1.Analysis of the current status of cancer incidence and mortality in Shanghai,2017 and trends of 2002-2017
Kai GU ; Yi PANG ; Chunxiao WU ; Chunfang WANG ; Liang SHI ; Yongmei XIANG ; Yangming GONG ; Peng PENG ; Jianming DOU ; Mengyin WU ; Xiaocong ZHANG ; Ganling DING ; Jianying YAN ; Yan SHI ; Chen FU
Tumor 2023;43(4):241-256
Background and purpose:The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on cancer occurrence and trends in Shanghai.This study aimed to investigate the cancer incidence and mortality in 201 7 and their trends from 2002 to 2017 in Shanghai. Methods:Data of new cancer diagnoses and deaths from 2002 to 2017 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.Cancer incidence and mortality stratified by year of diagnosis or death,gender and age group were analyzed.Number,proportion,crude rate,age-specific rate,age-standardized rate and others were calculated.The number,proportion and rates of common cancers in different groups were also calculated.Trends in age-standardized rate of incidence and death rates for all cancers combined and for the common cancer types by gender were estimated by joinpoint analysis and characterized by the annual percent change(APC)and average annual percent change(AAPC).Segi's 1960 world standard population was used for calculating age-standardized incidence and mortality. Results:The new cancer cases and deaths were 79 378 and 37 186 in Shanghai in 2017.The crude rate of incidence was 546.55/105,and the age-standardized rate was 246.31/105.The age-standardized rate of incidence was higher among females than among males.The crude rate of mortality was 256.04/1 05,and the age-standardized rate was 88.41/105.The age-standardized rate of mortality was higher among males than among females.The age-specific numbers and rates of incidence and mortality increased with age.The age-specific number and rate of incidence reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among males reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among females reached the peak at the age groups of older than 85 years,respectively.The sites of top 10 common cancer types sorted by the number of incidence cases among males were lung,colorectum,stomach,prostate,liver,thyroid,pancreas,bladder,kidney and oesophagus,and among females were lung,breast,thyroid,colorectum,stomach,pancreas,liver,brain,central nervous system(CNS),cervix uteri and gallbladder,the sites of those sorted by the number of deaths among males were lung,stomach,colorectum,liver,pancreas,prostate,oesophagus,bladder,lymphoma and gallbladder,among females were lung,colorectum,breast,stomach,pancreas,liver,gallbladder,brain,CNS,ovary and lymphoma.The top 10 common cancer types stratified by gender and the top 5 common cancer types stratified by common age groups merged of incidence and mortality had wide variations.Overall,the age-standardized rates of incidence were stable from 2002 to 2009,and increased 2.88%on average per year from 2009 to 201 7.The age-standardized rates of mortality were stable from 2002 to 2011,and decreased 2.66%on average per year from 2011 to 201 7.The trends differed by gender and cancer type. Conclusion:Lung cancer,colorectal cancer,pancreatic cancer,thyroid cancer,female breast cancer,cervical cancer and male prostate cancer are the most common cancers in Shanghai,the appropriate screening technical scheme should be formulated according to the current situation of malignant tumors in Shanghai,promote cancer opportunistic screening,promote appropriate technologies for intervention and management of cancer patients in the community,reduce the disease burden of malignant tumors.
