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Article(id=1240633242538275740, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202402086, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1707235200000, receivedDateStr=2024-02-07, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773719614871, onlineDateStr=2026-03-17, pubDate=1716566400000, pubDateStr=2024-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773719614871, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773719614871, creator=13701087609, updateTime=1773719614871, updator=13701087609, issue=Issue{id=1240633237542851387, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773719613680, creator=13701087609, updateTime=1773720039302, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240635022806405370, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240635022806405371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240633237542851387, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1736, endPage=1741, ext={EN=ArticleExt(id=1240633242794128297, articleId=1240633242538275740, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Time trend analyses of cancer incidence based on the Homepage of medical records, Sichuan, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the incidence trend of cancer from 2015 to 2020 in Sichuan Province and provide a reference for prevention and control of cancer.

Methods

Based on the cancer-related case information data on the Homepage of medical records in Sichuan Province from 2015 to 2020, the crude incidence rate was calculated, and the average annual change percentage (AAPC) of incidence rates was analyzed with Joinpoint 4.2.0.1.

Results

The new cancer cases in Sichuan Province increased from 181 490 in 2015 to 276 770 in 2020, and the incidence rate increased from 198.57/105 in 2015 to 304.76/105 in 2020. From 2015 to 2020, the average annual percentage change (AAPC) was 7.514%, 6.751%, 8.611%, 4.713%, and 6.838%, respectively. The incidence of cancer in the Chengdu Plain Economic Zone and the Northwest Sichuan Ecological Economic Zone showed a rising trend, AAPC values with statistical significancebeing 7.549% and 9.668%, respectively. From 2015 to 2020, the incidence rate of lung cancer, colorectal cancer, breast cancer, cervical cancer and prostate cancer in Sichuan Province showeda rising trend, with AAPC values of 11.220%(95%CI:5.866-16.845),6.606%(95%CI:1.395-13.202),6.322%(95%CI:1.411-11.472),5.765%(95%CI:1.431-10.284) and 13.222%(95%CI:7.396-19.364),respectively.

Conclusion

The incidence of cancer in Sichuan Province shows a rising trend, and the prevention and control situation is grim. Lung cancer, digestive system cancer, breast cancer, cervical cancer and prostate cancer are the dominant cancer types in Sichuan Province, and specific prevention, control and screening should be strengthened.

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目的

分析2015—2020年四川省恶性肿瘤发病趋势，为制定肿瘤防控规划和措施提供数据参考。

方法

基于四川省2015—2020年全省居民住院病历病案首页肿瘤相关的个案信息数据，计算发病率，使用Joinpoint 4.2.0.1计算平均年度变化百分比。

结果

2015—2020年间，四川省恶性肿瘤新发病例数从181 490例增加到276 770例，发病率从198.57/105上升到304.76/105，平均年度变化百分比（AAPC)分别为总体7.514%、男性6.751%、女性8.611%、城市4.713%、农村6.838%；成都平原经济区和川西北生态经济区恶性肿瘤发病上升趋势明显，AAPC值分别为7.549%、9.668%。2015—2020年四川省肺癌、结直肠癌、乳腺癌、宫颈癌和前列腺癌发病率均呈明显的上升变化趋势，AAPC值分别为11.220%（95%CI：5.866~16.845）、6.606%（95%CI：1.395~13.202）、6.322%（95%CI：1.411~11.472）、5.765%（95%CI：1.431~10.284）、13.222%（95%CI：7.396~19.364），差异均有统计学意义。

结论

四川省恶性肿瘤发病率随时间呈上升变化趋势，防控形势严峻。不同恶性肿瘤发病率变化趋势存在差异，肺癌、消化系统肿瘤、乳腺癌、宫颈癌和前列腺癌是四川省发病居前位的癌种，应增强特异性预防控制与筛查。

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张文彬，E-mail:
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刘潇霞（1984—），女，硕士，主治医师，研究方向: 肿瘤监测、肿瘤预防与控制；蔡红霞（1996—），女，硕士，医师,研究方向: 医疗质量管理、肿瘤流行病学

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刘潇霞（1984—），女，硕士，主治医师，研究方向: 肿瘤监测、肿瘤预防与控制；蔡红霞（1996—），女，硕士，医师,研究方向: 医疗质量管理、肿瘤流行病学

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刘潇霞（1984—），女，硕士，主治医师，研究方向: 肿瘤监测、肿瘤预防与控制；蔡红霞（1996—），女，硕士，医师,研究方向: 医疗质量管理、肿瘤流行病学

