河北省40年结直肠癌发病和死亡分析

背景与目的:结直肠癌是常见的消化道肿瘤之一,2012年全球约有136万结直肠癌新发病例,是世界第3高发恶性肿瘤,居恶性肿瘤死亡第4位,严重威胁着人类健康.该研究通过肿瘤登记地区结直肠癌发病死亡情况估计河北省结直肠癌疾病负担,与河北省三次全死因回顾调查资料比较,分析结直肠癌死亡率的时间变化趋势.方法:河北省肿瘤登记办公室收集到9个肿瘤登记处上报的2010—2012年恶性肿瘤发病和死亡资料.数据分性别、年龄别(0、1~4、5~9、10~14……80以上)计算恶性肿瘤发病率、死亡率和构成;采用2000年中国标准化人口构成和Segi's世界人口构成分别计算中国和世界人口年龄标准化发病率和死亡率.整理分析河北省1973—1975年、1990—1992年和2004—2005年三次全死因回顾调查的结直肠癌数据.采用Joinpoint回归模型分析磁县肿瘤登记处1988—2012年和涉县肿瘤登记处2000—2012年结直肠癌发病和死亡趋势.结果:河北省肿瘤登记地区2010—2012年结直肠癌新发病例2303例,死亡1229例.结直肠癌发病率为16.48/10万(男性18.12/10万,女性14.77/10万),中国人口标准化发病率为13.74/10万;结直肠癌死亡率为8.79/10万(男性10.23/10万,女性7.31/10万),中国人口标准化死亡率7.59/10万.河北省2010—2012年结直肠癌死亡率较1973—1975年升高了28.03%.磁县1988—2012年男性结直肠癌发病率年度平均变化百分比(annual percentage changes,APC)为3.55,死亡率APC为1.64.涉县2000—2012年男性结直肠癌发病率APC为4.68,女性为9.17.涉县2000—2012年男性结直肠癌死亡率APC为5.61.结论:河北省近40年结直肠癌发病与死亡呈现上升趋势.加强结直肠癌筛查,降低结直肠癌发病率和死亡率是河北省一项重要任务.     

2011—2016年河北省肿瘤登记地区食管癌发病和死亡流行情况分析

目的 食管癌是最常见的消化道恶性肿瘤之一,河北省则位于食管癌的高发区。本研究旨在分析2011—2016年河北省食管癌最新的流行趋势和特征。方法 对河北省27个肿瘤登记处的食管癌发病和死亡资料进行统计分析。按城乡、性别和年龄组分析发病率和死亡率。采用中国2000年普查人口和Segi′s世界人口计算年龄标准化率。应用灰色模型对高发区磁县和涉县的死亡率进行预测。结果 2011—2016年,河北省共报告食管癌14 905例,死亡9 933例,粗发病率为21.73/10万,粗死亡率为14.48/10万。发病率和死亡率均呈男性高于女性,农村高于城市的特点。河北省食管癌发病率和死亡率有下降趋势(P＜0.001)。磁县、涉县高发区发病率和死亡率呈长期下降趋势,预测未来十年食管癌死亡率将继续下降。结论 河北省食管癌发病率和死亡率呈稳步下降趋势,但其疾病负担仍然较重。食管癌的一级预防、早发现、早治疗应更关注农村居民和男性人群。     

2012—2016年河北省肿瘤登记地区肝癌发病和死亡流行情况分析

目的 分析河北省肝癌的发病和死亡状况及其趋势变化,为制订肝癌防治策略提供科学依据。方法 收集河北省2012—2016年27个肿瘤登记地区的肝癌发病和死亡数据,按城乡（城市/农村）、性别和年龄组分析肝癌发病率和死亡率。应用2000年中国人口普查和Segi's世界人口计算年龄标准化率。采用Joinpoint模型对磁县和涉县肝癌发病率和死亡率进行趋势分析。结果 2012—2016年,河北省共报告肝癌发病病例12 906例,死亡病例11 522例,粗发病率和死亡率分别为20.16/10万和18.00/10万。河北省肝癌发病率和死亡率均有一定程度下降,在女性和城市人口中下降幅度最大。磁县和涉县肝癌的发病率和死亡率呈长期下降趋势,但仍有一定波动。结论 河北省肝癌负担仍然较重,但发病率和死亡率呈下降趋势。未来应加大对农村居民和男性肝癌预防,以早期发现和治疗。     

