Li Dao-Juan, Liang Di, Song Guo-Hui, Li Yong-Wei, Wen Deng-Gui, Jin Jing, He Yu-Tong
Dao-Juan Li, Di Liang, Deng-Gui Wen, Jing Jin, Yu-Tong He, Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumour Hospital of Hebei Province, Shijiazhuang 050011, Hebei Province, China.
World J Gastroenterol. 2017 Apr 14;23(14):2625-2634. doi: 10.3748/wjg.v23.i14.2625.
To investigate the incidence and mortality rates of upper gastrointestinal cancer (UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.
Data for UGIC patients were collected from 21 population-based cancer registries covering 15.25% of the population in Hebei Province. Mortality data were extracted from three national retrospective death surveys (1973-1975, 1990-1992 and 2004-2005). The data were stratified by 5-year age groups, gender and area (high-risk/non-high-risk areas) for analysis. The age-period-cohort and grey system model were used.
The crude incidence rate of UGIC was 55.47/100000, and the adjusted rate (Segi's population) was 44.90/100000. Males in rural areas had the highest incidence rate (world age-standardized rate = 87.89/100000). The crude mortality rate of UGIC displayed a decreasing trend in Hebei Province from the 1970s to 2013, and the adjusted rate decreased by 43.81% from the 1970s (58.07/100000) to 2013 (32.63/100000). The mortality rate declined more significantly in the high-risk areas (57.26%) than in the non-high-risk areas (55.02%) from the 1970s to 2013. The median age at diagnosis of UGIC was 65.06 years in 2013. There was a notable delay in the median age at death from the 1970s (66.15 years) to 2013 (70.39 years), especially in the high-risk areas. In Cixian, the total trend of the cohort effect declined, and people aged 65-69 years were a population at relatively high risk for UGIC. We predicted that the crude mortality rates of UGIC in Cixian and Shexian would decrease to 98.80 and 133.99 per 100000 in 2018, respectively.
UGIC was the major cause of cancer death in Hebei Province, and males in rural areas were a high-risk population. We should strengthen early detection and treatment of UGIC in this population.
调查中国河北省上消化道癌（UGIC）的发病率和死亡率，并确定高危人群，以改善UGIC的预防和控制。
从覆盖河北省15.25%人口的21个基于人群的癌症登记处收集UGIC患者的数据。死亡率数据从三项全国性回顾性死亡调查（1973 - 1975年、1990 - 1992年和2004 - 2005年）中提取。数据按5岁年龄组、性别和地区（高危/非高危地区）分层进行分析。使用了年龄 - 时期 - 队列模型和灰色系统模型。
UGIC的粗发病率为55.47/10万，调整率（Segi人口）为44.90/10万。农村男性发病率最高（世界年龄标准化率 = 87.89/10万）。河北省UGIC的粗死亡率从20世纪70年代到2013年呈下降趋势，调整率从20世纪70年代的58.07/10万下降到2013年的32.63/10万，下降了43.81%。从20世纪70年代到2013年，高危地区的死亡率下降幅度（57.26%）比非高危地区（55.02%）更显著。2013年UGIC诊断的中位年龄为65.06岁。从20世纪70年代（66.15岁）到2013年（70.39岁），死亡中位年龄有显著延迟，尤其是在高危地区。在磁县，队列效应的总体趋势下降，65 - 69岁人群是UGIC相对高危人群。我们预测磁县和涉县UGIC的粗死亡率将分别在2018年降至每10万98.80和133.99。
UGIC是河北省癌症死亡的主要原因，农村男性是高危人群。我们应加强该人群UGIC的早期检测和治疗。
