradually higher than the female. In the diagnosis of staging. 46.1% of the cases had detailed diagnosis staging records, of which stage Ⅳ had the highest proportion of gastric cancers and stage Ⅰ was the least. 74.1% of the cases were pathologically diagnosed, and 71.7% of the cases had a detailed histological record, with adenocarcinoma accounting for 76.8% and signet ring cell carcinoma accounting for 9.4%. The proportion of male adenocarcinoma and tubular adenocarcinoma is higher than that of female, while the proportion of female signet ring cell carcinoma is higher than that of male. Gut type gastric cancer is still dominant and more men than women, while the proportion of women with diffuse gastric cancer is higher than men. The most common part of the incidence of gastric cancer and the proportion of women than men, and cardia cancer was significantly higher in men than women. The proportion of women with distal gastric cancer is higher than that of men, while the number of men with proximal gastric cancer is significantly higher than that of women. Conclusion The incidence of gastric cancer in Shanghai showed a significant and continuous downward trend from 1973 to 2004. And in recent years in gender, age, diagnostic staging, pathological types, the incidence of sites showed some significant features of the disease.