上海人群胃癌生存率研究
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摘要
背景与目的:我国胃癌的发病率和死亡率呈逐年上升趋势,以人群为基础的胃癌生存率资料反映了胃癌诊治效果,也可以为评价胃癌人群综合防治效果提供参考。方法:根据上海市肿瘤登记处收集的2002—2006年胃癌登记和生存随访报告资料,采用寿命表法和EdererⅡ法计算胃癌患者的观察生存率(observed survival,OS)和相对生存率(relative survival,RS)。结果:上海市2002—2006年共诊断胃癌病例28 243例,患者5年OS和RS分别为32.15%和45.81%。35~54岁年龄段患者生存率高于其他年龄组;Ⅰ期患者的生存率明显高于其他分期患者;管状腺癌的胃癌患者生存率显著高于其他类型;郊区患者5年OS高于市区患者。不同性别患者的生存率差异无统计学意义。2002—2006年与1972—1976年相比,男、女性胃癌患者的生存率均显著上升。结论:不同年龄、居住区域、诊断时期别、肿瘤组织学类型和病理学类型的患者生存率差异有统计学意义。上海地区胃癌的5年OS和RS在过去30年中显著升高,但仍低于发达国家。应提高胃癌患者早期诊断率,以改善胃癌患者的生存及预后情况。
Background and purpose: Incidence and mortality of gastric cancer have increased gradually in China. Population-based cancer survival rate can reflect improvements in cancer diagnosis and treatment, as well as provide evidence for gastric cancer prevention and control. Methods: Data from gastric cancer incidence and followup between 2002 and 2006 were collected by the Shanghai Cancer Registry. Life table and Ederer Ⅱ were used to calculate observed survival(OS) and relative survival(RS). Results: A total number of 28 243 gastric cancer cases were documented between 2002 and 2006 in Shanghai. The 5-year OS and RS of gastric cancer were 32.15% and 45.81%, respectively. Survival rates of gastric cancer varied by age, residence, diagnostic stage, and tumor histological type, but not by gender. Patients aged 35-44 years who were diagnosed at stage Ⅰ or with tubular adenocarcinoma, had the highest survival rates. Moreover, patients in rural areas had higher 5-year OS than those in urban areas. During the period 2002-2006, both 5-year OS and RS of gastric cancer increased dramatically, as compared with 1972-1976. Conclusion: Survival rates of gastric cancer varied by age, residence, diagnostic stage, and tumor histological type. The 5-year OS and RS significantly increased in Shanghai over the past three decades, but are still far below developed countries. Early diagnosis of gastric cancer would be an effective strategy to improve survival and prognosis of patients with gastric cancer.
Background and purpose: Incidence and mortality of gastric cancer have increased gradually in China. Population-based cancer survival rate can reflect improvements in cancer diagnosis and treatment, as well as provide evidence for gastric cancer prevention and control. Methods: Data from gastric cancer incidence and followup between 2002 and 2006 were collected by the Shanghai Cancer Registry. Life table and Ederer Ⅱ were used to calculate observed survival(OS) and relative survival(RS). Results: A total number of 28 243 gastric cancer cases were documented between 2002 and 2006 in Shanghai. The 5-year OS and RS of gastric cancer were 32.15% and 45.81%, respectively. Survival rates of gastric cancer varied by age, residence, diagnostic stage, and tumor histological type, but not by gender. Patients aged 35-44 years who were diagnosed at stage Ⅰ or with tubular adenocarcinoma, had the highest survival rates. Moreover, patients in rural areas had higher 5-year OS than those in urban areas. During the period 2002-2006, both 5-year OS and RS of gastric cancer increased dramatically, as compared with 1972-1976. Conclusion: Survival rates of gastric cancer varied by age, residence, diagnostic stage, and tumor histological type. The 5-year OS and RS significantly increased in Shanghai over the past three decades, but are still far below developed countries. Early diagnosis of gastric cancer would be an effective strategy to improve survival and prognosis of patients with gastric cancer.
引文
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[2]赫捷,陈万青.2012中国肿瘤登记年报[M].军事医学科学出版社,2012.
[3]哈米霍恩,虞积耀.消化系统病理学和遗传学[M].北京:人民卫生出版社,2006.
[4]董景五.疾病和有关健康问题的国际统计分类第十次修订本(ICD10)[M].第2版.北京:人民卫生出版社,2008.
[5]董景五.国际疾病分类肿瘤学专辑(ICD-O)[M].第3版.北京:人民卫生出版社,2003.
[6]KAPLAN E L,MEIER P.Nonparametric estimation from incomplete observations[J].J Am Stat Soc,1958,53(282):457-481.
[7]ESTEVE J,BENHAMOU E,RAYMOND L.Statistical methods in cancer research,volumeⅣ:descriptive epidemiology[M].IARC Scientific Publications No.128.IACR,Lyon.
[8]高玉堂,卢伟.上海市区恶性肿瘤发病率、死亡率和生存率(1973—2000)[M].第二军医大学出版社,2007.
[9]李立明.流行病学[M].人民卫生出版社,2008,11:19.
[10]龚巍巍,罗胜兰,胡如英,等.2005—2010年浙江省胃癌生存率分析[J].中华肿瘤杂志,2014,36(8):636-639.
[11]张永辉,朱健,陈永胜,等.启东市2001—2007年胃癌生存率分析[J].现代肿瘤医学,2011,19(11):2328-2330.
[12]秦新裕,刘凤林.努力提高胃癌的术后5年生存率[J].外科理论与实践,2008,13(1):4-6.
[13]EMERINK E J,HOSPERS G A,MULDER N H,et a1.Disparities in survival of stomach cancer among different socioeconomic groups in North-East Netherlands[J].Cancer Epidemiol,2011,35(5):413-416.
[14]GOREY K M,LUGINAAH I N,HOLOWATY E J,et al.Mediation of the effects of living in extremely poor neighborhoods by health insurance:breast cancer care and survival in California.1996 to 2011[J].Int J Equity Health,2013,12:6.doi:10.1186/1475-9276-12-6.