Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Int J Urol. 2022 Feb;29(2):121-127. doi: 10.1111/iju.14731. Epub 2021 Oct 27.
To assess temporal patterns and regional differences in the incidence rate, and factors associated with survival of urinary tract urothelial carcinoma.
The medical records of 8830 patients with new diagnoses of urinary tract urothelial carcinoma in the years 2001-2010 were retrieved from Taiwan National databases. Temporal trends, regional disparity and related survival factors were evaluated using the Cochran-Armitage trend test, local Moran's I statistic and log-rank test, respectively.
The annual urinary tract urothelial carcinoma incidence rates (standardized by age) were steady at approximately 3.14-3.41 per 100 000 person-years. Notably, women had a significantly higher annual urinary tract urothelial carcinoma incidence than men in most of the years studied (range of female-to-male annual standardized rate ratio: 2.08-3.25), and diabetes prevalence in urinary tract urothelial carcinoma increased significantly from 12.3% to 23.4% per year over the 10 years. High urinary tract urothelial carcinoma incidence cluster areas other than the latest endemic area of "blackfoot disease" were newly identified by local Moran's I statistic (P < 0.05). Furthermore, older age, male sex, end-stage kidney disease and more advanced tumor grade were associated with lower 5-year overall survival probabilities in the 2001-2015 cohort.
The incidence and survival of urinary tract urothelial carcinoma over the decade 2001-2010 were different according to population and regional features. Various urinary tract urothelial carcinoma screening, prevention, treatment and care plans should be developed depending on age, sex, comorbidity and area of residence.
评估尿路尿路上皮癌发病率的时间趋势和地域差异，以及与生存相关的因素。
从台湾国家数据库中检索了 2001 年至 2010 年期间 8830 例新诊断为尿路尿路上皮癌患者的病历。分别采用 Cochran-Armitage 趋势检验、局部 Moran's I 统计量和对数秩检验评估时间趋势、地域差异和相关生存因素。
尿路尿路上皮癌的年发病率（按年龄标准化）稳定在约 3.14-3.41/10 万人年。值得注意的是，在研究的大多数年份中，女性的尿路尿路上皮癌年发病率明显高于男性（女性与男性的年标准化发病率比范围：2.08-3.25），且尿路尿路上皮癌的糖尿病患病率在 10 年内从 12.3% 增加到 23.4%。局部 Moran's I 统计量新发现了除“黑脚病”最新流行区以外的高尿路尿路上皮癌发病率聚集区（P<0.05）。此外，在 2001-2015 年队列中，年龄较大、男性、终末期肾病和更高级别的肿瘤分级与 5 年总生存率降低相关。
在 2001-2010 年这十年中，尿路尿路上皮癌的发病率和生存率因人群和地域特征而异。应根据年龄、性别、合并症和居住地制定各种尿路尿路上皮癌筛查、预防、治疗和护理计划。
