| Objectives: To describe and analyze the patterns and trends of cancer epidemic in Tianjin from 1981 to the year 2000, and to examine epidemic characteristics and determinants associated with the changes in cancer incidence and mortality.Methods: The new cases and deaths of cancer in Tianjin from 1981 to the year 2000 were coded according to ICD-0-1. Incidence and mortality of cancer were calculated by groups of calendar year, gender and age, and further the secular trends of cancer during the two decades were analyzed. Relative risks for cancer incidence and mortality were estimated for people in different generations, of different genders and ages. Cancers of different sites were ranked by various incidence and mortality indexes to show the relative seriousness from assorted respects.Results: Totally 148095 new cases (male: 79942, female: 68153) and 87969 deaths (male: 50396, female: 37573) were reported in Tianjin from 1981 to 2000. Averagely, the crude and age standardized incidence rates were 209.42/100,000 and 173. 97/100,000. For males, the corresponding rates were 224.34/100,000 and 194.54/100,000; for females, the rates were 194.26/100,000 and 155. 87/100, 000. On the other hand, the average crude and age standardized mortality rates were 124.39/100,000 and 103. 50/100, 000. For males, the corresponding rates were 141.42/100,000 and 123.02/100,000; for females, the rates were 107.10/100,000 and 85.78/100,000. Crude rates for cancer incidence and mortality both increased during the 20 years, with more increase in crude incidence. However, age standardized rate for incidence remained stable, meanwhile, age standardized rate for mortality was descending, and, apparently, mortality incidence ratio was also descending. In addition, mortality incidence ratio varies considerably between different age groups. The nadir of age specific mortality incidence ratio was observed within the age group 30-39. The peak age specific rate of cancer incidence was observed in the age group 75-79, while 80-84 years group for cancer mortality.In the last two decades, overall cancer incidence rate was on the rise for people 65 years of age or more, but the rate decreased for people aged between 35 and 64, for those less than 35 years as a whole, incidence kept almost unchanged. On the otherhand, mortality rates were unexceptionably descending for age group 0-34, 35-64 and 65 years or more. Cancer incidence rises as the mean-age of population increase, as for a 1-year increase in population mean-age, there will be correspondingly a 12.0/100000 and 3. 2/100000 increase in cancer incidence and mortality, respectively. The relative risk of cancer incidence between 1980s and 1990s was 1.03, and 1.11 between male and female, compared with people less than 45 years, the relative risk was 6. 38 for 45-54 years group, 15.60 for 55-64 years group, 30.05 for 65-74 years group and 35. 52 for '75 years or more' group.The top 5 cancer sites by incidence rate were: lung cancer, stomach cancer, liver cancer, breast cancer and colorectal cancer; and the corresponding cancer sites for mortality were: lung cancer, stomach cancer, liver cancer, esophagus cancer and colorectal cancer. Statistical increasing trends for crude incidence were found in 7 of the top 10 cancer sites, lung cancer, breast cancer, colorectal cancer and pancreatic cancer doubled during the 20 years. Only esophagus cancer exhibited a decreasing trend. On the other hand, Statistical increasing trends for standardized incidence were found in 5 of the top 10 cancer sites, among them, lung cancer increased the most dramatically, whereas esophagus cancer, stomach cancer and liver cancer all exhibited decreasing trends.Statistical increasing trends for crude mortality were found in 5 of the top 10 cancer sites, lung cancer increased the most dramatically. Descending trends were observed in esophagus and stomach cancer. On the other hand, Statistical increasing trends for standardized mortality were found in 2 of the top 10 cancer sites, lung cancer and brain cancer. Whereas... |
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