基于人群的香港宫颈癌发病率、死亡率和肿瘤分期特异性生存分析：1997-2006 年。

A population-based analysis of incidence, mortality, and stage-specific survival of cervical cancer patients in Hong Kong: 1997-2006.

机构信息

Hong Kong Cancer Registry, R Block, 1/F, Queen Elizabeth Hospital, Kowloon, Hong Kong.

出版信息

Hong Kong Med J. 2011 Apr;17(2):89-95.

Abstract

OBJECTIVES

To determine the trends in incidence and mortality of cervical cancer patients diagnosed during 1997 to 2006, and to describe stage-specific survival using population-based cancer registry data.

DESIGN

Retrospective, population-based study.

SETTING

Hong Kong.

PATIENTS

All patients diagnosed with cervical cancer between 1997 and 2006. Patients eligible for survival analysis were followed up till 31 December 2007.

MAIN OUTCOME MEASURES

Age-standardised incidence and mortality rates and average annual percent changes in these parameters were calculated using the Poisson regression model. Survival was expressed as relative survival rate using a period approach. Hazard ratios of mortality including 95% confidence intervals for certain variables were estimated using the Cox proportional hazards model.

RESULTS

During the 10-year period of the study, overall annual incidence and mortality rates decreased by 4.2% and 6.0%, respectively. Significant rates of reduction were observed in all age-groups except those younger than 45 years. The reduction in incidence of squamous cell carcinoma (3.6% annually) was less than that of adenocarcinoma (5.2%) and other histological types (6.8%). In all, 3807 (86.4%) of the patients were included in survival analysis. The overall 5-year relative survival rate was 71.3% (95% confidence interval, 69.5-73.1%), while the values for stages I, II, III, and IV were 90.9%, 71.0%, 41.7%, and 7.8%, respectively. Age, stage, and histology were independent prognostic factors. Survival of stage IA patients was as good as that of the general population.

CONCLUSIONS

As in other industrialised countries, the incidence and mortality rate of cervical cancer were decreasing. Stage-specific population-based cancer survival was available for the first time, and was useful as an indicator of cancer control. Collaboration between public and private sectors to further improve the follow-up data could provide more comprehensive surveillance information.

摘要

目的

利用基于人群的癌症登记数据，确定 1997 年至 2006 年期间诊断出的宫颈癌患者的发病率和死亡率趋势，并描述特定分期的生存率。

设计

回顾性、基于人群的研究。

地点

中国香港。

患者

所有在 1997 年至 2006 年期间被诊断为宫颈癌的患者。符合生存分析条件的患者随访至 2007 年 12 月 31 日。

主要观察指标

使用泊松回归模型计算年龄标准化发病率和死亡率以及这些参数的平均年变化率。使用区间法表示生存率为相对生存率。使用 Cox 比例风险模型估计包括特定变量的 95%置信区间的死亡率风险比。

结果

在研究的 10 年期间，总体年发病率和死亡率分别下降了 4.2%和 6.0%。除 45 岁以下年龄组外，所有年龄组的发病率均呈显著下降趋势。鳞状细胞癌（每年下降 3.6%）的发病率下降幅度小于腺癌（每年下降 5.2%）和其他组织学类型（每年下降 6.8%）。共有 3807 例（86.4%）患者纳入生存分析。总体 5 年相对生存率为 71.3%（95%置信区间，69.5%至 73.1%），而Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期的生存率分别为 90.9%、71.0%、41.7%和 7.8%。年龄、分期和组织学是独立的预后因素。IA 期患者的生存率与一般人群相当。