CAJ | 학술논문

目的了解1973-2005年上海市区居民结直肠癌发病率的时间变化趋势.方法结直肠癌发病资料来自上海市肿瘤发病登记处,共采集32 962例结肠癌患者资料和24 662例直肠癌患者资料.根据人口普查资料中性别、年龄构成估算各年人口数,利用世界标准人口,采用直接法计算标化发病率.标化发病率年度变化百分比(APC)估算采用对数线性回归法,并用病例数进行加权.结果 1973-2005年男女性结直肠癌发病率均呈上升趋势,结肠癌的标化发病率分别从6.09/10万和5.70/10万上升至14.70/10万和14.35/10万,APC分别为3.03%(t=14.77,P<0.01)和3.21%(t=22.15,P<0.01).男女性直肠癌标化发病率分别从7.68/10万和6.51/10万上升至11.45/10万和8.28/10万,APC分别为1.34%(t=7.28,P<0.01)和0.93%(t=7.34,P<0.01).女性结直肠癌的APC在85岁～组达到最高,分别为5.86%和2.79%;而男性在80岁～组APC最高,分别为4.64%和2.38%.男女性45岁及以上各年龄组结肠癌的APC大于直肠癌.33年间,男女性结直肠癌的平均发病年龄由57～60岁推迟到66～70岁.结肠癌发病年龄较直肠癌略晚[2003-2005年,男性结肠癌平均发病年龄为(68.61±12.17)岁,男性直肠癌为(66.81±12.62)岁,t=4.90,P<0.01;女性结肠癌为(69.20±12.13)岁,女性直肠癌为(67.75±12.54)岁,t=3.81,P<0.01].结论上海市区男女性结直肠癌的标化发病率在33年里稳步上升,其中结肠癌上升趋势更加明显,有必要进一步探讨导致这种变化的原因.
목적 료해1973-2005년상해시구거민결직장암발병솔적시간변화추세.방법 결직장암발병자료래자상해시종류발병등기처,공채집32 962례결장암환자자료화24 662례직장암환자자료.근거인구보사자료중성별、년령구성고산각년인구수,이용세계표준인구,채용직접법계산표화발병솔.표화발병솔년도변화백분비(APC)고산채용대수선성회귀법,병용병례수진행가권.결과 1973-2005년남녀성결직장암발병솔균정상승추세,결장암적표화발병솔분별종6.09/10만화5.70/10만상승지14.70/10만화14.35/10만,APC분별위3.03%(t=14.77,P<0.01)화3.21%(t=22.15,P<0.01).남녀성직장암표화발병솔분별종7.68/10만화6.51/10만상승지11.45/10만화8.28/10만,APC분별위1.34%(t=7.28,P<0.01)화0.93%(t=7.34,P<0.01).녀성결직장암적APC재85세～조체도최고,분별위5.86%화2.79%;이남성재80세～조APC최고,분별위4.64%화2.38%.남녀성45세급이상각년령조결장암적APC대우직장암.33년간,남녀성결직장암적평균발병년령유57～60세추지도66～70세.결장암발병년령교직장암략만[2003-2005년,남성결장암평균발병년령위(68.61±12.17)세,남성직장암위(66.81±12.62)세,t=4.90,P<0.01;녀성결장암위(69.20±12.13)세,녀성직장암위(67.75±12.54)세,t=3.81,P<0.01].결론 상해시구남녀성결직장암적표화발병솔재33년리은보상승,기중결장암상승추세경가명현,유필요진일보탐토도치저충변화적원인.
Objective To explore the time trends of colorectal cancer incidence rates in urban Shanghai from 1973 to 2005. Methods Data on the incidence rates of colorectal cancer were obtained from a population-based cancer registry in Shanghai. A total of 32 962 colon cancer patients and 24 662 rectal cancer patients were registered. Population estimation were based on periodic censuses, with age-and sex-specific annual estimates derived for the remaining years. The rates were adjusted to the world standard population by using the direct method. Annul percent changes (APCs) in rates were estimated by means of a linear regression of the logarithm of the respective rates on calendar, weighted by the number of incidence cases. Results The incidence rates of colorectal cancer increased steadily during 1973 to 2005, the age-adjusted incidence rates of colon cancer increased from 6.09 and 5. 70 to 14.70 and 14. 35 per 100 000 in male and female respectively. The APCs were 3. 03 % (t=14. 77, P < 0. 01) and 3.21% (t=22. 15, P < 0. 01). The rates of rectal cancer increased from 7.68 and 6. 51 to 11.45 and 8. 28 per 100 000 in male and female respectively. The APCs were 1.34% (t=7. 28,P <0. 01) and 0. 93% (t=7. 34,P <0. 01). The top APCs for colon and rectal cancer in female were 5. 86% and 2. 79% at age above 85 and in male those were 4. 64% and 2. 38% at age of 80-. The APCs of colon cancer were greater than those of rectal cancer at the groups above 45 years old. The average ages when diagnosed were delayed from 57-60 to 66-70 during these 33 yearn The average diagnosed ages of colon cancer were later than those of rectal cancer slightly(from 2003 to 2005,the onset age of male colon cancer: 68. 61±12.17,male rectal cancer: 66.81±12. 62, t=4. 90, P < 0.01; female colon cancer:69. 20±12. 13, female rectal cancer:67. 75±12. 54,t=3. 81,P < 0. 01). Conclusion The incidence rates of colorectal cancer increased steadily during 1973 to 2005, especially for colon cancer. Further research is needed to identify the causes resulting in these changes.