摘要目的 分析2000—2014年中国肿瘤登记地区人群肺癌发病趋势及年龄变化情况.方法 选取2000—2014年全国肿瘤登记中心有连续数据的22个肿瘤登记处数据,覆盖人口621593469人年.提取数据库中《国际疾病分类(第10版)》(ICD-10)编码为C33～C34的全部肺癌患者共343663例.计算不同性别和地区人群的发病率、中国人口标化发病率(中标率)、年均变化百分比(AAPC)、标化平均发病年龄,按地区、年龄组分层后描述各年份发病率,利用线性回归模型分析平均发病年龄与年份间的相关性.结果 中国登记地区男性2000年肺癌发病率和中标率分别为56.98/10万和48.43/10万,2014年分别为89.51/10万和46.85/10万;女性2000年分别为27.77/10万和20.17/10万,2014年分别为51.31/10万和25.44/10万.2000—2014年,所有肿瘤登记地区肺癌发病率和中标率均呈上升趋势(发病率:AAPC=3.8％,95％CI:3.5％～4.1％;中标率:AAPC=0.4％,95％CI:0.2％～0.7％);女性发病率平均每年的上升幅度大于男性(男性:AAPC=3.5％,95％CI:3.2％～3.7％;女性:AAPC=4.5％,95％CI:4.1％～5.0％);调整人口年龄后,男性和女性发病率的年平均上升趋势均有所下降(男性:AAPC=-0.2％,95％CI:-0.4％～0.0％;女性:AAPC=1.4％,95％CI:1.0％～1.9％).2000年农村地区肺癌标化平均发病年龄由2000年的64.35岁上升到2014年的65.97岁(β=0.11,P<0.001),但在所有肿瘤登记地区及城市地区,未发现标化平均发病年龄有明显变化(P>0.05).男性人群肺癌标化平均发病年龄随时间推移有下降趋势(β=-0.02,P=0.014),女性人群未发现此趋势(β=-0.01,P=0.522).结论 2000—2014年中国登记地区肺癌发病率呈缓慢上升趋势,男性标化平均发病年龄略有降低,农村有所上升;肺癌仍将是恶性肿瘤防控的重点之一.

abstractsObjective To analyze the incidence trend and mean age at diagnosis for lung cancer in cancer registration areas of China from 2000 to 2014. Methods The data of lung cancer incidence used in this study were from 22 registries submitted to National Central Cancer Registry with continuous data during 2000 and 2014, covering about 621593469 person-years. All cancer cases were coded as C33-C34 according to the International Classification of Diseases-10th Revision (ICD-10) were extracted for this analysis with about 343663 patients. The incidence of different sex and regional population, the standardized incidence rate by Chinese population, the average annual change percentage (AAPC), the mean age and adjusted mean age of cancer incidence were calculated. The incidence of each year was described by regional and age groups, and the linear regression model was employed to analyze the relationship between mean age at onset and year. Results The crude incidence rate and age-standardized incidence rate (ASR) of lung cancer for men in cancer registry areas in 2000 were 56.98 per 100000 and 48.43 per 100000, respectively. The rates were 89.51 per 100000 and 46.85 per 100000 in 2014, respectively. For women in the same areas, the rates were 27.77 per 100000 and 20.17 per 100000 in 2000;while 51.31 per 100000 and 25.44 per 100000 in 2014, respectively. The crude incidence rate increased along with the age. In 2000-2014, the trend of crude rate and ASR of lung cancer were significantly increased (CR: AAPC=3.8％, 95％CI:3.5％-4.1％;ASR:AAPC=0.4％, 95％CI:0.2％-0.7％). The rise of crude rate in females was higher than that in males (Male:AAPC=3.5％, 95％CI:3.2％-3.7％;Female:AAPC=4.5％, 95％CI:4.1％-5.0％). However, the rise of the ASR declined for both male and female (Male:AAPC=-0.2％, 95％CI:-0.4％-0.0％;Female:AAPC=1.4％, 95％CI:1.0％-1.9％). The average age at diagnosis of lung cancer in rural areas was 64.35 years old in 2000, and increased to 65.97 years old in 2014 (β=0.11, P<0.001), while adjusted mean age at onset remained stable in all areas and urban areas (P>0.05). And the average age at onset increased significantly over time in male (β=-0.02, P=0.014), which was not seen in female (β=-0.01, P=0.522). Conclusion The crude incidence rate of lung cancer in cancer registry areas in China increased slowly during 2000-2014;and the standardized average age of male at diagnosis decreased slightly, while the age in rural areas increased during 2000-2014. Lung cancer will still be the focus of cancer prevention and control in the near future.