2016年上海市胰腺癌发病和死亡情况与2002—2016年流行趋势分析

doi:10.19401/j.cnki.1007-3639.2022.02.001

中国癌症杂志 ›› 2022, Vol. 32 ›› Issue (2): 97-105.doi: 10.19401/j.cnki.1007-3639.2022.02.001

2016年上海市胰腺癌发病和死亡情况与2002—2016年流行趋势分析

吴梦吟¹, 吴春晓¹, 庞怡¹, 王春芳², 顾凯¹, 龚杨明¹, 鲍萍萍¹, 施亮¹, 窦剑明¹, 向詠梅¹, 施燕¹()

1. 上海市疾病预防控制中心,慢性非传染病与伤害防治所,上海200336
2. 上海市疾病预防控制中心,疾病预防控制信息所,上海200336

收稿日期:2021-11-05 修回日期:2022-01-10 出版日期:2022-02-28 发布日期:2022-03-08
通信作者: 施燕 E-mail:shiyan@scdc.sh.cn
基金资助:
上海市医学领军人才(2019LJ24);上海市公共卫生体系建设三年行动计划学科建设项目“大数据与人工智能应用”(GWV-10.1-XK05);上海市科技成果转化和产业化项目(18401933403)

Incidence and mortality of pancreatic cancer in Shanghai 2016 and epidemic trend analysis from 2002 to 2016

WU Mengyin¹, WU Chunxiao¹, PANG Yi¹, WANG Chunfang², GU Kai¹, GONG Yangming¹, BAO Pingping¹, SHI Liang¹, DOU Jianming¹, XIANG Yongmei¹, SHI Yan¹()

1. Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
2. Division of Public Health Informatics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China

Received:2021-11-05 Revised:2022-01-10 Published:2022-02-28 Online:2022-03-08
Contact: SHI Yan E-mail:shiyan@scdc.sh.cn

摘要/Abstract

摘要：

背景与目的：上海市疾病预防控制中心每年更新上海市胰腺癌发病和死亡及其趋势的统计资料。胰腺癌是常见的消化道恶性肿瘤之一,由于其起病隐匿,预后极差,给患者及其家庭、社会带来了极大的疾病负担。分析2016年上海市胰腺癌发病和死亡情况及2002—2016年流行趋势,以期了解上海市胰腺癌的流行现状及变化趋势,为胰腺癌的防治和进一步研究提供依据。方法 2002—2016年上海市胰腺癌发病和死亡资料来源于上海市疾病预防控制中心人群基础肿瘤登记管理系统和死因登记系统。所有胰腺癌资料以病理学诊断（morphological verification,MV）和非病理学诊断作为最高诊断依据。根据发病或死亡年份、性别、年龄组统计各亚组人群发病和死亡数、粗率、构成比、年龄别率及累积率;使用Segi’s 1960世界标准人口构成计算年龄标准化发病率、年龄标准化死亡率及相应的35~64岁截缩率;使用Z检验比较不同亚组年龄别率的差异;使用加权卡方检验法比较不同亚组标化率的差异。逐年率值的时间趋势分析通过Joinpoint软件进行计算和比较;使用年度变化百分比描述整个研究期间上海市胰腺癌发病及死亡的变化趋势;使用Joinpoint回归模型比较不同时期发病率及死亡率的变化趋势。结果 2016年上海市胰腺癌新发病例的MV比例为41.25%,去除死亡认证病例的比例为0.68%,死亡发病数比为0.87。2016年上海市胰腺癌新发病例数和死亡人数分别为2 943例和2 554人,粗发病率为20.32/10万,标化发病率为7.28/10万,胰腺癌新发病例占所有恶性肿瘤的3.95%,居恶性肿瘤发病谱的第7位,35~64岁截缩发病率为9.53/10万;0~64岁、0~74岁及0~84岁累积发病率分别为0.34%、0.81%和1.76%;粗死亡率为17.64/10万,标化死亡率为6.01/10万,胰腺癌死亡病例占所有恶性肿瘤死亡病例的6.90%,居恶性肿瘤死亡谱的第5位,35~64岁截缩死亡率为7.16/10万;0~64岁、0~74岁及0~84岁累积死亡率分别为0.26%、0.64%和1.57%。男性的标化发病率和标化死亡率均显著高于女性。2016年上海市胰腺癌的年龄别发病和死亡的数量和率值均随年龄增加呈现上升趋势,年龄别发病率和死亡率在85岁以上组人群均达到了峰值,分别为108.66/10万和106.97/10万。2002—2016年上海市胰腺癌新发病例数和死亡人数呈现逐渐增加的趋势,其中胰腺癌的新发病例数由2002年的1 510例上升至2016年的2 943例;死亡人数由2002年的1 458人上升至2016年的2 554人。Joinpoint分析表明,2002—2016年上海市胰腺癌的标化发病率呈现明显的上升趋势,年均增速为0.89%[年度变化百分比（annual percent change,APC）=0.89,t=5.69,P<0.001],而标化死亡率的增加差异无统计学意义。结论 2002—2016年上海市胰腺癌发病率呈上升趋势,标化死亡率则保持稳定。由于目前尚无有效的筛查手段,因此基于人群的胰腺癌发病和死亡现况及趋势研究对于胰腺癌防治有重要的公共卫生意义。