Annual report on status of cancer in China, 2011

Objective: The National Central Cancer Registry(NCCR) collected population-based cancer registration data in 2011 from all cancer registries. National cancer incidence and mortality were compiled and cancer incident new cases and cancer deaths were estimated.Methods: In 2014, there were 234 cancer registries submitted cancer incidence and deaths occurred in 2011. All datasets were checked and evaluated based on the criteria of data quality from NCCR. Total 177 registries’ data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by area(urban/rural), gender, age group(0, 1-4, 5-9, 10-14…85+) and cancer type. Cancer incident cases and deaths were estimated using age-specific rates and national population in 2011. All incidence and death rates are age-standardized to the 2000 Chinese standard population and Segi’s population expressed per 100,000 persons.Results: All 177 cancer registries(77 in urban and 100 in rural areas) covered 175,310,169 populations(98,341,507 in urban and 76,968,662 in rural areas). The morphology verified cases(MV%) accounting for 70.14% and 2.44% of incident cases were identified through death certifications only(DCO%) with mortality to incidence ratio of 0.63. The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The incidence rate was 250.28/100,000(males 277.77/100,000, females 221.37/100,000), and the age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population(ASIRW) were 186.34/100,000 and 182.76/100,000 with the cumulative incidence rate(0-74 years old) of 21.20%. The cancer incidence and ASIRC in urban areas were 261.38/100,000 and 189.89/100,000 compared to 238.60/100,000 and 182.10/100,000 in rural areas, respectively. The cancer mortality was 156.83/100,000(194.88/100,000 in males and 116.81/100,000 in females), the age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 112.88/100,000 and 111.82/100,000, and the cumulative mortality rate(0-74 years old) was 12.69%. The cancer mortality and ASMRC were 154.37/100,000 and 108.20/100,000 in urban areas, and 159.42/100,000 and 117.97/100,000 in rural areas, respectively. Cancers of lung, female breast, stomach, liver, colon and rectum, esophageal, cervix, uterus, prostate and ovary were the most common cancers, accounting for about 75% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, cervical cancer and leukemia were the leading causes of cancer death, accounting for about 80% of all cancer deaths. The cancer incidence, mortality and spectrum showed difference between urban and rural areas, males and females.Conclusions: The coverage of cancer registration population had a greater increase than that in the last year. The data quality and representativeness are gradually improved. As the basic work of cancer prevention and control, cancer registry is playing an irreplaceable role. The disease burden of cancer is increasing, and the health department has to take effective measures to contain the increased cancer burden in China.     

Incidence and mortality of laryngeal cancer in China, 2011

Objective

Laryngeal cancer is the common cancer of the upper aerodigestive tract. We aimed to use the national cancer registration data in 2011 to estimate the incidence and mortality of laryngeal cancer within China.

Methods

Comparable, high-quality data from 177 population-based cancer registries were qualified for analysis. The pooled data were stratified by area, sex and age group. National new cases and deaths of laryngeal cancer were estimated using age-specific rates and national population in 2010. All incidence and death rates were age-standardized to the 2000 Chinese standard population and Segi’s population, which were expressed per 100,000 populations.

Results

All 177 cancer registries covered a total of 175,310,169 population (98,341,507 in urban and 76,968,662 in rural areas), accounting for 13.01% of the national population. The data quality indicators of proportion of morphological verification (MV%), percentage of cancer cases identified with death certification only (DCO%) and mortality to incidence ratio (M/I) were 77.98%, 2.62% and 0.55, respectively. Estimated 20,875 new cases of laryngeal cancer were diagnosed and 11,488 deaths from laryngeal cancer occurred in China in 2011. The crude incidence rate of laryngeal cancer was 1.55/100,000 (2.69/100,000 in males and 0.35/100,000 in females). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 1.13/100,000 and 1.14/100,000, respectively. Laryngeal cancer is much rarer in females than in males. The incidence rate was higher in urban areas than that in rural areas. The crude mortality rate of laryngeal cancer was 0.85/100,000 (1.42/100,000 in males and 0.25/100,000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were both 0.61/100,000. The mortality rate in males was much higher than that in females. There was no definite difference in mortality rates of laryngeal cancer between urban and rural areas.

