目的阐明上海市杨浦区2002-2012年间宫颈癌的发病率和死亡率。方法系统整理上海市肿瘤登记报告系统2002年1月至2012年12月杨浦区户籍人群宫颈癌发病和死亡资料,应用年均变化百分比(APC)模型分析宫颈癌发病率和死亡率的时间变化趋势,应用Kaplan-Meier模型结合Log-rank检验进行生存分析。采用2000年全国人口普查的标准女性人口年龄构成进行标化。结果2002-2012年间上海市杨浦区宫颈癌总新发患者628例,占同期全区女性恶性肿瘤的2.53%。宫颈癌年均粗发病率为10.80/10^5标化发病率为9.56/10^5。在此期间宫颈癌的粗发病率逐年增长(APC=11.10,P〈0.01),但是标化发病率没有明显改变(APC=1.05,P〉0.05)。以30-49岁女性人群宫颈癌发病率最高。2002—2012年问因宫颈癌死亡256例,占全区女性恶性肿瘤死亡患者的1.57%。宫颈癌年均粗死亡率为4.40/10^5,标化死亡率为2.02/10^5。宫颈癌患者的平均生存时间为8.36年。接受手术治疗患者平均生存时间显著高于未接受手术者(9.22年vs7.06年,P〈0.01)。宫颈癌患者的5年生存率为75.45%,其中手术治疗组5年生存率为84.69%,显著高于非手术组60.89%(P〈0.01)。结论上海市杨浦区户籍女性人群宫颈癌标化发病率和死亡率分别为9.56/10^5和2.02/10^5,手术治疗能显著提高患者的生存期。
Objective To investigate the incidence and mortality of cervical cancer among female permanent residents in Yangpu district of Shanghai from Jan. 2002 to Dec. 2012. Methods The data of cervical cancer patients among female permanent residents of Yangpu district were collected from the database of the registration and management system of Shanghai. The temporal trend in the incidence and mortality of cervical cancer during this period was assessed by annual percent change (APC) model. Kaplan-Meier analysis with log-rank test was applied for survival analysis. The incidence and mortality were standardized with age composition of standard female population from a nationwide census taken in 2000. Results A total of 628 cervical cancer patients were newly diagnosed between 2002 and 2012, and it accounted for 2.53% of female malignant diseases during the period in Yangpu district. The crude incidence of cervical cancer was 10, 80/10^5 and the standardized incidence was 9.56/10^5. The crude incidence of cervical cancer increased consecutively during the period (APC= 11.10, P〈0.01), whereas the standardized incidence showed no notable change (APC= 1.05, P〉0.05) . The incidence of cervical cancer reached the top in females aged 30-49 years old. A total of 256 cases died of cervical cancer during this period; the annual crude mortality of cervical cancer in our study was 4.40/10^5 and the standardized one was 2.02/10^5. The average survival time ofpatients with cervical cancer was 8.36 years in our study. The survival time was significantly longer in the patients receiving curative surgery compared with those did not (9.22 vs 7.06 years, P〈0.01). The overall 5-year survival rate of cervical cancer patients was 75.45%, with the rate of patients receiving curative surgery being significantly higher than that of those receiving no surgery (84.69% vs 60.89%, P〈0.01). Conclusion In permanent female residents in Yangpu district of Shanghai, the standardized incidence and mortality rates of cervical ca