| Objective:Breast cancer is one of the most common malignant tumors in women,which has caused serious disease burden to society.The incidence of breast cancer in urban residents of Liaoning province is increasing year by year,and breast cancer has become a common malignant tumor in Liaoning province.Breast cancer survival data are updated slowly,and relative survival rate is used to compare the survival rate of breast cancer in different periods and different regions.The purpose of this study is to compare the 5-year relative survival rate of breast cancer patients diagnosed in urban residents of Liaoning Province from 2000 to 2002 and from 2008 to 2009,and to study the causes of the changes in the 5-year relative survival rate of the two periods,and to propose preventive measures for improving the survival rate of breast cancer in urban residents of Liaoning Province.To provide some reference for breast cancer surveillance and prevention in Liaoning province.Methods:Newly diagnosed breast cancer patients in Liaoning Cancer Incidence Report platform from 2000 to 2002 and 2008 to 2009 were selected.The basic information,clinical information and survival status of the patients were retrospectively investigated by using the self-designed follow-up sheet for diagnosis,treatment and survival status of cancer patients.After screening by inclusion and exclusion criteria,a total of 1105breast cancer patients were included.SPSS25.0 software was used to analyze the data,and the significance test wasα=0.05.Observed Survival Rate(OSR)was calculated using life table method,Expected Survival Rate(ESR)was calculated using EdererⅡ,Relative Survival Rate(RSR)was calculated using EdererⅡ.RSR was the ratio of observed survival rate to expected survival rate.The Z test was used to compare the survival rate of the two periods,and the Log-rank test was used to analyze the influence of the factors of the two periods on the survival rate.The Cox proportional hazards regression model was used to analyze the multivariate analysis of the two periods,and the chi-square test was used to analyze the difference in the constituent ratio of the two periods.Results:A total of 1105 breast cancer patients were included in this study,and the loss of follow-up rates in the two periods were 9.17%and 8.96%,respectively.Among the breast cancer patients diagnosed between 2000 and 2002,198 survived and 94 died.Among those diagnosed with breast cancer in 2008-2009,590 survived and 223 died.Compared with the characteristic composition ratio of patients in the two periods,the composition ratio of clinical stage(P=0.017),age of diagnosis(P<0.001)and pathological type(P<0.001)were different.In the comparison of 1-year relative survival rates to 5-year relative survival rates in the two periods,3-year relative survival rates,4-year relative survival rates and 5-year relative survival rates increased by 9.34%(P=0.000),8.73%(P<0.001)and 9.27%(P=0.006),respectively,which were statistically significant.The 5-year relative survival rate was increased by 6.39%(P=0.132)in stageⅠtoⅡand 6.44%in stageⅢtoⅣ(P=0.366).In the two age groups,the survival rate of 45-54 years increased by 23.04%(P<0.001)and that of over 75years increased by 44.88%(P=0.004).In terms of surgery,the survival rate of breast cancer patients who participated in surgery was improved by 9.65%(P=0.002).Among the pathological types,the increase of invasive breast cancer was 9.73%(P=0.012),invasive non-specific cancer was 28.47%(P=0.236),and invasive specific cancer was9.51%(P=0.015).Log-rank test results showed that different population characteristics,clinical stage,age of diagnosis and surgical conditions affected the survival rate of breast cancer patients in two periods,and the year of diagnosis(Log rankχ~2=3.75,P=0.053).Clinical stage(Log rankχ~2=113.163,P<0.001);The age of diagnosis(Log rankχ~2=80.871,P<0.001);Pathological type(Log rankχ~2=0.589,P=0.443);Surgery(Log rankχ~2=175.729,P<0.001).Cox risk ratio analysis showed that the death risk of breast cancer patients in 2008-2009 was lower than that in 2000-2002,HR=0.65(0.47-0.91),and the death risk in late clinical stage was much higher than that in early clinical stage,HR=3.82(2.75-5.3).The risk of breast cancer death increased with age at diagnosis,HR=0.97(057-1.63),HR=1.39(0.83-2.33),HR=1.63(1.01-2.64),HR=4.48(2.74-7.31),and the risk of death in patients with breast cancer treated with surgery was lower than those without surgery,HR=0.21(0.08-0.55).Stratified comparisons were made between the two periods of survival.In the stratified age of diagnosis,there was a difference in survival rate between the two periods between 45and 54 years old(P<0.001)and survival rate over 75 years old(P=0.017).In the stratification of surgical status,there was a difference in the survival rate of patients treated with surgery between the two periods(P=0.010),and there was a difference in the survival rate of patients without surgery between the two periods(P=0.046).Conclusion:This study compared the survival rate of patients diagnosed with breast cancer from 2000 to 2002 and from 2008 to 2009,including the comparison of 5-year relative survival rate at different age of diagnosis,different clinical stages,surgical conditions and pathological types in the two periods and the difference of composition ratio between different groups in the two periods.The 5-year relative survival rate of breast cancer patients in urban areas of Liaoning Province was improved.The survival rate of the two periods was affected by clinical stage,age,and whether surgery was performed or not.The reasons for the change of 5-year relative survival rate of urban breast cancer in Liaoning Province were firstly the change of the characteristics of the patient population and the decrease of the number of patients in clinical stageⅢ-Ⅳ.Second,the promotion of screening,more elderly patients have been screened out to get diagnosis and treatment;Third,the overall level of treatment was improved.Both patients who received surgery and those who did not received surgery received better treatment. |
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