Conclusions

Larynx is a specialized area and cancer of larynx significantly affects the quality of life for the patients. Comprehensive measures should be carried out to prevent the ascent of laryngeal cancer.     

食管癌高发区贲门癌、胃癌流行强度分析及其对内镜筛查的启示

 目的 分析涉县等食管癌高发区贲门癌、胃癌的流行强度，明确其防治任务，探讨具体控制途径。方法 对比分析涉县、林县、磁县全人群肿瘤登记的食管癌、贲门癌、胃癌发病率与死亡率以及内镜筛查6233例40-69岁人群三种癌及癌前病变的检出率。结果 太行山南麓食管癌高发区食管癌、贲门癌和胃癌发病率或死亡率的合计占到全身恶性肿瘤的70％～80％。涉县2000-2004年贲门癌发病率男女性分别为69．9／10万和41．5／10万，死亡率男女性分别为54．3／10万和33．2／10万。高发区运用内镜碘染色指导活检技术筛查，食管鳞状上皮癌前病变及早期癌的检出率高，但贲门和胃腺上皮癌前病变及早期癌的检出率相对较低。结论 太行山南部食管癌高发区存在贲门癌和胃癌共同高发的现象，要想通过旱诊早治从整体上降低该地区上消化道癌的死亡率，必须加强内镜对贲门和胃腺上皮癌前病变及早期癌检出的研究。     

Annual report on status of cancer in China,2010简

Objective：Population-based cancer registration data in 2010 were collected,evaluated and analyzed by the National Central Cancer Registry （NCCR） of China.Cancer incident new cases and cancer deaths were estimated.Methods：There wvere 219 cancer registries submitted cancer incidence and death data in 2010.All data were checked and evaluated on basis of the criteria of data quality from NCCR.Total 145 registries＇ data were qualified and accepted for cancer statistics in 2010.Pooled data were stratified by urban/rural,area,sex,age group and cancer site.Cancer incident cases and deaths were estimated using age-specific rates and national population.The top ten common cancers in different groups,proportion and cumulative rate were also calculated.Chinese census in 2000 and Segi＇s population were used for age-standardized incidence/ mortality rates.Results：All 145 cancer registries （63 in urban and 82 in rural） covered a total of 158,403,248 population （92,433,739 in urban and 65,969,509 in rural areas）.The estimates of new cancer incident cases and cancer deaths were 3,093,039 and 1,956,622 in 2010,respectively.The morphology verified cases （MV％） accounted for 67.11％ and 2.99％ of incident cases were identified through death certifications only （DCO％） with mortality to incidence ratio （M/I） of 0.61.The crude incidence rate was 235.23/100,000 （268.65/100,000 in males,200.21/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASIRC,2000） and by world standard population （ASIRW） were 184.58/100,000 and 181.49/100,000 with the cumulative incidence rate （0-74 years old） of 21.l 1％.The cancer incidence and ASIRC were 256.41/100,000 and 187.53/100,000 in urban areas whereas in rural areas,they were 213.71/100,000 and 181.10/100,000,respectively.The crude cancer mortality in China was 148.81/100,000 （186.37/100,000 in males and 109.42/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASMRC,2000） and by world standard population （ASMRW） were 113.92/100,000 and 112.86/100,000,and the cumulative incidence rate （0-74 years old） was 12.78％.The cancer mortality and ASMRC were 156.14/100,000 and 109.21/100,000 in urban areas,whereas in rural areas,they were 141.35/100,000 and 119.00/100,000 respectively.Lung cancer,gastric cancer,colorectal cancer,liver cancer,esophageal cancer,pancreas cancer,encephaloma,lymphoma,female breast cancer and cervical cancer,were the most common cancers,accounting for 75％ of all cancer cases in urban and rural areas.Lung cancer,gastric cancer,liver cancer,esophageal cancer,colorectal cancer,pancreatic cancer,breast cancer,encephaloma,leukemia and lymphoma accounted for 80％ of all cancer deaths.Conclusions：The coverage of cancer registration population had a rapid increase and could reflect cancer burden in each area and population.As the basis of cancer control program,cancer registry plays an irreplaceable role in cancer epidemic surveillance,evaluation of cancer control programs and making anticancer strategy.China is facing serious cancer burden and prevention and control should be enhanced.     

