Bao Ping-Ping, Zheng Ying, Wu Chun-Xiao, Huang Zhe-Zhou, Gao Yu-Tang, Jin Fan, Xiang Yong-Bing, Zhong Wei-Jian, Lu Wei, Wu Fan
Department of Cancer Control & Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China.
Department of Epidemiology, Shanghai Cancer Institute, Shanghai, 200032, People's Republic of China.
BMC Cancer. 2016 Apr 21;16:284. doi: 10.1186/s12885-016-2313-2.
To provide a comprehensive overview of temporal trends in cancer incidence during 1973-2010 in urban Shanghai.
The estimated annual percent changes (EAPCs) for the whole period and for the time segments in age-standardized incidence rates (ASR) were evaluated with Joinpoint analysis. Age-period-cohort (APC) models were modeled to examine the effects of age, period and birth cohort on cancer incidence.
The overall ASR decreased slightly and significantly in males (EAPC of -0.41) but increased significantly in females (EAPC of 0.57) during 1973-2010 in urban Shanghai. The incidence trend was not linear and varied by time segments. During the most recent 10 years (2001-2010), the ASR in males decreased by 1.65% per year and stabilized in females. Incidence rates continued to decline during 1973-2010 for esophagus, stomach, and liver cancer in both sexes, as well as male lung cancer and cervix cancer. It should be noted that it was the first time to document a significant decline in lung cancer incidence among males during 1973-2010 with EAPC of -0.58%, and a notable upward for cervix cancer since 1996 with EAPC of 8.94%. Unfavorable trends in incidence were observed for the most common cancer sites in the 38 years period: colorectum, gallbladder & biliary tract, pancreas, kidney, bladder, brain & central nervous system (CNS), thyroid, non-Hodgkin's lymphoma (NHL), prostate, female breast, corpus uteri, and ovary. APC analysis showed age, period and birth cohort yielded different effects by cancer sites.
The observed trends primarily reflect dramatic changes in socioeconomic development and lifestyles in urban Shanghai over the past four decades.
全面概述1973 - 2010年上海市区癌症发病率的时间趋势。
采用Joinpoint分析评估整个时期及各时间段年龄标准化发病率（ASR）的年度估计变化百分比（EAPC）。构建年龄 - 时期 - 队列（APC）模型，以研究年龄、时期和出生队列对癌症发病率的影响。
1973 - 2010年上海市区男性的总体ASR略有显著下降（EAPC为 -0.41），而女性则显著上升（EAPC为0.57）。发病率趋势并非呈线性，且因时间段而异。在最近10年（2001 - 2010年），男性的ASR每年下降1.65%，女性则趋于稳定。1973 - 2010年期间，男女食管癌、胃癌和肝癌以及男性肺癌和宫颈癌的发病率持续下降。需要注意的是，这是首次记录到1973 - 2010年男性肺癌发病率显著下降，EAPC为 -0.58%，自1996年以来宫颈癌发病率显著上升，EAPC为8.94%。在这38年期间，观察到常见癌症部位的发病率呈不利趋势：结直肠癌、胆囊及胆道、胰腺、肾脏、膀胱、脑及中枢神经系统（CNS）、甲状腺、非霍奇金淋巴瘤（NHL）、前列腺、女性乳腺癌、子宫体和卵巢。APC分析表明，年龄、时期和出生队列对不同癌症部位产生不同影响。
观察到的趋势主要反映了过去四十年来上海市区社会经济发展和生活方式的巨大变化。
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