关键词: 胰腺癌, 发病率, 死亡率, 趋势分析, 上海市

Abstract:

Background and purpose: The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on pancreatic cancer occurrence and trends in Shanghai. Pancreatic cancer, which has increased the disease burden to the society and patients with their families due to the lack of early symptoms and poor prognosis, remains one of the most common gastrointestinal tumors. This study aimed to analyze the current epidemic status of pancreatic cancer in Shanghai in 2016 and the prevalence trend from 2002 to 2016, and to provide a basis for the prevention and treatment of pancreatic cancer and further research. Methods: Data on pancreatic cancer in Shanghai from 2002 to 2016 were obtained through Shanghai Municipal Center for Disease Control and Prevention Population-based Cancer Registry and Vital Statistics System. In all cases of pancreatic cancer, morphological verification (MV) and non-morphological verification were taken as the highest basis for diagnosis. The number of cases and deaths, crude rates, composition ratios, age-specific rates and cumulative rates were counted according to the year of incidence or death, sex and age groups. Segi’s 1960 world standard population was used to calculate age-standardized rates of incidence and mortality and corresponding truncated age-standardized rate (35-64 years) of pancreatic cancer. Z-test and Cochran test were used to compare the differences of age-specific rates and age-standardized rates among different subgroups, respectively. Temporal trend analyses were conducted by Joinpoint software, and annual percent changes (APCs) were used to describe the trends. Results: In 2016, the MV proportion of new cases of pancreatic cancer in Shanghai was 41.25%, the proportion of cases with death certification only was 0.68%, and the ratio of death to incidence was 0.87. The number of new cases and deaths of pancreatic cancer in Shanghai in 2016 was 2 943 and 2 554, respectively. The crude incidence of pancreatic cancer in Shanghai in 2016 was 20.32/100 000, with an age-standardized incidence of 7.28/100 000. New cases of pancreatic cancer accounted for 3.95% of all malignant tumors, ranking 7 ^th in the incidence spectrum of malignant tumors. The truncated age-standardized incidence (35-64 years) was 9.53/100 000, and the cumulative incidences for 0-64 years, 0-74 years and 0-84 years were 0.34%, 0.81% and 1.76%, respectively. The crude mortality of pancreatic cancer in Shanghai in 2016 was 17.64/100 000, with an age-standardized mortality of 6.01/100 000. Deaths of pancreatic cancer accounted for 6.90% of all malignant tumor deaths, ranking 5 ^th in the mortality spectrum of malignant tumors. The truncated age-standardized mortality (35-64 years) was 7.16/100 000, and the cumulative mortalities for 0-64 years, 0-74 years and 0-84 years were 0.26%, 0.64% and 1.57%, respectively. The age-standardized incidence and mortality were significantly higher in men than in women. The age-specific new cases, deaths and rates of pancreatic cancer in Shanghai in 2016 showed an upward trend with increasing age, and the age-specific incidence and mortality peaked at 108.66/100 000 and 106.97/100 000, respectively, among people aged 85 and over. From 2002 to 2016, both the number of new cases and deaths of pancreatic cancer in Shanghai showed a gradual increase trend, of which the number of new cases of pancreatic cancer increased from 1 510 in 2002 to 2 943 in 2016, and the number of deaths increased from 1 458 in 2002 to 2 554 in 2016. Joinpoint analyses showed a significant upward trend in the standardized incidence of pancreatic cancer in Shanghai from 2002 to 2016, with an average annual increase of 0.89% (APC=0.89, t=5.69, P<0.001), while the increase in standardized mortality was not statistically significant. Conclusions: The incidence of pancreatic cancer in Shanghai from 2002 to 2016 showed an upward trend, while the mortality showed a fluctuating trend. Since there is no effective screening tool, a population-based study on the current epidemic status and trend of pancreatic cancer is of great significance for pancreatic cancer prevention and treatment.