Incidence and mortality of colorectal cancer in China, 2011

Objective: Colorectal cancer is the third most common type of cancer and the fourth leading cause of cancer-related death in the world. This article provides the most up-to-date overview of colorectal cancer burden in China.Methods: Totally 234 cancer registries submitted data of 2011 to the National Central Cancer Registry(NCCR). Qualified data from 177 registries was pooled and analyzed. The crude incidence and mortality rates of colorectal cancer were calculated by age, gender and geographic area. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. China census in 2000 and Segi’s world population were applied for age standardized rates.Results: The estimate of new cases diagnosed with colorectal cancer of China in 2011 was 310,244(178,404 for males and 131,840 for females, 195,117 in urban areas and 115,128 in rural areas), accounting for 9.20% of overall new cancer cases. The crude incidence of colorectal cancer ranked fourth in all cancer sites with rate of 23.03/100,000(25.83/100,000 for males and 20.08/100,000 for female, 28.25/100,000 in urban areas and 17.54/100,000 in rural areas). The age-standardized rates by China population and by World population were 16.79/100,000 and 16.52/100,000, respectively. The estimated number of colorectal cancer deaths of China in 2011 was 149,722(86,427 for males and 63,295 for females, 91,682 in urban areas and 58,040 in rural areas), accounting for 7.09% of overall cancer deaths. The crude mortality rate for colorectal cancer ranked fifth leading cause of cancer-related death in all cancer sites with rate of 11.11/100,000(12.51/100,000 for males and 9.64/100,000 for female, 13.27/100,000 in urban areas and 8.84/100,000 in rural areas). The age-standardized rates by China population and by World population for mortality were 7.77/100,000 and 7.66/100,000, respectively. For both of incidence and mortality, the rates of colorectal cancer were much higher in males than in females, and in rural areas than in urban areas. The rate of colorectal cancer increased greatly with age, especially after 40 or 45 years old.Conclusions: Colorectal cancer is a relative common cancer in China, especially for males in urban areas. Targeted prevention and early detection programs should be carried out.     

Pancreatic cancer incidence and mortality patterns in China, 2011

Objective

The National Central Cancer Registry (NCCR) collected population-based cancer registration data in 2011 from all cancer registries in China. The incidence and mortality rates for pancreatic cancer were compiled and pancreatic cancer incident new cases and deaths were estimated.

Methods

A total of 234 cancer registries submitted cancer data to NCCR. Data from 177 cancer registries were qualified and compiled for cancer statistics in 2011. Pancreatic cancer cases were extracted and analyzed from the national database. The pooled data were stratified by area (urban/rural), gender and age group (0, 1-4, 5-9, 10-14…85+). Pancreatic cancer incident cases and deaths were estimated using age-specific rates and national population in 2010. The national census in 2000 and Segi’s population were used for age-standardized rates.

