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2002-2012年上海市杨浦区社区人群甲状腺癌的发病和生存情况分析
沈琪1,倪翀2,乔鹏3,陈蕾2,赵佳3,张蓉3,韩雪3,曹广文2*
0
(1. 同济大学附属杨浦医院老年医学一科, 上海 200090;
2. 第二军医大学热带医学与公共卫生学系流行病学教研室, 上海 200433;
3. 上海市杨浦区疾病预防控制中心, 上海 200090
*通信作者)
摘要:
目的 了解上海市杨浦区户籍人群2002-2012年间甲状腺癌的发病率和死亡率,探讨外科治疗对生存的影响。方法 从2002年1月至2012年12月上海市肿瘤登记报告中抽取全部杨浦区户籍人群甲状腺癌发病和死亡资料,年度人口资料来自杨浦区公安局,应用年均变化百分比(APC)模型分析患者发病的时间趋势,应用Kaplan-Meier模型并结合Log-rank检验进行生存分析。结果 2002-2012年间杨浦区共报告甲状腺癌新发病例1 488例,占同期全区恶性肿瘤的3.19%。其中男性357例,女性1 131例。甲状腺癌女性平均粗发病率为19.45/105,高于男性(5.85/105,P<0.05);女性标化发病率为12.15/105,也高于男性(3.69/105, P<0.05)。2002-2012年间杨浦区户籍人群甲状腺癌的发病趋势年均上升(APC=21.72%, P<0.05)。11年间杨浦区因甲状腺癌死亡146例。年均粗死亡率男性为0.69/105,女性为1.79/105(P<0.05);标化死亡率男性为0.35/105,女性为0.85/105(P<0.05)。男性、女性的甲状腺癌死亡率均在60岁之后明显上升。甲状腺癌患者的1~5年生存率分别为97.20%、96.70%、96.10%、95.40%和94.80%。手术治疗组1~5年生存率分别为99.20%、98.90%、98.70%、98.30%和97.90%,高于非手术治疗组(分别为91.9%、90.60%、89.00%、88.00%和86.70%,P<0.05)。结论 上海市杨浦区户籍人群甲状腺癌发病率远高于死亡率,2002-2012年间发病率显著升高而死亡率变化不明显。女性发病率与死亡率均高于男性,手术治疗可延长甲状腺癌患者的生存期。
关键词:  甲状腺肿瘤  发病率  死亡率  存活率
DOI:10.16781/j.0258-879x.2016.05.0569
投稿时间:2015-09-30修订日期:2016-01-15
基金项目:国家重点基础研究发展计划("973"计划)(2015CB554000),国家自然科学基金重点国际合作基金(81520108021).
Incidence and survival analysis of thyroid cancer among permanent residents in Yangpu district of Shanghai during 2002-2012
SHEN Qi1,NI Chong2,QIAO Peng3,CHEN Lei2,ZHAO Jia3,ZHANG Rong3,HAN Xue3,CAO Guang-wen2*
(1. Department of Geriatrics, Yangpu Hospital, Tongji University, Shanghai 200090, China;
2. Department of Epidemiology, Faculty of Tropical Medicine and Public Health, Second Military Medical University, Shanghai 200433, China;
3. Center of Disease Control and Prevention of Yangpu District, Shanghai 200090, China
*Corresponding author)
Abstract:
Objective To analyze the incidence and mortality of thyroid cancer among permanent residents in Yangpu district of Shanghai from January 2002 to December 2012, so as to evaluate the effect of surgical treatment on their survivals. Methods The data of thyroid cancer in permanent residents of Yangpu district were collected from the database of cancer registration and management system in Shanghai. Annual demographic data were obtained from Public Safety Department of Yangpu district. The temporal trend in the incidence and mortality of thyroid cancer was assessed using annual percent change (APC) model. Kaplan-Meier analysis with log-rank test was performed for survival analysis. Results A total of 1 488 cases with thyroid cancer were diagnosed from January 2002 to December 2012, accounting for 3.19% of the total patients with malignant diseases during the time in the area. Of those, 1 131 were females. The crude incidence rate was 19.45/105 in females, being significantly higher than 5.85/105 in males (P<0.05). The standardized incidence rate was 12.15/105 in females, also being significantly higher than 3.69/105 in males (P<0.05). The crude incidence of thyroid cancer increased significantly (APC=21.72%, P<0.05) from 2002 to 2012. A total of 146 cases died of thyroid cancer during this period, with the annual crude mortality being 1.79/105 in females, which was significantly higher than that in males (0.69/105, P<0.05). The standardized mortality rate was 0.35/105 in males and 0.85/105 in females (P<0.05). Both the incidence and mortality rates increased rapidly after 60 years old for both males and females. The 1- to 5- year survival rates in all cases were 97.20%, 96.70%, 96.10%, 95.40% and 94.80%, respectively. The rates in those receiving surgery were 99.20%, 98.90%, 98.70%, 98.30%, and 97.90%, which were significantly higher than those without surgery (91.9%, 90.60%, 89.00%, 88.00%, and 86.70%, respectively) (P<0.05 for each comparison). Conclusion The incidence of thyroid cancer is significantly higher than the mortality in permanent residents of Yangpu district in Shanghai. The incidence, rather than the mortality, is dramatically increased during 2002 and 2012. Both the incidence and mortality of thyroid cancer are significantly higher in females than in males, and surgical resection can significantly prolong the survival of thyroid cancer patients.
Key words:  thyroid neoplasms  incidence  mortality  survival rate