Yi L, Zhao T, Li Y Y, Chen W Q, Zhao D L
Cancer Center, People's Hospital of Feicheng, Shandong Province, Feicheng 271600, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 May 6;51(5):403-408. doi: 10.3760/cma.j.issn.0253-9624.2017.05.007.
To investigate the trend of esophageal and stomach cancer incidence and mortality in Feicheng during 2000 to 2013, and to evaluate the effects of the national project of screening for upper digestive tract cancers from 2006 to 2015 in Feicheng. We collected 26 569 cases, which were coded of C15 and C16 in the 10th edition of international classification of diseases (ICD) during the period of 2000-2013. The data came from cancer registration system of Feicheng, Shandong Province, China. These cases already covered 21 679 882 person-year. The annual percent change (APC) of incidence and mortalit were analyzed. The risk factors of upper gastrointestinal cancer were investigated and evaluated for people aging 40-69 in three street offices and eleven townships of Feicheng, and endoscopic screening was conducted among people who was in high risk. The corresponding data were used to analyze the early detection project of upper gastrointestinal cancer screening and early diagnosis, with the index of detection rate, early diagnosis rate, early treatment rate and other indicators. There were 26 569 new cases of esophageal cancer and gastric cancer occurred in Feicheng from 2000 to 2013. The incidence of esophageal cancer gradually increased since 2000 with 76.06 per 100 000 people (575/756 005) and reached the peak in 2010 with incidence rate of 118.76 per 100 000 people (852/717 429), with the annual percent change at about 4.3% (95 2.7%-5.9%) and showed a downward trend after then but has no significance, with APC about-7.1% (95-15.8%-2.5%). The incidence of gastric cancer was increased from 2000 with an incidence rate of 37.70 per 100 000 people (285/756 005) to 2013 with an incidence rate of 54.59 per 100 000 (538/985 512), with an annual percent change of about 3.3% (95 2.1%-4.5%). Esophageal cancer and gastric cancer mortality showed a relatively stable trend during 2000 to 2013, esophageal cancer with APC about 0.1% (95: -1.3%-1.5%) and stomach cancer with APC about 0.8% (95: -0.5%-2.0%). From 2006 to 2015, 58 579 residents aged 40-69 years old participated cancer screening project covered 206 105 populations in Feicheng. There were 1 124 invasive cancers and in situ cases from upper digestive tract were detected, with the detective rate at 1.92%. Among those cases, 941 cases were in early stage with the early diagnosis rate of 83.72%, and about 88.97% of detected patients received appropriate treatment after diagnosis. The incidence of esophageal cancer and gastric cancer with a very high level of incidence and mortality, this made the prevention and control situation was still very serious. The project of cancer screening, early diagnosis and treatment on upper digestive tract cancers in Feicheng plays a positive role on cancer control.
为研究2000年至2013年肥城市食管癌和胃癌的发病及死亡趋势，并评估2006年至2015年全国上消化道癌筛查项目在肥城市的实施效果。我们收集了2000 - 2013年期间国际疾病分类第10版（ICD）中编码为C15和C16的26569例病例。数据来自中国山东省肥城市癌症登记系统。这些病例已覆盖21679882人年。分析了发病率和死亡率的年度变化百分比（APC）。对肥城市三个街道办事处和十一个乡镇40 - 69岁人群的上消化道癌危险因素进行调查和评估，并对高危人群进行内镜筛查。用检出率、早期诊断率、早期治疗率等指标对相应数据进行上消化道癌筛查及早期诊断的早诊项目分析。2000年至2013年肥城市共发生食管癌和胃癌新发病例26569例。食管癌发病率自2000年起逐渐上升，从每10万人中76.06例（575/756005）升至2010年的高峰，发病率为每10万人中118.76例（852/717429），年度变化百分比约为4.3%（95%可信区间：2.7% - 5.9%），此后呈下降趋势但无统计学意义，APC约为 - 7.1%（95%可信区间： - 15.8% - 2.5%）。胃癌发病率从2000年的每10万人中37.70例（285/756005）升至2013年的每10万人中54.59例（538/985512），年度变化百分比约为3.3%（95%可信区间：2.1% - 4.5%）。2000年至2013年期间，食管癌和胃癌死亡率呈相对稳定趋势，食管癌APC约为0.1%（95%可信区间： - 1.3% - 1.5%），胃癌APC约为0.8%（95%可信区间： - 0.5% - 2.0%）。2006年至2015年，肥城市58579名40 - 69岁居民参加了癌症筛查项目，覆盖206105人。共检出上消化道浸润癌和原位癌1124例，检出率为1.92%。其中941例为早期，早期诊断率为83.72%，约88.97%的检出患者诊断后接受了适当治疗。食管癌和胃癌的发病率和死亡率处于很高水平，防控形势依然严峻。肥城市上消化道癌筛查及早诊早治项目对癌症防控起到了积极作用。
