印度南部丁迪古尔地区基于注册系统的癌症控制监测统计评估。

Assessment of Registry-Based Surveillance Statistics Used for Cancer Control in the Dindigul District in South India.

机构信息

Epidemiology, Biostatistics and Cancer Registry, Cancer Institute (W.I.A), Chennai, India.

Christian Fellowship Community Health Centre and Christian Cancer Hospital Ambilikkai, Dindigul District, Tamil Nadu, India.

出版信息

J Registry Manag. 2023 Spring;50(1):26-33.

PMID:37577285

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10414206/

Abstract

BACKGROUND

Cancer incidence rates from the Dindigul district were lower by 50% than Chennai in Tamil Nadu for most cancers. This study describes the cancer surveillance statistics and provides an assessment of missing cases from routine registration in the Dindigul Ambilikkai Cancer Registry (DACR), covering a predominantly rural population in the Dindigul district.

METHOD

A total of 21,214 incident cancers in the DACR during 2003-2017 were examined for this study. Cancer registration was carried out by active case-finding following standard international norms. A total of 12,541 incident cancers registered during 2003-2012 and followed through 2014 were used to estimate survival. Data on follow-up were obtained through a mixture of active and passive methods. Survival probability was estimated by actuarial methods. A random survey carried out independently was used to assess the quality of case ascertainment.

RESULTS

The age-standardized rate (ASR) per 100,000 population was higher among women (76.2) than men (61) in 2013-2017, with both sexes reporting a 17% increase compared to 2003-2007. The most common cancers were cervix (ASR,18.5) and female breast (ASR,17.1), with percentage changes of -19% and +46.1%, respectively. Lung cancer (ASR, 5.5) was top among men with an increasing trend (+57.1%). The percent change in ASR of mouth cancer showed opposite trends among men (+24.3%) and women (- 21.4%). The ASR of colorectal cancers almost doubled among men between 2003-2007 and 2013-2017 (3.9; +94.7%). The 5- and 10-year absolute survival for all cancers were 31% and 20%, respectively. Out of 365 incident cancers that occurred during 2003-2010 in the surveyed areas, 310 (84.9%) were already registered in the DACR, while 55 were newly identified from the survey (15.1%). Inadequate coverage of sources outside the Dindigul district was significant ( = .002), with the highest number of missed cases from hospitals under nongovernment sectors (58.3%). Underascertainment was higher among cancer patients living in hilly regions (60%) and border areas (47.4%) than in core regions ( = .05).

CONCLUSION

Because of an enacted government order making cancer a notifiable disease, the registry-based cancer surveillance could be extended, covering a population of 80 million in a cost-effective manner with enhanced coverage and systematic evaluation of cancer-screening programs.

摘要

背景

在泰米尔纳德邦的丁迪古尔地区，癌症发病率比金奈低 50%。本研究描述了癌症监测统计数据，并评估了丁迪古尔 Ambilikkai 癌症登记处（DACR）常规登记中缺失的病例，该登记处覆盖了丁迪古尔区的主要农村人口。

方法

本研究共检查了 2003-2017 年 DACR 中 21214 例新发癌症病例。癌症登记是按照国际标准规范通过主动病例发现进行的。2003-2012 年登记并随访至 2014 年的 12541 例新发癌症病例用于估计生存率。通过主动和被动混合方法获得随访数据。通过 actuarial 方法估计生存概率。独立进行的随机调查用于评估病例确定的质量。

结果

2013-2017 年，女性（ASR76.2）的年龄标准化率（ASR）高于男性（ASR61），与 2003-2007 年相比，两性均报告增加了 17%。最常见的癌症是宫颈癌（ASR18.5）和女性乳腺癌（ASR17.1），百分比变化分别为-19%和+46.1%。肺癌（ASR5.5）是男性中最常见的癌症，呈上升趋势（+57.1%）。男性口腔癌的 ASR 变化百分比呈上升趋势（+24.3%），而女性呈下降趋势（-21.4%）。2003-2007 年至 2013-2017 年期间，男性结直肠癌的 ASR 几乎翻了一番（3.9；+94.7%）。所有癌症的 5 年和 10 年绝对生存率分别为 31%和 20%。在调查地区 2003-2010 年期间发生的 365 例癌症中，310 例（84.9%）已在 DACR 中登记，而 55 例是通过调查新发现的（15.1%）。登记处以外来源的覆盖范围不足（ =.002），非政府部门医院的漏报病例最多（58.3%）。山区（60%）和边境地区（47.4%）的癌症患者漏诊率高于核心地区（ =.05）。