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International Journal of Environmental Research and Public Health, 2023, 20(1): 826., articleTitle=Analysis on incidence and mortality trends and age-period-cohort of breast cancer in Chinese women from 1990 to 2019, refAbstract=null)], funds=[Fund(id=1240633252386501088, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, awardId=2022NSFSC0640, language=CN, fundingSource=四川省自然科学基金(2022NSFSC0640), fundOrder=null, country=null), Fund(id=1240633252495553000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, awardId=2023YFG0148, language=CN, fundingSource=四川省科技厅重点研发项目(2023YFG0148), fundOrder=null, country=null), Fund(id=1240633252604604913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, awardId=2022-YF05-02005-SN, language=CN, fundingSource=成都市科技局技术创新研发项目(2022-YF05-02005-SN), fundOrder=null, country=null), Fund(id=1240633252776571389, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, awardId=S22004, language=CN, fundingSource=四川省医学科研课题计划(S22004), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240633245780471831, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, xref=1., ext=[AuthorCompanyExt(id=1240633245788860440, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, companyId=1240633245780471831, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Office of Sichuan Cancer Prevention and Control Center Department of Prevention, Sichuan Cancer Hospital&Institute, Sichuan Cancer Center, Cancer Hospital Affiliate to University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Cancer, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1240633245793054745, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, companyId=1240633245780471831, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川省肿瘤医院研究所，四川省癌症防治中心，电子科技大学附属肿瘤医院，四川省肿瘤临床医学研究中心，四川省癌症防治中心办公室（预防部），成都 610041)]), AuthorCompany(id=1240633245876940833, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, xref=2., ext=[AuthorCompanyExt(id=1240633245885329442, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, companyId=1240633245876940833, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.成都市第七人民医院,医疗质量管理部)]), AuthorCompany(id=1240633245998575660, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, xref=3., ext=[AuthorCompanyExt(id=1240633246006964269, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, companyId=1240633245998575660, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.四川省卫生健康信息中心)])], figs=[ArticleFig(id=1240633251228873098, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, language=EN, label=Fig.1, caption=Hospital-based incidence of Cancer from 2015 to 2020 in Sichuan Province, figureFileSmall=qDjq9Llpl6xCKlknAUddDw==, figureFileBig=VBExjy4mXnGVLHbbWcuoZw==, tableContent=null), ArticleFig(id=1240633251333730708, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, language=CN, label=图1, caption=2015—2020年四川省以医院为基础的恶性肿瘤发病情况

注：A：城、乡分类发病趋势；B：经济区分类发病趋势。

, figureFileSmall=qDjq9Llpl6xCKlknAUddDw==, figureFileBig=VBExjy4mXnGVLHbbWcuoZw==, tableContent=null), ArticleFig(id=1240633251577000356, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, language=EN, label=Fig.2, caption=Hospital-based incidence of major cancer from 2015 to 2020 in Sichuan Province, figureFileSmall=KSn/6/xP9KdXSrphoU3hvg==, figureFileBig=wjtC1KqNszdkNgAKLhh1Ow==, tableContent=null), ArticleFig(id=1240633251707023793, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, language=CN, label=图2, caption=2015—2020年四川省以医院为基础的重点恶性肿瘤发病情况

注：A：重点癌种发病趋势；B：特定性别癌种发病趋势。

, figureFileSmall=KSn/6/xP9KdXSrphoU3hvg==, figureFileBig=wjtC1KqNszdkNgAKLhh1Ow==, tableContent=null), ArticleFig(id=1240633251824464315, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, language=EN, label=Table 1, caption=

The incidence trend of Cancer based on hospital tumor surveillance from 2015 to 2020 in Sichuan Province

, figureFileSmall=null, figureFileBig=null, tableContent=
地区性别病例数（例）
201520162017201820192020
全部地区合计181 490242 731261 288261 667276 468276 770
男性107 044142 395153 648152 298158 627156 873
女性74 383100 283107 574109 278117 779119 890
城市地区合计98 751107 980120 496121 033127 933131 422
男性57 11562 62769 37868 72271 26972 348
女性41 60145 33751 09952 28256 63659 073
农村地区合计100 983128 149137 666137 708145 594144 908
男性60 85675 91882 51481 90785 68984 288
女性40 09052 19755 10855 74059 87260 614
成都平原经济区合计88 550115 763124 858125 919134 608137 836
男性51 73466 48472 85672 70176 26277 073
女性36 78649 259519735316058 30360 762
川南经济区合计31 08446 94351 33451 31653 61953 842
男性18 10227 79530 27029 96830 92130 704
女性12 97419 12921 04621 33822 69023 138
川东北经济区合计35 26359 43267 19466 12869 18368 471
男性21 51236 47240 56539 48341 09240 232
女性13 73922 95026 61726 62928 08628 238
攀西经济区合计5 97810 79211 11111 53212 26912 263
男性3 4375 9186 0366 2426 5666 414
女性2 5394 8735 0715 2845 6985 845
川西北生态经济区合计2 3713 1993 6653 8463 8483 918
男性1 3321 8762 1652 2352 1172 213
女性1 0371 3231 5001 6111 7311 704
地区性别发病率（1/105）AAPC（95%CI）（%）P
201520162017201820192020
全部地区合计198.77266.17286.33287.00303.80304.767.514(0.810~14.660)0.035
男性227.98303.73327.82325.56339.96337.096.751(-0.174~14.157)0.054
女性167.71226.30242.38246.17265.62270.768.611(2.182~15.445)0.020
城市地区合计286.08311.32345.11344.20360.28368.898.106(1.242~15.435)0.030
男性327.33357.62394.23388.38399.36404.577.212(-0.249~15.231)0.055
女性243.72264.00295.10299.28320.64332.939.332(3.258~15.764)0.012
农村地区合计177.83226.77244.36245.87262.37262.5610.165(-0.082~21.463)0.051
男性206.27258.49281.89281.60297.37294.159.522(-0.622~20.701)0.060
女性146.94192.32203.61207.04224.43228.4311.126(1.672~22.666)0.041
成都平原经济区合计226.78295.61317.81319.23339.42347.107.549(1.738~13.692)0.022
男性260.57334.14365.50363.78380.01383.936.851(1.894~13.159)0.033
女性191.67255.71268.54273.18297.61309.448.537(2.773~14.625)0.014
川南经济区合计171.51259.55283.95285.01299.74302.089.780(-0.006~20.524)0.050
男性193.58297.99324.57322.82335.36334.399.205(-1.205~20.713)0.071
女性147.89218.40240.46244.65261.75267.7610.607(1.729~20.261)0.029
川东北经济区合计135.90230.82262.47260.69276.02275.1212.720(-1.593~29.116)0.071
男性158.78271.23303.56298.30314.08309.7010.379(-4.542~27.633)0.132
女性110.81186.58217.51219.53234.41237.3610.689(-17.178~47.932)0.386
攀西经济区合计96.94174.42177.26181.75191.88191.2811.180(-2.165~26.346)0.083
男性108.32185.62187.21191.62200.19195.159.553(-2.827~23.510)0.102
女性84.81162.47166.59171.13182.97187.0813.198(-1.460~30.037)0.068
川西北生态经济区合计117.33158.89181.57191.24192.76197.559.688(1.929~18.039)0.025
男性129.90183.57211.51219.32209.69220.639.211(-0.148~19.448)0.052
女性104.15133.41150.80162.44175.44173.8410.383(4.495~16.602)0.007
), ArticleFig(id=1240633251962876358, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, language=CN, label=表1, caption=

