2002-2021年上海市女性乳腺癌发病和死亡情况分析:基于人群基础的研究OA

Objective To analyze the epidemiological characteristics and trends of the incidence and mortality of female breast cancer in Shanghai from 2002 to 2021.Methods Data on new cases and deaths of female breast cancer from 2002 to 2021 were obtained from the Population-based Cancer Registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention.Cases or deaths,proportion,crude rate,age-specific rate,age-standardized rate(ASR)and others were calculated stratified by year of diagnosis or death and age-group.ASRs were calculated using Segi's 1960 world standard population.Trends of the annual percent change(APC)of ASRs,age-specific rates and proportions of new cases with selected diagnostic character of female breast cancer stratified by different groups were analyzed by Joinpoint analysis software.Results Annual new cases increased from 3 341 in 2002 to 7 086 in 2021,with ASR of incidence changing from 30.87/10⁵ to 46.62/10⁵.The trend of ASRs of incidence increased at an average annual rate of 2.25%(P<0.001)from 2002 to 2021.Annual deaths increased from 881 to 1 328,with ASR of mortality decreased from 7.71/10⁵ to 5.98/10⁵.The trend of ASRs of mortality increased at an average annual rate of 1.66%from 2002 to 2010(P=0.029),followed by a decelerating decline at an average annual rate of 2.44%from 2010 to 2021(P<0.001).In 2021,the crude rate of incidence of female breast cancer was 94.24/10⁵ in Shanghai,and the ASR was 46.62/10⁵.The crude rate of mortality was 17.66/10 ⁵,and the ASR was 5.98/10 ⁵.Age-specific rates of incidence and mortality generally increased with aging.The age-specific incidence rate peaked in the 60-64 years old(160.63/10⁵),followed by a marked decline after the 70-74 years old.The age-specific mortality rate peaked in the≥85 years old(99.35/10⁵).The analysis on age-specific trends showed increases of both the median and mean ages at onset of female breast cancer.Increasing trends in age-specific incidence rates were observed across the majority of age groups,whereas age-specific mortality rates showed declining trends.The proportion of morphological verification(MV)increased;however,the proportion of cases with unspecified histological type also increased.The proportions of cases diagnosed at Stage Ⅰ and unknown stage showed increasing trends.Conclusions The ASR of female breast cancer incidence in Shanghai remains relatively high,whereas the ASR of mortality has declined.The age-specific characteristics at onset showed a pronounced trend toward aging.Improvements in early detection and clinical management of breast cancer may have influenced these epidemiological features,contributing to reduced mortality through improved survival rates in Shanghai.Nevertheless,considerable scope remains for further advancements in screening,diagnosis,and survival improvement for breast cancer.This study provided a scientific basis for further research,prevention and control for breast cancer.