摘要目的 利用1998-2007年中国肿瘤发病数据对肿瘤发病趋势进行分析,并对2008-2015年肿瘤发病情况进行预测.方法 从全国肿瘤登记中心数据库中提取1998-2007年中国肿瘤发病数据,包括40个登记处,共登记肿瘤发病1109 594例,覆盖人群446 734 668人年.计算地区别、性别肿瘤发病率,采用世界人口年龄结构计算标化发病率.用JoinPoint软件对10年发病率的变化趋势进行分析,计算年度变化率(APC值).利用年龄-时期-队列的贝叶斯模型对城乡和性别发病数据进行拟合,预测2008-2015年中国肿瘤发病情况.结果 1998-2007年,我国城市男性肿瘤发病率为277.61/10万(472 307/170 131 309),标化发病率为202.05/10万,女性发病率为236.35/10万(389 586/164 830 893),标化发病率为159.15/10万；农村男性发病率为272.23/10万( 153 478/56 377 236),标化发病率为244.34/10万,女性发病率为170.09/10万(94 223/55 395 230),标化发病率为137.90/10万.10年间,城市男性发病率由1998年的247.00/10万(27 758/11 237 967)上升至2007年的305.76/10万(68 953/22 551 353),城市女性由207.37/10万(22 476/10 838 355)上升至263.20/10万(58 055/22 057 787)；农村男性由1998年的232.33/10万(10 045/4 323 628)上升至2007年的303.65/10万(23 313/7 677 484),农村女性由139.03/10万(5836/4 197 806)上升至197.40/10万(14 850/7 522 690).调整人口年龄结构后,城市男性APC(95％CI)值为0.5％(-0.2％ ～1.3％),差异无统计学意义.而城市女性、农村男性和农村女性APC(95％CI)值分别为1.7％(1.3％ ～2.0％)、1.8％(0.9％ ～2.6％)、2.8％(1.8％ ～3.7％),呈升高趋势.年龄-时期-队列贝叶斯模型预测,2015年我国恶性肿瘤发病率城市男性为309.13/10万(年新发肿瘤114.0万例),城市女性为303.79/10万(年新发肿瘤104.6万例),农村男性为288.66/10万(年新发肿瘤101.9万例),农村女性为222.59/10万(年新发肿瘤73.4万例).结论 我国肿瘤发病率呈逐年升高趋势,农村上升趋势大于城市,女性大于男性,预计肿瘤患者将逐年增多,亟须采取有效防治措施.

abstractsObjective Based on the national cancer incidence database from 1998 to 2007,to analyze the cancer incidence trend and predict the cancer burden between 2008 and 2015.Methods We picked up the cancer incidence data of 40 cancer registry sites from National Central Cancer Registry Database between 1998 and 2007.In total,1 109 594 cancer cases were registered,covering 446 734 668person-year.The separate incidence by district and gender were calculated,and the standardized incidence rate was calculated by world's population age structure.The incidence trend between the 10 years was analyzed by JoinPoint software,as well as the age-percentage-changes (APC).Age-Period-Cohort Bayesian Model was applied to fit the cancer incidence data stratified by age,district and gender.The cancer incidence between 2008 and 2015 was then predicted.Results During the period of 1998 - 2007,in urban areas,the male cancer incidence rate was 277.61/100 000 (472 307/170 131 309 ),with the age standardized rate (ASR) at 202.05/100 000; while the female cancer incidence rate was 236.35/100 000 (389 586/164 830 893),with the ASR at 159.15/100 000; in rural areas,the male and female cancer incidence rates were separately 272.23/100 000 ( 153 478/56 377 236) and 170.09/100 000 (94 223/55 395 230),with the corresponding ASR at 244.34/100 000 and 137.90/100 000.Crude incidence rate in urban men increased from 247.00/100 000 (27 758/11 237 967 ) in 1998 to 305.76/100 000 (68 953/22 551 353 ) in 2007 ; while it increased from 207.37/100 000 ( 22 476/10 838 355 ) to 263.20/100 000 ( 58 055/22 057 787) among urban women.The crude incidence rate in rural men increased from 232.33/100 000(10 045/4 323 628 ) to 303.65/100 000 (23 313/7 677 484 ) and it increased from 139.03/100 000(5836/4 197 806) to 197.40/100 000 ( 14 850/7 522 690) among rural women.After age adjustment,the urban male APC value ( 95％ CI) was 0.5％ ( - 0.2％ ～ 1.3％ ),showed no significantly statistical difference.However,the urban female APC value (95％ CI),rural male APC value (95％ CI) and rural female APC value (95％CI) were separately 1.7％ ( 1.3％ ～2.0％ ),1.8％ (0.9％ ～2.6％ ) and 2.8％(1.8％ ～3.7％ ),all showed an obvious uptrend.The outcome of Age-Period-Cohort Bayesian model predicted that by year 2015,the incidence cancer rate in urban areas will reach 309.13/100 000 ( 1.140million new cases) among males and 303.79/100 000 ( 1.046 million new cases) among females; while in rural areas the rate will reach 288.66/100 000 (1.019 million new cases ) among males and 222.59/100 000 (0.734 million new cases ) among females.Conclusion The cancer incidence has increased annually; the uptrend in rural areas was more obvious than it in urban areas; the uptrend in females was more obvious than it in males.It is predicted that the annual incidence will continue to increase in the next years,and effective control programs should be carried out immediately.