2015—2020年四川省以医院为基础的恶性肿瘤发病率变化趋势情况

, figureFileSmall=null, figureFileBig=null, tableContent=
地区性别病例数（例）
201520162017201820192020
全部地区合计181 490242 731261 288261 667276 468276 770
男性107 044142 395153 648152 298158 627156 873
女性74 383100 283107 574109 278117 779119 890
城市地区合计98 751107 980120 496121 033127 933131 422
男性57 11562 62769 37868 72271 26972 348
女性41 60145 33751 09952 28256 63659 073
农村地区合计100 983128 149137 666137 708145 594144 908
男性60 85675 91882 51481 90785 68984 288
女性40 09052 19755 10855 74059 87260 614
成都平原经济区合计88 550115 763124 858125 919134 608137 836
男性51 73466 48472 85672 70176 26277 073
女性36 78649 259519735316058 30360 762
川南经济区合计31 08446 94351 33451 31653 61953 842
男性18 10227 79530 27029 96830 92130 704
女性12 97419 12921 04621 33822 69023 138
川东北经济区合计35 26359 43267 19466 12869 18368 471
男性21 51236 47240 56539 48341 09240 232
女性13 73922 95026 61726 62928 08628 238
攀西经济区合计5 97810 79211 11111 53212 26912 263
男性3 4375 9186 0366 2426 5666 414
女性2 5394 8735 0715 2845 6985 845
川西北生态经济区合计2 3713 1993 6653 8463 8483 918
男性1 3321 8762 1652 2352 1172 213
女性1 0371 3231 5001 6111 7311 704
地区性别发病率（1/105）AAPC（95%CI）（%）P
201520162017201820192020
全部地区合计198.77266.17286.33287.00303.80304.767.514(0.810~14.660)0.035
男性227.98303.73327.82325.56339.96337.096.751(-0.174~14.157)0.054
女性167.71226.30242.38246.17265.62270.768.611(2.182~15.445)0.020
城市地区合计286.08311.32345.11344.20360.28368.898.106(1.242~15.435)0.030
男性327.33357.62394.23388.38399.36404.577.212(-0.249~15.231)0.055
女性243.72264.00295.10299.28320.64332.939.332(3.258~15.764)0.012
农村地区合计177.83226.77244.36245.87262.37262.5610.165(-0.082~21.463)0.051
男性206.27258.49281.89281.60297.37294.159.522(-0.622~20.701)0.060
女性146.94192.32203.61207.04224.43228.4311.126(1.672~22.666)0.041
成都平原经济区合计226.78295.61317.81319.23339.42347.107.549(1.738~13.692)0.022
男性260.57334.14365.50363.78380.01383.936.851(1.894~13.159)0.033
女性191.67255.71268.54273.18297.61309.448.537(2.773~14.625)0.014
川南经济区合计171.51259.55283.95285.01299.74302.089.780(-0.006~20.524)0.050
男性193.58297.99324.57322.82335.36334.399.205(-1.205~20.713)0.071
女性147.89218.40240.46244.65261.75267.7610.607(1.729~20.261)0.029
川东北经济区合计135.90230.82262.47260.69276.02275.1212.720(-1.593~29.116)0.071
男性158.78271.23303.56298.30314.08309.7010.379(-4.542~27.633)0.132
女性110.81186.58217.51219.53234.41237.3610.689(-17.178~47.932)0.386
攀西经济区合计96.94174.42177.26181.75191.88191.2811.180(-2.165~26.346)0.083
男性108.32185.62187.21191.62200.19195.159.553(-2.827~23.510)0.102
女性84.81162.47166.59171.13182.97187.0813.198(-1.460~30.037)0.068
川西北生态经济区合计117.33158.89181.57191.24192.76197.559.688(1.929~18.039)0.025
男性129.90183.57211.51219.32209.69220.639.211(-0.148~19.448)0.052
女性104.15133.41150.80162.44175.44173.8410.383(4.495~16.602)0.007
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The incidence trend of primary cancer based on hospital tumor surveillance from 2015 to 2020 in Sichuan Province

