关键词: 恶性肿瘤, 发病率, 死亡率, 趋势, 上海

Abstract: Background and purpose: Cancer has become a serious public health problem that threatens the health of Shanghai residents. This study aimed to investigate the cancer incidence and mortality in Shanghai in 2014. Methods: The data were collected from Shanghai Cancer Registry. Cancer incidence and mortality stratified by gender and region were analyzed. Crude rate, age-standardized rate, age-specific and region-specific rates, cumulative rate and truncated rate were calculated. The proportion and rates of 10 common cancers in different groups were also calculated. Joinpoint software was used to analyze the incidence and mortality trend during 2002-2014, and the annual percentage changes (APC) for whole period and for the time segments were estimated. Segi’s population was used for calculating age-standardized incidence and mortality. Results: Shanghai Cancer Registry covered the total residential population with 14.50 million in 2014. The total reported new cancer cases and deaths were 68 541 and 37 242, respectively. The pathologically verified cases accounted for 79.49%, and 0.04% of cases were identified through death certifications only with mortality to incidence ratio of 0.54. The crude incidence in Shanghai Cancer Registry was 477.79 per 100 000. The age-standardized incidence by world standard population was 223.57 per 100 000. The incidence was higher in females than that in males, and the incidence in suburban areas was higher than that in urban areas. Cancer incidence increased rapidly after the age of 40 years and reached the peak in the age group of 80-84 years. The top 10 incidences of cancers were lung cancer, colorectal cancer, thyroid cancer, gastric cancer, breast cancer, liver cancer, prostate cancer, pancreatic cancer, brain and central nervous system tumor, and bladder cancer. The incidence cases for top 10 cancers accounted for 75.89% of total cases. The crude mortality in Shanghai Cancer Registry was 259.61 per 100 000. The age-standardized mortality rates by world standard population was 95.73 per 100 000. The mortality of males was higher than that of females, and the mortality in urban areas was similar to that in suburban areas. Cancer mortality increased rapidly after the age of 45 years and reached the peak in the age group of ≥85 years. The top 10 causes of cancer death were lung cancer, colorectal cancer, gastric cancer, liver cancer, pancreatic cancer, breast cancer, esophageal cancer, gallbladder cancer, prostate cancer, and brain and central nervous system tumor. The top 10 types of cancer accounted for 78.12% of all cancer deaths. For all cancers combined, the incidence rates were stable from 2002 to 2014 among males, whereas they increased significantly (APC=2.17%; P<0.001) among females. By contrast, the mortality rates decreased significantly among both males (APC=-0.82%; P<0.05) and females (APC=-0.76%; P<0.05). Conclusion: Lung cancer, digestive system malignancies, thyroid cancer and female breast cancer are the most common cancers in Shanghai. These cancers should be focused on. The incidence rates increased among females and the mortality rates decreased among both genders during 2002-2014.

Key words: Malignancies, Incidence, Mortality, Trends, Shanghai