ABSTRACT
Objective:To characterize the trends in the incidence and mortality of colorectal cancer in Jing'an District of Shanghai， thus optimizing the prophylactic options for this malignancy. Methods:Data from Shanghai Cancer Registration and Reporting System were used to analyze the colorectal cancer prevalence in Jing'an District from 1993 to 2017. Joinpoint software was used to analyze the trends in the standardized incidence rate and mortality rate by calculating the annual percentage of change （APC） and the average annual percentage of change （AAPC）. Results:A total of 13 580 new cases of colorectal cancer were reported in Jing'an District during 1993 and 2017， with an average crude incidence rate of 52.94/105 and a standardized incidence rate of 24.77/105. The total number of deaths was 7 572， with an average crude mortality rate of 29.52/105 and a standardized mortality rate of 12.20/105. The standardized incidence rate of colorectal cancer in Jing'an District from 1993 to 2017 showed an increasing trend （AAPC=1.64%，P<0.001）， and the standardized incidence rate of colorectal cancer in both sexes increased （AAPC： 2.10% in men， 1.04% in women）. The age-standardized mortality rate （ASMR） did not change significantly. The incidence rate of colorectal cancer increased in men in both age groups of 50 to 74 years and 75 years and older， with an AAPC of 2.07% and 3.32%， respectively. However， this was not evident in women of all age groups. The mortality rate of colorectal cancer in men aged 0-49 years， as well as in men and women at 50-74 age groups， decreased significantly， with an AAPC of -7.46%，-1.13%， and -2.72%， respectively. The mortality rate of colorectal cancer in men of 75 years or older showed no significant trend， while that in women of 75 years or older increased （AAPC=2.30%）. Conclusion:The overall standardized incidence rate of colorectal cancer in Jing'an District from 1993 to 2017 was increased， and ASMR did not change significantly. Public health prophylactic options are suggested， including improvement of lifestyle/physical activity and eradication of precancerous lesion polypus in males aged ≥50 years to reduce the incidence of colorectal cancer， and enforcement of second-grade prophylaxis in females aged ≥75 years to decrease the mortality of colorectal cancer.
ABSTRACT
Objective:To analyze the long-term trend of viral hepatitis mortality in Jing’an District of Shanghai， and to provide a reference for viral hepatitis prevention and control. Methods:Mortality rate， standard mortality rate， PYLL and potential years of life lost rate （PYLL‰） of viral hepatitis in Jing’an district of Shanghai from 1976 to 2015 were calculated. The annual percent change （APC） of the mortality and PYLL‰ were analyzed by Joinpoint regression analysis. Results:From 1976 to 2015， there were 1 342 viral hepatitis death cases， including 832 males and 510 females. The average crude mortality rate was 8.31/100 000， and the average age-standardized mortality rate was 5.45/100 000. Among the deaths of viral hepatitis， men had a higher mortality rate， age-standardized mortality rate and PYLL% than women （χ2Pearson=107.34， 112.93， 39.15， all P<0.01）， men were mainly in the age group of 35-64 years （accounted for 62.62%）， while women were mainly in the age group of 65 years and above （accounted for 55.49 %）， and the average death age of men was earlier than that of women （by rank-sum test： Z=-8.879，P<0.01）. After 1990 （except in 2002）， hepatitis B was the main cause of deaths from viral hepatitis， accounting for 75.00%-100%， and the proportion of other and unclassified cases gradually decreased. Overall， the mortality rate of viral hepatitis declined significantly during 1976-2015 （APC=-2.0%，P<0.05）， with the turning point in 2002. The mortality rate of viral hepatitis declined significantly from 2002 to 2015 （APC=-8.1%，P<0.05）. The overall PYLL‰ of viral hepatitis declined significantly during 1976-2015 （APC=-3.7%，P<0.05）， with the turning point in 1992. After 1992， the PYLL‰ of viral hepatitis declined significantly during 1992-2015 （APC=-6.5%，P<0.05）. Conclusion:There has been a significant decline trend of viral hepatitis in the mortality rate in Jing’an District of Shanghai from 2002 to 2015， with hepatitis B as the main cause of death.