摘要
[目的]描述和分析上海市与肥胖相关的恶性肿瘤发病趋势,为完善上海市肿瘤防治决策以及评估有关防治措施的效果提供支持依据。[方法]发病率数据来源于上海市恶性肿瘤登记系统,疾病分类编码采用ICD-10和ICD-O-3。趋势描述和分析采用基于对数线性模型的平均年度变化百分比(AAPC)和年度变化百分比(APC),并采用人群归因危险度(PARP)估计与肥胖相关的恶性肿瘤发病数。[结果]无论是从长期趋势(1973—2008年)还是短期变动(2002—2008年)来看,上海市≥50岁女性乳腺癌发病水平呈持续上升趋势,市区平均每年上升2.34%,郊区每年上升4.00%;无论是全部上海市女性或≥50岁女性的子宫内膜癌发病水平均未表现出明显的变动趋势;上海市除郊区女性外的人群结直肠癌发病水平均表现出明显上升趋势,市区平均每年分别上升2.33%,郊区每年上升2.51%;上海市肾癌发病水平均表现出有波动的明显上升趋势,市区平均每年上升5.20%,郊区每年上升7.57%。短期趋势(2002—2008年)分析表明,上海市除郊区男性外的人群食管及胃贲门腺癌发病水平均表现出明显下降趋势,市区平均每年下降10.49%,郊区每年下降2.94%。2009年上海市上述5类肿瘤中肥胖相关发病数为1 431例,发病贡献比例为11.37%,其中子宫内膜癌的肥胖发病贡献最为突出,占子宫内膜癌发病总数的比例为23.41%。[结论]上海市应推动人群肥胖控制、高危人群筛查等多种策略的综合实施以改变与肥胖相关的主要恶性肿瘤发病不断上升的趋势。
[ Objective ] To describe the incidence trends of obesity-associated cancers, and to provide basis for cancercontrol-related policy making and prevention program evaluation in Shanghai. [ Methods ] Incidence rate data from Shanghai cancer registry system were coded by ICD-10 and ICD-O-3 and analyzed. Average annual percentage change （AAPC） and annual percentage change （APC） based on log linear model was adopted to describe the incidence trend. Population attributable risk percent （PARP） was employed to estimate the obesity-associated incidence cases. [ Results ] Whether over the long-term （1973-2008） or short-term （2002-2008） period, the breast cancer incidence rate of females at age of 50 years old and above was increasing continually and significantly with an AAPC of 2.34% in urban areas during 1973-2008 and an APC of 4.00% in suburb areas during 2002-2008. The incidence rates of endometrial cancer of all females and of the 50 years old and above did not present significant trends of variation. The colorectum cancer presented significant ascending trends, except among the suburb females, for the urban with an AAPC of 2.33% during 1973-2008 and the suburb with an APC of 2.51% during 2002-2008. The kidney cancer showed significant ascending trends for the urban residents with an AAPC of 5.20% during 1973-2008 and the suburb residents with an APC of 7.57% during 2002-2008. During 2002-2008, the esophagus and gastric cardia adenocarcinoma presented significant descending trends, except among the suburb males, for the urban residents with an APC of 10.49% and the suburb residents with an APC of 2.94%. In 2009, the obesity-associated incidence number of the above 5 cancers was 1431, accounting for 11.37% of the total incidence count of the above 5 cancers. The endometrial cancer had the largest proportion of the obesity-associated cancers and covered 23.41% of its total incidence cases. [ Conclusion ] Multiple strategies including obesity control and screening for high risk populations should be implemented in Shanghai to alter the increasing trends of several obesity-associated cancers.
出处
《环境与职业医学》
CAS
北大核心
2013年第6期420-426,共7页
Journal of Environmental and Occupational Medicine
关键词
肥胖
恶性肿瘤
发病率
乳腺癌
子宫内膜癌
结直肠癌
肾癌
食管及胃贲门腺癌
obesity
cancer
incidence rate
breast cancer
endometrial cancer
colorectum cancer
kidney cancer
esophagus and gastric cardia adenocarcinoma