, figureFileSmall=null, figureFileBig=null, tableContent=
癌种性别病例数（例）
201520162017201820192020
肺癌合计33 55144 27949 38350 11155 87760 838
男性23 00330 54833 40733 48436 51838 192
女性10 53213 71915 96316 60419 34422 646
结直肠癌合计19 70124 94127 84527 13628 86428 194
男性11 77215 10116 66816 25717 29016 784
女性7 9249 83511 16710 86811 56311 409
肝癌合计15 36421 52124 40624 17823 99323 299
男性11 76516 51618 80718 59218 61118 083
女性3 5945 0005 5955 5765 3795 216
食管癌合计16 81422 65123 45521 92621 41719 880
男性13 46917 86518 53117 41317 10315 984
女性3 3384 7804 9124 5034 3063 896
胃癌合计13 80318 75519 72118 88818 47317 340
男性10 23813 76914 39613 75713 28112 663
女性3 5614 9805 3205 1175 1884 675
女性乳腺癌女性9 06810 33912 03212 14512 72212 257
子宫颈癌女性6 4957 7848 3888 3528 9978 812
前列腺癌男性3 7524 9265 5666 1987 0316 990
癌种性别发病率（1/105）AAPC（95%CI）（%）P
201520162017201820192020
肺癌合计36.7548.5554.1254.9661.4066.9911.220(5.866~16.845)0.004
男性48.9965.1671.2871.5878.2682.079.366(3.408~15.667)0.011
女性23.7530.9635.9737.4043.6351.1415.037(10.618~19.633)0.001
结直肠癌合计21.5827.3530.5129.7631.7231.056.606(1.395~13.202)0.042
男性25.0732.2135.5634.7537.0536.076.536(1.090~13.397)0.048
女性17.8722.1925.1624.4826.0825.776.754(1.878~12.973)0.033
肝癌合计16.8323.6026.7526.5226.3725.661.542(-3.649~7.013)0.104
男性25.0635.2340.1339.7439.8938.861.920(-3.292~7.412)0.091
女性8.1011.2812.6112.5612.1311.780.481(-4.750~5.998)0.150
食管癌合计18.4224.8425.7024.0523.5321.891.828(-6.537~10.942)0.589
男性28.6938.1139.5437.2236.6534.352.086(-5.811~10.646)0.516
女性7.5310.7911.0710.149.718.801.078(-9.069~12.356)0.792
胃癌合计15.1220.5721.6120.7220.319.09-1.519(-10.185~7.982)0.668
男性21.8129.3730.7129.4128.4627.21-1.664(-10.139~7.610)0.632
女性8.0311.2411.9911.5311.7010.56-0.555(-9.749~9.576)0.881
女性乳腺癌女性20.4423.3327.1127.3628.6927.686.322(1.411~11.472)0.023
子宫颈癌女性14.6417.5718.9018.8120.2919.905.765(1.431~10.284)0.020
前列腺癌男性7.9910.5111.8813.2515.0715.0213.222(7.396~19.364)0.003
), ArticleFig(id=1240633252231311829, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240633242538275740, language=CN, label=表2, caption=