2.Survival analysis of cancer cases diagnosed during 2002-2013 in Shanghai:a population-based study
Chunxiao WU ; Kai GU ; Yi PANG ; Chunfang WANG ; Liang SHI ; Yongmei XIANG ; Yangming GONG ; Peng PENG ; Jianming DOU ; Mengyin WU ; Xiaocong ZHANG ; Ganling DING ; Jiaying YAN ; Yan SHI ; Chen FU
Tumor 2023;43(4):257-265
Objective:To investigate the survival of cancer cases diagnosed during 2002-2013 in Shanghai. Methods:Data on new cancer cases with dead and follow-up information were obtained from the population-based cancer registry and vital statistics system of Shanghai Municipal Center for Disease Control and Prevention.Survival indicators stratified by year of diagnosis,gender,site and age were analyzed.Number of cases and proportion were calculated.The observed survival rates were calculated based on the life table.The probabilities of surviving from 0 to 99 years old were estimated according to the Elandt-Johnson model,and then the cumulative expected survival rates were calculated according to the Ederer Ⅱ method.Finally,the relative survival rates and average annual percent changes of their trends were calculated.The age-standardized relative survival rates adjusted by International Cancer Survival Standard weights were calculated. Results:Total 644 520 new cancer cases were diagnosed during 2002-2013 in Shanghai,accounting for 643 545(99.85%)cases included in the observed cohort for survival analysis.The 5-year observed survival rate increased from 37.61%to 46.47%.The 5-year relative survival rate increased from 42.1 8%to 51.11%.The 5-year age-standardized relative survival rate increased from 40.57%to 49.80%.Among the 5-year relative survival rates of cases diagnosed during 2011 to 2013,99.43%of thyroid cancer was the highest,followed by female breast cancer(88.35%)and corpus uteri cancer(85.56%);5.87%of pancreas cancer was the lowest,followed by gallbladder cancer(13.64%)and oesophagus cancer(17.72%).the rate of lung cancer with the largest number of cases was 23.59%,followed by colorectal cancer(59.82%)and stomach cancer(38.65%).The 5-year relative survival rate of total cases of all sites increased from 40.55%in 2002 to 52.77%in 2013,with an average annual percent change of 2.40%.13 cancer types showed increasing trends,such as liver cancer and lung cancer,while the trends of other cancer types were not statistically significant,such as pancreatic cancer and gallbladder cancer. Conclusion:The diagnostic levels and survival rates of cancer cases have been improved continuously in Shanghai.The trends of different cancer types were varied.
3.Incidence and mortality of esophageal cancer in Shanghai 2016 and changing trend analysis from 2002 to 2016
Xiaocong ZHANG ; Peng PENG ; Chunxiao WU ; Yi PANG ; Chunfang WANG ; Mengyin WU ; Yangming GONG ; Ganling DING ; Chen FU ; Yan SHI ; Kai GU
Tumor 2023;43(4):287-296
Objective:More than half of esophageal cancer incidences and deaths occurred in China.Based on the Shanghai Tumor Registration data,this study analyzed the incidence and mortality of esophageal cancer in Shanghai in 2016 and the changing trend from 2002 to 2016,in order to provide an epidemic basis for the prevention and treatment of esophageal cancer. Methods:Data on esophageal cancer in Shanghai from 2002 to 2016 were obtained through Shanghai Municipal Center for Disease Control and Prevention Population-based Cancer Registry and Vital Statistics System.The number of cases and deaths,crude rates,composition ratios,age-specific rates and cumulative rates were counted according to the year of diagnosis or death,gender and age groups.Segi's 1960 world standard population was used to calculate age-standardized rates of incidence and mortality,and corresponding truncated age-standardized rate(35-64 years old)on esophageal cancer.Z-test and Cochran test were used to compare the differences of age-specific rates and age-standardized rates among different subgroups,respectively.Temporal trend analyses were conducted by Joinpiont 4.9.1.0 software. Results:In 2016,the proportion of morphological verification of new cases of esophageal cancer in Shanghai was 73.1 8%,the proportion of death certificate only was 0.72%,and the ratio of death to incidence was 0.84.The number of new cases and deaths of esophageal cancer in Shanghai in 2016 were 1 398 and 1 171,accounting for 1.88%and 3.1 6%of all malignant tumors,respectively.The crude incidence and mortality of esophageal cancer were 9.65/100 000 and 8.09/100000,with age-standardized incidence and mortality of 3.36/100 000 and 2.67/100,000,respectively.The age-standardized incidence and mortality were significantly higher in males than in females.The age-specific incidence and mortality increased with age,and peaked at 50.54/100 000 and 53.35/1 00 000,respectively,among people aged 85 years and older.From 2002 to 2016,both the number of new cases and deaths of esophageal cancer in Shanghai showed a downward trend,and the age-standardized incidence and mortality also showed a downward trend,with an average annual deceleration of 4.45%[annual percent change(APC)=-4.45,P<0.001]and 4.1 7%(APC=-4.17,P<0.001),respectively. Conclusion:The incidence and mortality of esophageal cancer in Shanghai were at a low epidemic level across China,and showed a downward trend from 2002 to 2016.Esophageal cancer screening should focus on males and subjects aged 55 to 64 years.