Results

All 177 cancer registries (77 in urban and 100 in rural areas) covered 175,310,169 populations (98,341,507 in urban and 76,968,662 in rural areas). The morphology verified pancreatic cancer cases (MV%) accounting for 40.52% and 4.33% of pancreatic cancer incident cases were identified through death certifications only (DCO%) with mortality to incidence ratio (M/I) of 0.91. The estimated number of newly diagnosed pancreatic cancer cases and deaths were 80,344 and 72,723 in 2011, respectively. The crude incidence rate was 5.96/100,000 (males 6.57/100,000, females 5.32/100,000). The age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 4.27/100,000 and 4.23/100,000 respectively, ranking 10^th among all cancers. Pancreatic cancer incidence rate and ASIRC were 7.03/100,000 and 4.94/100,000 in urban areas whereas they were 4.84/100,000 and 3.56/100,000 in rural areas. The incidence rate of pancreatic cancer of 33 cancer registries increased from 3.24/100,000 in 2003 to 3.59/100,000 in 2011 with an annual percentage change (APC) of 1.44. The pancreatic cancer mortality rate was 5.40/100,000 (males 5.88/100,000, females 4.89/100,000), ranking 6^th among all cancers. The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 3.81/100 000 and 3.79/100 000. The pancreatic cancer mortality and ASMRC were 6.47/100,000 and 4.48/100,000 in urban areas, and 4.27/100,000 and 3.08/100,000 in rural areas, respectively. The mortality rates of pancreatic cancer showed an approximately 1.14-fold increase, from 2.85/100,000 in 2003 to 3.26/100,000 in 2011, with an APC of 1.68.

Conclusions

The burden of pancreatic cancer is increasing in China. Identification of high-risk population and adequate treatment and prevention are important.     

National cancer incidence and mortality in China, 2012

Background

Population-based cancer registration data in 2012 from all available cancer registries were collected by the National Central Cancer Registry (NCCR). NCCR estimated the numbers of new cancer cases and cancer deaths in China with compiled cancer incidence and mortality rates.

Methods

In 2015, there were 261 cancer registries submitted cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the NCCR criteria of data quality. Qualified data from 193 registries were used for cancer statistics analysis as national estimation. The pooled data were stratified by area (urban/rural), gender, age group [0, 1–4, 5–9, 10–14, …, 85+] and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding national population in 2012. The Chinese census data in 2000 and Segi’s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year.

Results

Qualified 193 cancer registries (74 urban and 119 rural registries) covered 198,060,406 populations (100,450,109 in urban and 97,610,297 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 69.13% and 2.38%, respectively, and the mortality to incidence rate ratio (M/I) was 0.62. A total of 3,586,200 new cancer cases and 2,186,600 cancer deaths were estimated in China in 2012. The incidence rate was 264.85/100,000 (289.30/100,000 in males, 239.15/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 191.89/100,000 and 187.83/100,000 with the cumulative incidence rate (0–74 age years old) of 21.82%. The cancer incidence, ASIRC and ASIRW in urban areas were 277.17/100,000, 195.56/100,000 and 190.88/100,000 compared to 251.20/100,000, 187.10/100,000 and 183.91/100,000 in rural areas, respectively. The cancer mortality was 161.49/100,000 (198.99/100,000 in males, 122.06/100,000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 112.34/100,000 and 111.25/100,000, and the cumulative mortality rate (0–74 years old) was 12.61%. The cancer mortality, ASMRC and ASMRW were 159.00/100,000, 107.231/100,000 and 106.13/100,000 in urban areas, 164.24/100,000, 118.22/100,000 and 117.06/100,000 in rural areas, respectively. Cancers of lung, stomach, liver, colorectum, esophagus, female breast, thyroid cervix, brain tumor and pancreas were the most common cancers, accounting for about 77.4% of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer, pancreatic cancer, female breast cancer, brain tumor, leukemia and lymphoma were the leading causes of cancer death, accounting for about 84.5% of all cancer deaths. The cancer spectrum showed difference between urban and rural, males and females both in incidence and mortality rates.

Conclusions

Cancer surveillance information in China is making great progress with the increasing number of cancer registries, population coverage and the improving data quality. Cancer registration plays a fundamental role in cancer control by providing basic information on population-based cancer incidence, mortality, survival and time trend. The disease burden of cancer is serious in China, so that, cancer prevention and control, including health education, health promotion, cancer screening and cancer care services in China, should be enhanced.     