2015—2020年四川省以医院为基础的重点恶性肿瘤发病率变化趋势情况

, figureFileSmall=null, figureFileBig=null, tableContent=
癌种性别病例数（例）
201520162017201820192020
肺癌合计33 55144 27949 38350 11155 87760 838
男性23 00330 54833 40733 48436 51838 192
女性10 53213 71915 96316 60419 34422 646
结直肠癌合计19 70124 94127 84527 13628 86428 194
男性11 77215 10116 66816 25717 29016 784
女性7 9249 83511 16710 86811 56311 409
肝癌合计15 36421 52124 40624 17823 99323 299
男性11 76516 51618 80718 59218 61118 083
女性3 5945 0005 5955 5765 3795 216
食管癌合计16 81422 65123 45521 92621 41719 880
男性13 46917 86518 53117 41317 10315 984
女性3 3384 7804 9124 5034 3063 896
胃癌合计13 80318 75519 72118 88818 47317 340
男性10 23813 76914 39613 75713 28112 663
女性3 5614 9805 3205 1175 1884 675
女性乳腺癌女性9 06810 33912 03212 14512 72212 257
子宫颈癌女性6 4957 7848 3888 3528 9978 812
前列腺癌男性3 7524 9265 5666 1987 0316 990
癌种性别发病率（1/105）AAPC（95%CI）（%）P
201520162017201820192020
肺癌合计36.7548.5554.1254.9661.4066.9911.220(5.866~16.845)0.004
男性48.9965.1671.2871.5878.2682.079.366(3.408~15.667)0.011
女性23.7530.9635.9737.4043.6351.1415.037(10.618~19.633)0.001
结直肠癌合计21.5827.3530.5129.7631.7231.056.606(1.395~13.202)0.042
男性25.0732.2135.5634.7537.0536.076.536(1.090~13.397)0.048
女性17.8722.1925.1624.4826.0825.776.754(1.878~12.973)0.033
肝癌合计16.8323.6026.7526.5226.3725.661.542(-3.649~7.013)0.104
男性25.0635.2340.1339.7439.8938.861.920(-3.292~7.412)0.091
女性8.1011.2812.6112.5612.1311.780.481(-4.750~5.998)0.150
食管癌合计18.4224.8425.7024.0523.5321.891.828(-6.537~10.942)0.589
男性28.6938.1139.5437.2236.6534.352.086(-5.811~10.646)0.516
女性7.5310.7911.0710.149.718.801.078(-9.069~12.356)0.792
胃癌合计15.1220.5721.6120.7220.319.09-1.519(-10.185~7.982)0.668
男性21.8129.3730.7129.4128.4627.21-1.664(-10.139~7.610)0.632
女性8.0311.2411.9911.5311.7010.56-0.555(-9.749~9.576)0.881
女性乳腺癌女性20.4423.3327.1127.3628.6927.686.322(1.411~11.472)0.023
子宫颈癌女性14.6417.5718.9018.8120.2919.905.765(1.431~10.284)0.020
前列腺癌男性7.9910.5111.8813.2515.0715.0213.222(7.396~19.364)0.003
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基于病案首页数据的四川省2015—2020年恶性肿瘤发病时间趋势分析
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刘潇霞 1 , 蔡红霞 2 , 乔良 1 , 张文彬 1 , 李丽娜 1 , 马婧 1 , 钟志刚 1 , 罗玉英 3
现代预防医学 | 流行病与统计方法 2024,51(10): 1736-1741
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现代预防医学 | 流行病与统计方法 2024, 51(10): 1736-1741
基于病案首页数据的四川省2015—2020年恶性肿瘤发病时间趋势分析
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刘潇霞1, 蔡红霞2, 乔良1, 张文彬1 , 李丽娜1, 马婧1, 钟志刚1, 罗玉英3
作者信息
  • 1.四川省肿瘤医院研究所，四川省癌症防治中心，电子科技大学附属肿瘤医院，四川省肿瘤临床医学研究中心，四川省癌症防治中心办公室（预防部），成都 610041
  • 2.成都市第七人民医院,医疗质量管理部
  • 3.四川省卫生健康信息中心

    • 刘潇霞（1984—），女，硕士，主治医师，研究方向: 肿瘤监测、肿瘤预防与控制；蔡红霞（1996—），女，硕士，医师,研究方向: 医疗质量管理、肿瘤流行病学

通讯作者:

张文彬，E-mail:
Time trend analyses of cancer incidence based on the Homepage of medical records, Sichuan
Xiao-xia LIU1, Hong-xia CAI2, Liang QIAO1, Wen-bin ZHANG1 , Li-na LI1, Jing MA1, Zhi-gang ZHONG1, Yu-ying LUO3
Affiliations
  • Office of Sichuan Cancer Prevention and Control Center Department of Prevention, Sichuan Cancer Hospital&Institute, Sichuan Cancer Center, Cancer Hospital Affiliate to University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Cancer, Chengdu, Sichuan 610041, China
出版时间: 2024-05-25 doi: 10.20043/j.cnki.MPM.202402086
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摘要
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目的

分析2015—2020年四川省恶性肿瘤发病趋势，为制定肿瘤防控规划和措施提供数据参考。

方法

基于四川省2015—2020年全省居民住院病历病案首页肿瘤相关的个案信息数据，计算发病率，使用Joinpoint 4.2.0.1计算平均年度变化百分比。

结果

2015—2020年间，四川省恶性肿瘤新发病例数从181 490例增加到276 770例，发病率从198.57/105上升到304.76/105，平均年度变化百分比（AAPC)分别为总体7.514%、男性6.751%、女性8.611%、城市4.713%、农村6.838%；成都平原经济区和川西北生态经济区恶性肿瘤发病上升趋势明显，AAPC值分别为7.549%、9.668%。2015—2020年四川省肺癌、结直肠癌、乳腺癌、宫颈癌和前列腺癌发病率均呈明显的上升变化趋势，AAPC值分别为11.220%（95%CI：5.866~16.845）、6.606%（95%CI：1.395~13.202）、6.322%（95%CI：1.411~11.472）、5.765%（95%CI：1.431~10.284）、13.222%（95%CI：7.396~19.364），差异均有统计学意义。

结论

四川省恶性肿瘤发病率随时间呈上升变化趋势，防控形势严峻。不同恶性肿瘤发病率变化趋势存在差异，肺癌、消化系统肿瘤、乳腺癌、宫颈癌和前列腺癌是四川省发病居前位的癌种，应增强特异性预防控制与筛查。

恶性肿瘤  /  发病率  /  时间趋势  /  病案首页
Objective

To analyze the incidence trend of cancer from 2015 to 2020 in Sichuan Province and provide a reference for prevention and control of cancer.