Key words: Pancreatic cancer, Incidence, Mortality, Trend analysis, Shanghai

中图分类号:

R735.9

吴梦吟, 吴春晓, 庞怡, 王春芳, 顾凯, 龚杨明, 鲍萍萍, 施亮, 窦剑明, 向詠梅, 施燕. 2016年上海市胰腺癌发病和死亡情况与2002—2016年流行趋势分析[J]. 中国癌症杂志, 2022, 32(2): 97-105.

WU Mengyin, WU Chunxiao, PANG Yi, WANG Chunfang, GU Kai, GONG Yangming, BAO Pingping, SHI Liang, DOU Jianming, XIANG Yongmei, SHI Yan. Incidence and mortality of pancreatic cancer in Shanghai 2016 and epidemic trend analysis from 2002 to 2016[J]. China Oncology, 2022, 32(2): 97-105.

图/表 7

表 1

图 1

图 2

表 2

2002—2016年上海市胰腺癌发病和死亡年龄别率变化趋势"

Index	Age group	Age-specific rat/10^-5			Age-specific rate 2007-2011/2002-2006			Age-specific rate 2012-2016/2007-2011
Index	Age group	2002—2006	2007—2011	2012—2016	Rate	Z value	P value	Rate	Z value	P value
Incidence	20-	0.14	0.24	0.18	1.72	1.152	0.249	0.75	0.608	0.543
	25-	0.23	0.22	0.26	0.96	0.104	0.917	1.19	0.434	0.664
	30-	0.29	0.40	0.54	1.35	0.824	0.410	1.37	1.088	0.276
	35-	1.08	1.02	1.21	0.95	0.262	0.793	1.18	0.833	0.405
	40-	2.47	2.09	2.02	0.85	1.355	0.175	0.96	0.252	0.801
	45-	4.67	4.45	4.37	0.95	0.595	0.552	0.98	0.218	0.827
	50-	7.67	9.75	10.79	1.27	4.179	<0.001	1.11	1.912	0.056
	55-	14.09	15.88	18.22	1.13	2.356	0.018	1.15	3.401	0.001
	60-	25.40	25.94	25.76	1.02	0.456	0.648	0.99	0.191	0.849
	65-	38.34	39.64	37.94	1.03	0.794	0.427	0.96	1.147	0.251
	70-	56.57	60.66	56.43	1.07	2.011	0.044	0.93	2.059	0.040
	75-	75.22	83.06	85.09	1.10	2.995	0.003	1.02	0.778	0.436
	80-	92.62	98.98	100.34	1.07	1.715	0.086	1.01	0.415	0.678
	≥85	87.07	111.03	107.71	1.28	4.977	<0.001	0.97	0.805	0.421
Mortality	20-	0.04	0.06	0.06	1.50	0.450	0.653	0.99	0.007	0.994
	25-	0.07	0.13	0.04	1.86	0.945	0.345	0.31	1.565	0.118
	30-	0.29	0.26	0.18	0.90	0.249	0.803	0.66	0.943	0.346
	35-	0.79	0.65	0.72	0.82	0.809	0.419	1.10	0.374	0.708
	40-	1.65	1.65	1.43	1.00	0.016	0.987	0.87	0.865	0.387
	45-	3.46	3.72	3.18	1.08	0.828	0.407	0.86	1.524	0.128
	50-	6.00	7.76	8.11	1.29	3.967	0.000	1.04	0.726	0.468
	55-	10.42	13.07	14.34	1.26	3.975	0.000	1.10	2.048	0.041
	60-	19.60	22.04	20.74	1.12	2.258	0.024	0.94	1.459	0.145
	65-	32.16	36.08	32.47	1.12	2.561	0.010	0.90	2.585	0.010
	70-	48.58	54.81	50.00	1.13	3.264	0.001	0.91	2.474	0.013
	75-	68.42	77.13	79.31	1.13	3.470	0.001	1.03	0.867	0.386
	80-	87.24	98.12	97.75	1.12	2.992	0.003	1.00	0.116	0.908
	≥85	89.58	111.41	110.47	1.24	4.494	<0.001	0.99	0.226	0.821

