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| 1977-2021年江苏启东宫颈癌发病趋势分析 |
| Analysis of Cervical Cancer Incidence Trends in Qidong, Jiangsu from 1977 to 2021 |
| 投稿时间：2024-02-19 修订日期：2024-03-27 |
| DOI： |
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| 中文关键词: 宫颈癌 发病率 趋势 流行病学 启东 |
| 英文关键词:cervical cancer incidence trend epidemiology Qidong |
| 基金项目: |
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| 摘要点击次数: 83 |
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| 中文摘要: |
| [目的] 分析江苏省启东市宫颈癌发病率的长期趋势，为宫颈癌预防控制提供策略依据。 [方法] 基于启东市1977-2021年宫颈癌登记病例数据库，计算粗发病率、中国人口标化率（中标率: CASR）、世界人口标化率（世标率:WASR）、35~64岁截缩率、0~74岁累积发病率、累积发病风险等，并开展出生队列发病率分析。用Joinpoint 4.9.0.0软件进行Joinpoint 回归分析，计算宫颈癌发病率年度变化百分比（APC）和平均年度变化百分比（AAPC）。[结果] 启东市1977-2021年共计发生宫颈癌2,253例，占全人群恶性肿瘤发病例数的1.62%。宫颈癌占女性恶性肿瘤发病病例数的4.03%，粗发病率为8.75/10万，CASR为4.54/10万，WASR为6.01/10万，35~64岁截缩率为15.09/10万，0~74岁累积发病率为0.63%，累积发病风险为0.63%。1977-2021年宫颈癌各年龄组发病率随年龄增加而不断升高。平均发病年龄为55.36岁，其中最低的2010年为47.51岁。时间趋势结果显示，宫颈癌粗发病率的总AAPC值为6.01% (95%CI: 4.95-7.08) (P < 0.001)，其中1977-1999年间呈下降趋势，APC为-2.51%，1999-2017年间呈上升趋势，APC为14.44%（P < 0.001）；CASR、WASR的升降趋势与粗发病率相似。年龄组及时期分析显示，早期的高发病率年龄组在老年组，而最近15年来的高发年龄组出现在45-54岁组；25-64岁之间各年龄组的AAPC均呈上升趋势（P < 0.05）。出生队列结果显示，1937-1941出生队列者的宫颈癌发病率最低，各年龄组的出生队列发病率呈现“V”型趋势。[结论] 启东宫颈癌发病率的长期监测显示出其先缓慢下降，后快速上升的变化，且发病年龄呈现年轻化的趋势。分析还提示宫颈癌的HPV感染病因已经并且将继续对区域性的流行趋势产生影响，降低HPV病毒感染及加强疫苗接种等防控措施值得进一步加强。 |
| 英文摘要: |
| [Purpose]: To analyze the long-term trend of cervical cancer incidence in Qidong City, Jiangsu Province, and to provide a strategic basis for cervical cancer prevention and control. [Methods] Based on the cervical cancer registration database in Qidong City from 1977 to 2021, the crude incidence rate, the standardized rate of the Chinese population (CASR), the standardized rate of the World population (WASR), the truncated rate of 35-64 years old, the cumulative rate of 0-74 years old, and the cumulative risk were calculated; the incidence rates of birth cohorts were analyzed. Joinpoint regression analysis was performed with Joinpoint 4.9.0.0 software to calculate the annual percentage change (APC) and the average annual percentage change (AAPC) of cervical cancer incidence. [Results] A total of 2,253 cases of cervical cancer registered in Qidong City from 1977 to 2021, accounting for 1.62% of all sites combined in the whole population. Cervical cancer accounted for 4.03% of the total number of cancers in women, the crude incidence rate was 8.75/100,000, the CASR was 4.54/100,000, the WASR was 6.01/100,000, the truncated rate of 35-64 years was 15.09/100,000, the cumulative rate of 0-74 years was 0.63%, and the cumulative risk was 0.63%. The incidence of cervical cancer in all age groups from 1977 to 2021 increased with age. The average incident age was 55.36 years, with the lowest age of 47.51 years in 2010. Secular trend analysis showed that the AAPC of the crude incidence of cervical cancer was 6.01% (95%CI: 4.95-7.08) (P < 0.001), among which the trend decreased from 1977 to 1999, with an APC of -2.51%; and then the trend increased from 1999 to 2017, with an APC of 14.44% (P < 0.001). The rising and falling trend curves of the CASR and WASR were similar to that of the crude incidence. The age group and time period analysis showed that the peak incidence age group was in the elderly group, while the peak incidence age group in the last 15 years appeared in the 45-54 year old group. The AAPCs of all groups among 25-64 years old demonstrated upward trends (Ps < 0.05). The birth cohort analysis showed that the cervical cancer incidence in the 1937-1941 birth cohort was the lowest, and the birth cohort-specific rates in all age groups showed "V-shape" trends. [Conclusion] Long-term monitoring of cervical cancer incidence in Qidong has shown a trend of initially slow decline followed by a rapid increase, with the incident age of displaying a trend towards younger ages. The analysis suggests that the etiology of HPV infection in cervical cancer has and will continue to impact regional epidemic trends. Measures to reduce HPV infection and enhance vaccination efforts are worth further strengthening. |
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