Methods

Based on the cancer-related case information data on the Homepage of medical records in Sichuan Province from 2015 to 2020, the crude incidence rate was calculated, and the average annual change percentage (AAPC) of incidence rates was analyzed with Joinpoint 4.2.0.1.

Results

The new cancer cases in Sichuan Province increased from 181 490 in 2015 to 276 770 in 2020, and the incidence rate increased from 198.57/105 in 2015 to 304.76/105 in 2020. From 2015 to 2020, the average annual percentage change (AAPC) was 7.514%, 6.751%, 8.611%, 4.713%, and 6.838%, respectively. The incidence of cancer in the Chengdu Plain Economic Zone and the Northwest Sichuan Ecological Economic Zone showed a rising trend, AAPC values with statistical significancebeing 7.549% and 9.668%, respectively. From 2015 to 2020, the incidence rate of lung cancer, colorectal cancer, breast cancer, cervical cancer and prostate cancer in Sichuan Province showeda rising trend, with AAPC values of 11.220%(95%CI:5.866-16.845),6.606%(95%CI:1.395-13.202),6.322%(95%CI:1.411-11.472),5.765%(95%CI:1.431-10.284) and 13.222%(95%CI:7.396-19.364),respectively.

Conclusion

The incidence of cancer in Sichuan Province shows a rising trend, and the prevention and control situation is grim. Lung cancer, digestive system cancer, breast cancer, cervical cancer and prostate cancer are the dominant cancer types in Sichuan Province, and specific prevention, control and screening should be strengthened.