4.Colorectal cancer incidence and mortality trends in urban Shanghai,China from 1973 to 2017:a Joinpoint regression and age-period-cohort analysis
Mengyin WU ; Kai GU ; Chunxiao WU ; Yi PANG ; Chunfang WANG ; Yangming GONG ; Peng PENG ; Jianming DOU ; Xiaocong ZHANG ; Yongmei XIANG ; Yan SHI ; Yingbin LIU ; Chen FU
Tumor 2023;43(4):325-336
Objective:To describe the epidemiological features and temporal trends of colorectal cancer in urban Shanghai from 1973 to 2017. Methods:Data on colorectal cancer in urban Shanghai was obtained through Shanghai Cancer Registry and Vital Statistics System.Joinpoint analysis was used to describe the temporal trends and annual percent change(APC)and age-period-cohort analysis was used to estimate the association between age,period and birth cohort and colorectal cancer. Results:A total of 105 847 cases and 60 447 deaths of colorectal cancer were diagnosed in urban Shanghai over the 45-year study period.Both the number of new cases and the number of deaths showed an increasing trend.In the same period,the age-standardized incidence of colorectal cancer in urban areas of Shanghai increased significantly from 14.1/100 000 in 1973 to 27.7/100 000 in 2017,while the age-standardized mortality rate increased from 8.2/100 000 to 10.7/100 000.The overall average annual age-standardized incidence and mortality rates were 20.4/100 000 and 11.0/100 000,respectively.With the increase of age,the age-standardized morbidity and mortality of colorectal cancer showed an obvious upward trend.Taking 1993-1997 as reference,the risk of colorectal cancer in Shanghai reached the highest in 2013-2017,and the corresponding relative risk was 1.2(95%confidence interval:1.2-1.3),while the lowest was 0.9(95%confidence interval:0.8-1.0)during 1973-1977.Mortality risk,on the contrary,decreased with the increase of time.Before 1953-1957,the risk of colorectal cancer in urban Shanghai increased with the increase of birth cohort time,and then showed a downward trend.There was a corresponding decline in the risk of colorectal cancer death among people born after 1957. Conclusion:The incidence and mortality of colorectal cancer in Shanghai showed an increasing trend from 1973 to 2017,but the prevalence trend of colorectal cancer is still different among different populations.
5.The relationship between Helicobacter pylori eradication and gastric cancer in middle-aged and elderly population
Jie ZHOU ; Fanqian YANG ; Yukai ZHU ; Yukai ZHU ; Mengyin PENG ; Miao WU
Journal of Public Health and Preventive Medicine 2024;35(6):101-104
Objective To understand the incidence and mortality of gastric cancer in middle-aged and elderly population after Helicobacter pylori eradication , and provide theoretical guidance for the prevention of this disease in Luzhou area. Methods A total of 541 patients with Helicobacter pylori eradication from 2019 to 2021 were selected , they were divided into control group and observation group according to whether they developed gastric cancer in later stage, patients with gastric cancer due to Helicobacter pylori infection were selected as positive control group (N=205) . In addition, the expression of tumor markers such as CEA, CA199, CA125 and proliferation-related factor Ki67 were compared among the three groups, binary Logistic regression was used to analyze the risk factors of gastric cancer in the middle-aged and elderly population after Helicobacter pylori eradication. Results Among the 39(7.21%) of 541 patients developed gastric cancer after HP eradication , including 23males and 16females, with no gender difference (P>0.05) .The positive rate of moderate and severe atrophy of gastric mucosa and the ratio of PPI ≥1 year in the observation group were higher than those in the control group (P<0.05) . In addition , serum CEA , CA199 , CA125 levels were the highest in the positive control group , followed by the observation group , Ki67 expression was also the same. Logistic regression analysis showed that PPI ≥1 year (OR=1.642) , gastric mucosal atrophy (OR=1.459) or severe (OR=3.271) and presence of IM (OR= 3.669) were independent risk factors for gastric cancer after Hp eradication. Conclusion The risk of developing gastric cancer was higher in the middle-aged and elderly after Helicobacter pylori eradication , and the risk of developing gastric cancer was higher in patients with moderate or severe atrophy of gastric mucosa , PPI ≥1 year and having IM , gastroscopic screening should be strengthened to prevent gastric cancer..