表 2

图 4

表 3

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Index	Incidence of pancreatic cancer			Death of pancreatic cancer
Index	Total	Male	Female	Total	Male	Female
Case n	2 943	1 594	1 349	2 554	1 364	1 190
Constituent ratio/%	3.95	4.10	3.79	6.90	6.00	8.34
Crude rate/10^-5	20.32	22.19	18.49	17.64	18.99	16.31
ASR world/10^-5*	7.28	8.56	6.03	6.01	7.05	4.98
Truncated rate/10^-5
35-64 years	9.53	12.15	6.90	7.16	9.00	5.32
Cumulative rate/%
0-64 years	0.34	0.43	0.25	0.26	0.32	0.19
0-74 years	0.81	0.97	0.65	0.64	0.78	0.51
0-84 years	1.76	1.96	1.57	1.57	1.77	1.38

Index	2002-2006		2007-2011		2012-2016
Index	Case n	Constituent ratio/%	Case n	Constituent ratio/%	Case n	Constituent ratio/%
Morphological verification	1 756	20.70	2 862	25.55	5 102	37.68
Classification (ICD-10)
Head of pancreas	2 982	35.15	2 832	25.28	2 115	15.62
Body of pancreas	239	2.82	241	2.15	195	1.44
Tail of pancreas	314	3.70	345	3.08	317	2.34
Pancreatic duct	7	0.08	8	0.07	16	0.12
Endocrine pancreas	134	1.58	120	1.07	123	0.91
Other parts of pancreas	27	0.32	52	0.46	95	0.70
Overlapping lesion of pancreas	222	2.62	323	2.88	344	2.54
Pancreas, unspecified	4 558	53.73	7 281	65.00	10 337	76.33
Histological type
Ductal carcinoma	231	2.72	629	5.62	1 420	10.49
Adenocarcinoma	922	10.86	1 152	10.28	1 466	10.83
Other types	254	2.99	229	2.04	405	2.99
Neoplasm, malignant	7 076	83.41	9 192	82.06	10 251	75.70
Neoplasm staging
Ⅰ	130	1.53	137	1.22	284	2.10
Ⅱ	279	3.29	421	3.76	729	5.38
Ⅲ	481	5.67	596	5.32	734	5.42
Ⅳ	1 740	20.51	2 699	24.09	3 128	23.10
Unknown	5 853	69.00	7 349	65.60	8 667	64.00

2016年上海市胰腺癌发病和死亡情况与2002—2016年流行趋势分析

Incidence and mortality of pancreatic cancer in Shanghai 2016 and epidemic trend analysis from 2002 to 2016

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