Qin Jiejie, Wu Mengyin, Zhao Shulin, Gu Kai, Cai Renzhi, Tang Ziwei, Zhu Defeng, Tian Jingyan, Yao Wei, Shen Baiyong, Shi Yan
Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Pancreatic Neoplasms Translational Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Oncol. 2025 Aug 1;15:1615492. doi: 10.3389/fonc.2025.1615492. eCollection 2025.
Shanghai has become a modern and international metropolis. A more comprehensive understanding of cancer incidence and mortality rates and socioenvironmental factors is explored to develop effective cancer control policies in Shanghai.
Cancer registration data are currently collected in Shanghai from 1973 to 2017, and socioenvironmental factors were obtained from the Shanghai statistical yearbook. Multivariate ridge regression analysis explored the contributions of socioenvironmental factors to cancer incidence and mortality, and the estimated annual percentage change (EAPC) was calculated for each cancer type by gender and district.
Multivariate ridge regression analysis indicated that the number of divorces, total waste gas from industry, areas of buildings completed, and number of computers probably drove the increase in cancer incidence, and health expenditure and medical insurance cost probably contributed to the decrease in cancer mortality in Shanghai. Age-standardized cancer incidences of the lung in female patients, prostate, thyroid, and cervix increased most, and the incidence and mortality of esophagus, liver, and stomach cancers decreased most in Shanghai from 2002 to 2017. The most common cancer sites diagnosed were lung, colorectal, female breast, and male prostate in Shanghai in 2017, similar to the pattern in high-income countries. Stricter air control strategies, lower divorce rates, healthier lifestyles, and more effective HPV vaccination campaigns may be useful actionable measures of cancer prevention.
The longitudinal cancer data from the real world, which span decades, reported here and Shanghai's experience in cancer prevention and control can be a reference for government guidelines in preventing population-level cancer incidence during city development.
上海已成为一座现代化国际大都市。为制定上海市有效的癌症控制政策，对癌症发病率、死亡率及社会环境因素进行了更全面的了解。
目前收集了上海1973年至2017年的癌症登记数据，并从《上海统计年鉴》获取社会环境因素数据。多变量岭回归分析探讨了社会环境因素对癌症发病率和死亡率的影响，并按性别和地区计算了每种癌症类型的估计年度百分比变化（EAPC）。
多变量岭回归分析表明，离婚数量、工业废气排放总量、竣工建筑面积和计算机数量可能推动了癌症发病率上升，而卫生支出和医疗保险费用可能有助于降低上海的癌症死亡率。2002年至2017年期间，上海女性肺癌、前列腺癌、甲状腺癌和宫颈癌的年龄标准化发病率上升幅度最大，食管癌、肝癌和胃癌的发病率和死亡率下降幅度最大。2017年上海诊断出的最常见癌症部位是肺癌、结直肠癌、女性乳腺癌和男性前列腺癌，与高收入国家的模式相似。更严格的空气控制策略、更低的离婚率、更健康的生活方式以及更有效的人乳头瘤病毒（HPV）疫苗接种活动可能是有用的癌症预防可行措施。
本文报告的来自现实世界长达数十年的纵向癌症数据以及上海的癌症防控经验，可为政府在城市发展过程中预防人群层面癌症发病率的指南提供参考。