食管癌高低发区贲门癌发病对比分析简

目的：分析食管癌高低发区贲门癌发病的特点和异同,为贲门癌防治提供科学依据。方法：收集、整理1988-2007年食管癌低发区广东中山市与高发区河北磁县全人群肿瘤登记中的贲门癌发病资料,比较其发病数、粗率、中国与世界标化发病率（简称中标率与世标率）、构成比和发病趋势等指标。结果：1988-2007年广东中山与河北磁县贲门癌世标发病率分别为0.50/105和23.87/105,磁县发病远高于中山,是中山的47.74倍,两地贲门癌发病均呈上升趋势,尤以河北磁县显著。此外,广东中山市贲门癌男女发病数比例高于河北磁县。结论：虽然期间两地贲门癌发病均呈上升趋势,但其贲门癌发病存在显著差异,食管癌高发区河北磁县贲门癌发病远高于食管癌低发区广东中山,且其发病趋势与食管癌相反,而中山相同。     

Decrease in the Esophageal Cancer Incidence Rate in Mountainous but Not Level Parts of Cixian County,China, Over 29 Years

Background: Cixian county has one of the highest incidence rates of esophageal cancer (EC) in China, as well as ‍the world. In 1974, the Cixian population-based cancer registry system was established, so that there is now information ‍on esophageal cancer cases over almost 30 years. Methods: Data from Cixian Cancer Registry were checked and ‍analyzed using SPSS 11.5. Results: From 1974 to 2002, a total of 18,471 new esophageal cancer cases were registered ‍in Cixian, 11,068 in males and 7,403 in females. The age standardized incidence rate (ASR) for males was 208.77 per ‍100,000, while for females it was 120.47 per 100,000. There was a clear trend for decrease overall in the incidence ‍rate of esophageal cancer over the 29 years (X2=19.94, P<0.001). As to the geographic distribution, the incidence rate ‍in mountainous and hilly areas showed a significant decline (X2 = 195.00 and X2 = 46.08, respectivbely, both P<0.001). ‍Data for esophageal cancer incidence in level land areas in contrast were relatively steadily, with increase in recent ‍years. Conclusion: Esophageal cancer has decreased in Cixian county during the last 29 years, but this is due to ‍change in mountainous and hilly areas. Compared to other regions in the world, Cixian county still has a very high ‍incidence of ECs.     

EPIDEMIC STRENGTH OF CARDIA AND DISTANT STOMACH CANCER IN THE HIGH RISK REGION OF ESOPHAGEAL CANCER AND THEIR IMPLICATION TO EDOSCOPIC SCREENING

Objective： To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods： Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results： The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3 and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70～80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion： The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.     

Clustering and Geographic Variation of Upper Gastrointestinal Cancers in a High-risk Region of Esophageal Cancer in Northern China

Aim: Geographic variation of upper gastrointestinal carcinomas (UGIC) was assessed in a high-risk regionin northern China. Methods: Shexian, Linzhou, Yangcheng and Cixian are four counties with world agestandardizedincidence rates (ASR) of esophageal cancer as high as 124.9, 99.5, 160.1, and 164.9 per 100,000respectively for males, and 70.8, 68.8, 92.1, and 104.6 for females for 1998 to 2002. Geographically, Shexian isentirely mountainous, Linzhou and Yangcheng are mostly mountainous, and Cixian is one-third mountains, onethirdhills, and the other third plains. The corresponding populations is 382,000, 982,000, 395,000 and 625,000 asin 2000. In the present analyses, the world ASRs of esophageal squamous cell carcinoma (ESCC), adenocarcinomaof the esophagogastric junction (AEG), gastric non-cardia carcinoma (GNCC), and the percentages of these inoverall tumor ASRs for 1998 to 2002 were compared across the four counties to show geographic variation andclustering. Additionally, site-specific detection rates of precursors and cancers in our population-based endoscopesurveys with local 40- to 69-year-old residents were also compared between a Cixian commune (2,013 surveyed)and a Shexian commune (1,514). Results: ASRs for ESCC, AEG, and GNCC combined amount to 210.5 to325.8 per 100,000 in men and 117.5 to 185.7 in women, accounting for respectively 70.6 to 82.1% and 53.4 to77.0 % of the all ASRs. In geographic distribution, the percentages of AEG and GNCC in UGICs increasedfrom Cixian (males 32.8%, females 22.1%) to Yangcheng (50.7%, 38.6%) and Linzhou (52.7%, 41.4%), andfurther to Shexian (61.7% , 61.9); while that of ESCC decreased in the same direction from Cixian, to Yangchengand Linzhou, and further to Shexian (67.2% , 77.9% ; 49.3% , 61.4% and 47.3%, 58.6% ; to 38.3% , 38.1%).Similarly, the detection rates of low- and high-grade intraepithelia neoplasia as well as cancers of the esophaguswere significantly higher in the Cixian commune than the Shexian commune (8.7, 4.4, 0.7% vs 7.0, 3.2, 0.4%P=0.004 ); but the rates for the esophagogastric junction were systematically and significantly lower in the Cixianthan in the Shexian commune (2.2, 0.5, 0.8 % Vs 3.3, 0.9, 1.7 %, P=0.001). Conclusions: Clustering of uppergastrointestinal carcinomas may suggest the existence of common risk factors, while geographic variation intopography/histology may be related to regional differences in carcinogen exposure. These observations identifya need for environment improvement, such as programs to improve drinking water conditions. To study highsusceptibility in a historically low mobile population, international collaborative research in this region mayprove to be very fruitful.     