Cancer  /  Incidence  /  Time trend  /  The homepage of medical records
刘潇霞, 蔡红霞, 乔良, 张文彬, 李丽娜, 马婧, 钟志刚, 罗玉英. 基于病案首页数据的四川省2015—2020年恶性肿瘤发病时间趋势分析. 现代预防医学, 2024 , 51 (10) : 1736 -1741 . DOI: 10.20043/j.cnki.MPM.202402086
Xiao-xia LIU, Hong-xia CAI, Liang QIAO, Wen-bin ZHANG, Li-na LI, Jing MA, Zhi-gang ZHONG, Yu-ying LUO. Time trend analyses of cancer incidence based on the Homepage of medical records, Sichuan[J]. Modern Preventive Medicine, 2024 , 51 (10) : 1736 -1741 . DOI: 10.20043/j.cnki.MPM.202402086
正文
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据国家癌症中心发布的肿瘤登记数据估算，2018年我国新发癌症超过482万例，死亡约257万例。长期以来，恶性肿瘤所致的死亡在我国居民总死亡中占比位居前列[1]，疾病负担严重。长期持续、实时准确掌握当地恶性肿瘤发病及变化趋势，对癌症防控决策至关重要。本文基于四川省2015—2020年四川省居民住院病案首页肿瘤相关的个案信息数据，对恶性肿瘤发病率进行分析，纵向呈现覆盖全省全域的恶性肿瘤发病趋势，为肿瘤预防控制策略和措施的制定提供基线数据参考。
1　资料与方法
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1.1　资料来源
“四川省肿瘤随访登记大数据服务平台”是四川省以医院为基础、汇聚全省肿瘤相关住院病案首页的肿瘤监测平台（后简称“平台”），该平台采集了2015—2020年全省开展住院医疗服务的医疗机构肿瘤相关病案首页信息，按照中国肿瘤登记信息统计要求，对病案首页中患者基本信息、全部诊断治疗信息、出入院信息等数据进行逻辑判定、整合[2-3]，共计采集6 848家医疗机构2015—2020年质量合格的病案首页记录8 282 254份，其中四川省户籍病案首页6 971 019份，覆盖全省21个市州、183个县区的9 117.22万户籍人口，县区覆盖率100%，全省二级及以上医疗机构采集率达99%以上。按照国家癌症中心下发的《中国肿瘤登记工作指导手册（2016）》定义，将首次发生的恶性肿瘤及中枢神经系统良性肿瘤患者（所患癌种ICD-10编码为C00—C97、D32—D33、D42—D43、D45—D47）作为统计对象[4-5]。人口数据来源于四川省人口普查信息统计。
1.2　统计学处理
按照国家标准GB2260—2015，将四川省地级以上城市归为城市地区，县及县级市归为农村地区。按照四川省发展与改革委员会制定的经济区分类标准，将四川省按经济发展特征划分为成都经济区（包括成都市、德阳市、绵阳市、眉山市、资阳市）、川南经济区（包括自贡市、泸州市、宜宾市、内江市、乐山市）、攀西经济区（包括攀枝花市、凉山州、雅安市）、川东北经济区（包括遂宁市、南充市、达州市、广安市、巴中市、广元市）和川西北生态经济区（包括阿坝州、甘孜州）[6]。
所有数据通过Excel 2019、SPSS 23.0、Joinpoint 4.2.0.1软件进行整理和分析拟合，根据2000年第五次全国人口普查结构和Segi世界人口结构为标准对发病率进行标准化，分别计算中标率和世标率[7]；通过JoinPoint对数线性模型，计算平均年度变化百分比（average annual percent change，AAPC），评价发病率的时间趋势，以α=0.05为检验水准来检验趋势是否有统计学意义[8]。
2　结果
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2.1　2015—2020年四川省恶性肿瘤整体发病趋势
2015—2020年四川省恶性肿瘤发病率从2015年的198.77/105上升到2020年304.76/105，发病率AAPC值为7.514%（P=0.035）；男性发病率从2015年的227.98/105上升到2020年337.09/105，发病率AAPC值为6.751%（P=0.054）；女性发病率从2015年的167.71/105上升到2020年270.76/105，AAPC值为8.611%（P=0.020）；城市地区发病率从2015年的286.08/105上升到2020年的368.89/105，发病率AAPC值为8.106%（P=0.030），农村地区发病率从2015年的177.83/105上升到2020年的262.56/105，发病率AAPC值为10.165%（P=0.051），城市、农村地区女性人群发病率变化差异具有统计学意义（P小于0.05）；成都平原经济区发病率从2015年的226.78/105上升到2020年的347.10/105，川南经济区发病率从171.51/105提高到302.08/105，川东北经济区发病率从135.90/105上升到275.12/105，攀西经济区发病率从96.94/105提高到191.28/105，川西北生态经济区发病率从117.33/105上升到197.55/105，发病率AAPC值分别为7.549%（P=0.022）、9.780%（P=0.050）、12.720%（P=0.071）、11.180%（P=0.083）、9.688%（P=0.025）。各经济区人群发病率呈上升趋势变化，AAPC值均大于5%，成都平原经济区和川西北生态经济区各年度发病率变化差异具有统计学差异（P<0.05），川南经济区、川东北经济区和攀西经济区差异无统计学意义（P>0.05）。详见表1、图1。
2.2　2015—2020年四川省重点恶性肿瘤发病趋势
2015—2020年四川省肺癌、结直肠癌、女性乳腺癌、宫颈癌和男性前列腺癌疾病负担严重。肺癌发病率从36.75/105上升到66.99/105，AAPC值为11.22%（P=0.004），其中男性发病率AAPC值为9.366% (P=0.011)，女性发病率AAPC值为15.037%（P=0.001）；结直肠癌发病率从21.58/105上升到31.05/105，AAPC值为6.606%（P=0.042），其中男性AAPC值为6.536% (P=0.048)，女性AAPC值为6.754%（P=0.033）；乳腺癌发病率从20.44/105上升到27.68/105，AAPC值为6.322%（P=0.023）；子宫颈癌从14.64/105上升到19.90/105，AAPC值为5.765%（P=0.020）；前列腺癌从上升到7.99/105上升到15.02/105，AAPC值为13.222%（P=0.003），差异均有统计学意义（P<0.05）；肝癌发病率从16.83/105上升到2017年的26.75/105后略有下降到2020年的25.66/105，食管癌发病率从18.42/105上升到2017年的25.70/105后略有下降到2020年的21.89/105，胃癌发病率从15.12/105上升到2017年的21.61/105后略有下降到2020年的19.09/105。食管癌、肝癌和胃癌发病率的时间变化趋势不明显，详见表2、图2。
