Jin F, Devesa S S, Chow W H, Zheng W, Ji B T, Fraumeni J F, Gao Y T
Shanghai Cancer Institute, Shanghai, China.
Int J Cancer. 1999 Nov 12;83(4):435-40. doi: 10.1002/(sici)1097-0215(19991112)83:4<435::aid-ijc1>3.0.co;2-j.
Incidence rates for a number of cancers in urban Shanghai, China, have been changing markedly. Herein we update the trends using population-based data from the Shanghai Cancer Registry for 1972-1994. During 1993-1994, cancers of the lung, stomach, and liver were the 3 leading forms among men, with age-adjusted (world standard) incidence rates of 50.9, 39.2, and 26.5 per 100,000 person-years, respectively, followed by cancers of the colon (12.4) and esophagus (10.0). Among women, cancers of the breast (27.5), stomach (19.1), and lung (17.7) were the most common tumors, followed by cancers of the colon (11.3) and liver (9.4). Over the 23-year period, the rate for all cancers combined, excluding non-melanoma skin cancer, decreased from 247.5 to 215.2 among men and from 173.6 to 154.0 among women. However, trends for individual forms of cancer varied considerably. Rates doubled for cancers of the colon and biliary tract in both sexes, and they increased substantially for cancers of the brain and nervous system, kidney, pancreas, prostate, corpus uteri, female breast, and ovary, and for non-Hodgkin's lymphoma. Rates for cancers of the lung and rectum changed little. Rates declined by at least one-half for cancers of the esophagus and cervix, with notable decreases also for cancers of the stomach and liver. Some of these trends may reflect variations in diagnostic or screening practices, although changes in lifestyle and other environmental exposures are likely to play important roles. Further epidemiologic research in China is needed to identify risk factors influencing the cancer incidence trends.
中国上海市区多种癌症的发病率一直在显著变化。在此，我们利用上海癌症登记处1972 - 1994年基于人群的数据更新了发病趋势。在1993 - 1994年期间，肺癌、胃癌和肝癌是男性中排名前三的癌症类型，年龄调整后（世界标准）发病率分别为每10万人年50.9例、39.2例和26.5例，其次是结肠癌（12.4例）和食管癌（10.0例）。在女性中，乳腺癌（27.5例）、胃癌（19.1例）和肺癌（17.7例）是最常见的肿瘤，其次是结肠癌（11.3例）和肝癌（9.4例）。在这23年期间，除非黑色素瘤皮肤癌外，所有癌症合并发病率在男性中从247.5降至215.2，在女性中从173.6降至154.0。然而，个别癌症类型的趋势差异很大。男女结肠癌和胆道癌的发病率翻了一番，脑和神经系统、肾脏、胰腺、前列腺、子宫体、女性乳腺和卵巢癌以及非霍奇金淋巴瘤的发病率大幅上升。肺癌和直肠癌的发病率变化不大。食管癌和宫颈癌的发病率下降了至少一半，胃癌和肝癌的发病率也有显著下降。其中一些趋势可能反映了诊断或筛查方法的差异，尽管生活方式和其他环境暴露的变化可能也起到了重要作用。中国需要进一步开展流行病学研究以确定影响癌症发病趋势的危险因素。