中国4个食管癌高发区上消化道癌的流行现状

[目的]描述我国食管癌高发区食管癌和胃癌亚部位的流行特征,为高发区上消化道癌的病因研究提供依据。[方法]对河北省磁县、涉县、河南省林州和山东省肥城4个食管癌高发区2006~2008年的登记资料进行重新复核,分析食管癌、胃癌的亚部位分布及流行趋势。[结果]4个肿瘤登记处2006~2008年食管癌新发病例7025例,男性4267例(60.7%),女性2758例(39.3%);胃癌新发病例共计5473例,其中男性3778例(69.0%),女性1695例(31.0%)。食管癌亚部位以食管中段较多,共2707例,占38.5%;胃癌亚部位以贲门癌发病为主,共2935例,占全部胃癌新发病例的53.6%。食管癌、胃癌3年的发病变化相对稳定;而亚部位发病中,贲门癌在胃癌中所占的比例逐年升高。[结论]贲门癌在食管癌高发区比例较高,且发病有上升趋势,应加强对高发区贲门癌病因学的研究。肿瘤亚部位提供重要信息,应在肿瘤登记处加强对亚部位的收集。     

河北磁县居民十年恶性肿瘤发病资料分析

目的河北磁县是我国恶性肿瘤高发现场之一.本文分析了该县1988～1997年恶性肿瘤发病情况和特点,为今后的防治工作提供科学依据.方法发病资料取自磁县肿瘤登记处,采用ICD-9编码,全部发病资料录入微机,采用EPI软件进行统计分析.结果磁县1988～1997年恶性肿瘤新发病例12806例,其中男性7670例,女性5136例.男女性世界标化发病率分别为408.94/10万和234.69/10万.男性恶性肿瘤发病率较为稳定,女性呈波浪式下降,各年标化发病率均为男性高于女性.磁县十年中常见肿瘤前五位是:食管癌、胃癌、肺癌、肝癌、结直肠癌.男性食管癌发病率有下降趋势,胃癌则有上升趋势.女性胃癌、乳腺癌有上升趋势.除儿童期为白血病居第一位外,其余各年龄段均以食管癌居首位.结论危害磁县居民健康的肿瘤主要是消化系统肿瘤和肺癌.男性居民应作为主要的防治人群.     