3　讨论
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本研究结果显示，2015—2020年四川省恶性肿瘤发病率逐年升高,人口老龄化程度、恶性肿瘤相关危险因素暴露水平、筛查技术推广、筛查可及性以及当地医疗卫生水平等都是影响恶性肿瘤流行特征及变化的因素[9]。
恶性肿瘤的发病具有明显的地区差异和性别差异，根据各年中国肿瘤登记年报数据显示，我国恶性肿瘤发病率城市高于农村，男性高于女性，但近年来肺癌等高发恶性肿瘤发病的城乡间、性别间差距在逐渐缩小[10]。与四川省结果一致，但同时本研究数据显示，2015—2020年间，四川省城市、农村地区女性人群发病率显著上升，增幅较大（城市AAPC=9.332%、农村AAPC=11.126%），高于全国水平，反映了四川省女性癌症发病率整体水平虽低于男性，但增长速度较大，可能受生理和行为因素影响。例如：女性吸烟年代比男性吸烟滞后数年至数十年所致的女性肺癌发病上升时期延后[10]；雌激素使用所致的女性乳腺癌发病上升；近年女性“两癌”筛查覆盖范围扩大，提高了检出率。与此同时，四川省城市地区、成都平原经济区发病率增幅显著，可能受城市化进程加快，生活方式趋向于西方发达国家模式，行为方式相关恶性肿瘤发病呈上升趋势。川西北生态经济区女性人群发病率增幅显著，可能是受益于近年来政策引领下癌防工作全面推进，填补了民族地区癌症健康教育和筛查的空白，逐渐树立正确的癌防健康意识，提高了筛查检出率。因此，应重视女性人群的癌防健康教育和早期筛查。
四川省肺癌发病率高居首位，在男性、女性及城乡发病顺位中均位居第一位，且发病随时间的变化呈明显上升趋势（AAPC=11.22%），女性（AAPC=15.037%）明显高于男性（AAPC=9.366%）。吸烟是导致肺癌最重要的病因，全球70%以上的肺癌病理是有吸烟引起的[11]，肺癌的流行变化趋势很大程度与烟草消费量的变化趋势相关。我国是全球最大的烟草生产国和消费国，烟草的控制形势严峻。近年来，我国人群的总体吸烟率虽有所下降，但至2018年，我国成年男性中仍有半数吸烟[12]，女性和青少年吸烟率也在上升[13]。《四川省人群健康状况及重点疾病报告》显示[14]，2017年四川省成年人吸烟率、二手烟暴露率分别为30.34%、69.56%，到2021年依然维持在29.40%和67.52%[14-15]，控烟和降低二手烟暴露率可能是四川省降低肺癌发病率的重要途径。近年来北京、上海、深圳等发达地区相继出台和实施了严格的公共场所禁烟令，四川地区也有广泛推行，但缺乏更严格的法规文件，执行力度有待加强。此外，还应从空气污染、职业暴露等多方位、多渠道控制危险因素，提高居民对肺癌筛查的认知和意识。
2015—2020年间，四川省包括食管癌、肝癌、胃癌在内的消化系统恶性肿瘤发病率呈上升后下降趋势，与全国及其他省的变化趋势基本一致[16-18]，提示我国在消化系统恶性肿瘤，尤其是上消化道癌、肝癌的防治方面取得了一定成效。但结直肠癌发病率有明显的上升趋势,女性上升趋势略高于男性，这与全国结直肠癌近几年发病趋势一致[19]。可能与经济发展带来的人群饮食模式发生转变，高脂高热食品摄入过多而蔬菜水果摄入减少，也与老龄化加剧、肥胖率增高、社会精神压力增加等问题相关[20]。《中国结直肠癌筛查与早诊早治指南（2020，北京）》明确指出[21]，结直肠镜是识别结直肠癌早期病变切实可行的方法，因此适时推行并扩大结直肠癌机会性筛查覆盖面，可以有效提高早期病变检出率，降低发病率和死亡率。
四川省特定性别的恶性肿瘤发病呈明显的上升趋势。男性前列腺癌发病随时间的变化呈明显上升趋势（AAPC=13.222%），可能与吸烟、缺乏运动、不良环境因素影响以及发病年龄晚等因素有关[22-23]，因此前列腺癌的早期预防是降低发病与死亡的关键措施。女性乳腺癌、宫颈癌发病也呈逐年上升趋势（乳腺癌AAPC=6.322%，宫颈癌AAPC=5.765%），除与年龄、激素水平和筛查等密切相关外，可能也与近年来社会经济快速发展，不健康生活方式以及生殖模式的改变等有关[24]。
综上所述，四川省恶性肿瘤发病随时间呈上升趋势，呈现地区、性别和癌种差异性，防控形势严峻。四川省居民在控烟、饮食结构优化以及倡导运动等方面尚有较大优化空间，可作为癌防健康教育的重点方向；开展有针对性健康教育的同时，重视肺癌、消化道恶性肿瘤、男性前列腺癌、女性乳腺癌、宫颈癌筛查与早诊早治，推进重点癌症风险评估和机会性筛查的覆盖范围，提升基层筛查能力建设。同时从政策层面制定相关政策法规，多维度多途径改善危险因素的暴露，优化癌症防控策略，形成由政府、社会、家庭和个人共同参与的癌症防控体系。
基金
收起
  • 四川省自然科学基金(2022NSFSC0640)
  • 四川省科技厅重点研发项目(2023YFG0148)
  • 成都市科技局技术创新研发项目(2022-YF05-02005-SN)
  • 四川省医学科研课题计划(S22004)
文献
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2024年第51卷第10期
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doi: 10.20043/j.cnki.MPM.202402086
  • 接收时间：2024-02-07
  • 首发时间：2026-03-17
  • 出版时间：2024-05-25
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  • 收稿日期：2024-02-07
基金
四川省自然科学基金(2022NSFSC0640)
四川省科技厅重点研发项目(2023YFG0148)
成都市科技局技术创新研发项目(2022-YF05-02005-SN)
四川省医学科研课题计划(S22004)
作者信息
    1.四川省肿瘤医院研究所，四川省癌症防治中心，电子科技大学附属肿瘤医院，四川省肿瘤临床医学研究中心，四川省癌症防治中心办公室（预防部），成都 610041
    2.成都市第七人民医院,医疗质量管理部
    3.四川省卫生健康信息中心

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2种不同金属材料的力学参数
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species		 占总种数比例
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total species (%)		 属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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