关键词: 恶性肿瘤, 发病率, 死亡率, 趋势, 肺癌

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 2015. Methods: The data were collected from Shanghai Cancer Registry. Cancer incidence and mortality stratified by gender and region were analyzed. Crude rate, agestandardized rate (ASR), 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 trends of lung cancer during 2002-2015, and the annual percent change (APC) for the whole period and the time segments were estimated. Segi’s population was used for calculating age-standardized incidence and mortality. Results: The total reported new cancer cases and deaths were 71 610 and 38 445, respectively. The percentage of morphologically verified cases (MV%) accounted for 78.42%, and 0.21% of cases were identified through the percentage of death certifications only (DCO%) with mortality to incidence ratio (M/I ratio) of 0.55. The crude incidence in Shanghai Cancer Registry was 497.33/105, and the ASR was 228.82/105. The cancer incidence in female was higher than that in male, 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 at the age group of 80-84 years. The top 10 incidence of cancers were lung cancer, colorectal cancer, thyroid cancer, stomach cancer, breast cancer, liver cancer, prostate cancer, pancreatic cancer, central nervous system (CNS) tumor and bladder cancer. The incidence cases for top 10 cancers accounted for 76.59% of total cases. The crude mortality in Shanghai Cancer Registry was 267.00/105, and the ASR was 95.99/105. The cancer mortality in male was higher than that in female, 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 at the age group of 85+ years. The top 10 mortality of cancers were lung cancer, colorectal cancer, stomach cancer, liver cancer, pancreatic cancer, breast cancer, esophageal cancer, gallbladder cancer, prostate cancer and CNS tumor. The mortality cases for top 10 cancers accounted for 78.07 % of total cases. Up to Dec.31, 2016, there were 399 027 survivors with cancer in Shanghai. The prevalence rate of cancer was 2.77%. The rates in urban areas and suburb were 3.07% and 2.55%, respectively. Breast cancer was the most common malignancy in all cancer survivors, accounting for 15.33%. One half of the cases with cancer survivied for five years. Joinpoint analysis showed that 2011 was the joinpoint for incidence of lung cancer in both genders. For males, the incidence rates of lung cancer decreased significantly during 2002-2011 (APC=-1.34%; P<0.001), but increased significantly during 2011-2015 (APC=3.30%; P<0.001). For females, the incidence rates were stable during 2002-2011, while they increased substantially during 2011-2015 (APC=15.25%, P<0.001). In contrast, the mortality rates decreased significantly from 2002 to 2015 for males (APC= -0.72%, P=0.030), and no significant trend was found for females. The proportion of cases with stage I lung cancer or adenocarcinoma of newly diagnosed cases increased during this period in both genders. Conclusion: Lung cancer, digestive system malignancies, thyroid cancer and breast cancer are the most common cancers in Shanghai. Breast cancer is the most common malignancy in all cancer survivors. There has been a steady increase in the incidence of lung cancer in both genders since 2011.

Key words: Cancer, Incidence, Mortality, Trends, Lung cancer