石家庄市区户籍人口2012年恶性肿瘤发病分析

目的:研究石家庄市区户籍人口2012年恶性肿瘤发病情况。方法:2012年石家庄市区237 万户籍人口医疗保险覆盖率达99% 以上。将2012年1 月1 日至12月31日于石家庄市医保中心首次报销的住院恶性肿瘤个案经与医院数据核对后作为分子,市公安局2012年中户籍人口数作为分母,计算发病率,分析性别、年龄别和部位别肿瘤的发病特点。结果:2012年石家庄市区户籍人口恶性肿瘤粗发病率为237.53/10万,中国人口年龄调整发病率（中调率）为129.86/10万,世界人口年龄调整发病率（世调率）为167.71/10万。发病率随年龄增加而增加,男女均于75~79岁组达到高峰,分别为1 729.42/10万和867.35/10万。男性前10位的恶性肿瘤依次为肺癌、胃癌、结直肠癌、肝癌、食管癌、肾癌、前列腺癌、白血病、膀胱癌、淋巴瘤;女性分别为乳腺癌、肺癌、结直肠癌、胃癌、宫颈癌、子宫体癌、卵巢癌、淋巴瘤、食管癌及肝癌。石家庄市区户籍人口男性恶性肿瘤的粗发病率、世调率分别为269.05/10万、187.52/10万,女性分别为207.57/10万、150.44/10万。与全国31个城市2009年的世调率相比,男性肺癌、胃癌、结直肠癌与全国水平相近,女性乳腺癌高于全国水平;与北京市相比,石家庄市区男性胃癌、食管癌世调率分别约为北京市男性的2倍,但北京市男性胰腺癌、前列腺癌,女性甲状腺癌的世调率分别是石家庄市区的2 倍。结论:石家庄市区户籍人口2012年主要恶性肿瘤如肺癌、胃癌、结直肠癌、乳腺癌的世调率与全国31个城市2009年的水平相当;与北京市相比,食管癌、胃癌高发,但甲状腺癌、前列腺癌、胰腺癌低发。      

Ovary cancer incidence and mortality in China, 2011

Objective

To evaluate and analyze ovary cancer incidence and mortality in China in 2011 using ovary cancer data from population-based cancer registration in China, and to provide scientific information for its control and prevention.

Methods

Invasive cases of ovary cancer were extracted and analyzed from the overall Chinese cancer database in 2011, which were based on data from 177 population-based cancer registries distributing in 28 provinces. The crude, standardized, and truncated incidences and mortalities et al. were calculated and new and deaths cases from ovary cancer throughout China and in different regions in 2011 were estimated using Chinese practical population.

Results

The estimates of new ovary cancer cases and deaths were 45,223 and 18,430, respectively, in China in 2011. The crude incidence rate, age-standardized rate by Chinese standard population (ASR-C) and age-standardized rate by world standard population (ASR-W) incidence were 6.89/100,000, 5.35/100,000 and 5.08/100,000, respectively; the crude, ASR-C and ASR-W mortalities were 2.81/100,000, 2.01/100,000 and 1.99/100,000, respectively. The incidence and mortality in urban areas were higher than those in rural areas. The age-specific incidence and mortality increased rapidly from age 35-39 and peaked at age 60-64 or 75-79 years. After age 45 or 55, the age-specific incidence and death rates in urban were much higher than those in rural areas.

Conclusions

Compared with GLOBOCAN 2012 data, the ovary cancer incidence in China in 2011 was at middle level, but its mortality was at low level worldwide.     

中国河北省磁县1983年至2015年上消化道癌死亡率趋势分析

  目的   分析中国河北省磁县33年间上消化道癌死亡率变化情况，为肿瘤防治提供依据。   方法   按照肿瘤登记规范，收集整理磁县肿瘤登记处1983年1月1日至2015年12月31日肿瘤登记资料，评价上消化道癌死亡率变化情况，分析上消化道癌死亡率变化趋势。计算粗发病率、中国标准化死亡率和世界标准化死亡率的变化百分比，配合调整率的线性回归模型，估计死亡率的年度变化百分比（annual percent change，APC），结合Joinpoint线性回归分析年份及年龄组死亡率转折点及变化趋势。   结果   磁县33年间上消化道癌平均粗死亡率为119.31/10万，其中男性为149.21/10万，女性为88.40/10万；中国标准化死亡率为160.85/10万，其中男性为227.00/10万，女性为108.07/10万；世界标准化死亡率为162.39/10万，其中男性为228.52/10万，女性为109.30/10万。   结论   上消化道癌死亡率呈下降趋势，仍居于磁县恶性肿瘤死亡率的首位，年龄组死亡率随年龄的升高而升高。