Analysis of incidence and mortality for upper digestive tract cancers and results of early detection and treatment program in Feicheng, Shandong Province / 中华预防医学杂志

ABSTRACT

Objective@#To investigate the trend of esophageal and stomach cancer incidence and mortality in Feicheng during 2000 to 2013, and to evaluate the effects of the national project of screening for upper digestive tract cancers from 2006 to 2015 in Feicheng.@*Methods@#We collected 26 569 cases, which were coded of C15 and C16 in the 10th edition of international classification of diseases (ICD) during the period of 2000-2013. The data came from cancer registration system of Feicheng, Shandong Province, China. These cases already covered 21 679 882 person-year. The annual percent change (APC) of incidence and mortalit were analyzed. The risk factors of upper gastrointestinal cancer were investigated and evaluated for people aging 40-69 in three street offices and eleven townships of Feicheng, and endoscopic screening was conducted among people who was in high risk. The corresponding data were used to analyze the early detection project of upper gastrointestinal cancer screening and early diagnosis, with the index of detection rate, early diagnosis rate, early treatment rate and other indicators.@*Result@#There were 26 569 new cases of esophageal cancer and gastric cancer occurred in Feicheng from 2000 to 2013. The incidence of esophageal cancer gradually increased since 2000 with 76.06 per 100 000 people (575/756 005) and reached the peak in 2010 with incidence rate of 118.76 per 100 000 people (852/717 429), with the annual percent change at about 4.3% (95%CI 2.7%-5.9%) and showed a downward trend after then but has no significance, with APC about-7.1% (95%CI-15.8%-2.5%). The incidence of gastric cancer was increased from 2000 with an incidence rate of 37.70 per 100 000 people (285/756 005) to 2013 with an incidence rate of 54.59 per 100 000 (538/985 512), with an annual percent change of about 3.3% (95%CI 2.1%-4.5%). Esophageal cancer and gastric cancer mortality showed a relatively stable trend during 2000 to 2013, esophageal cancer with APC about 0.1% (95%CI -1.3%-1.5%) and stomach cancer with APC about 0.8% (95%CI -0.5%-2.0%). From 2006 to 2015, 58 579 residents aged 40-69 years old participated cancer screening project covered 206 105 populations in Feicheng. There were 1 124 invasive cancers and in situ cases from upper digestive tract were detected, with the detective rate at 1.92%. Among those cases, 941 cases were in early stage with the early diagnosis rate of 83.72%, and about 88.97% of detected patients received appropriate treatment after diagnosis.@*Conclusion@#The incidence of esophageal cancer and gastric cancer with a very high level of incidence and mortality, this made the prevention and control situation was still very serious. The project of cancer screening, early diagnosis and treatment on upper digestive tract cancers in Feicheng plays a positive role on cancer control.