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.
目的： 分析山东省肥城市2000—2013年上消化道癌症发病死亡趋势，对2006至2015年肥城市上消化道癌早诊早治效果进行评估。 方法： 提取山东省肥城市肿瘤登记处的肿瘤登记系统中2000—2013年国际疾病分类编码第10版中编码为C15、C16全部患者信息，共计26 569例，覆盖人口21 679 882人年。分析上消化道癌症发病、死亡率的变化趋势，计算年度变化百分率（APC）。2006—2015年先后对肥城市3个街道办事处和11个乡镇的40~69岁户籍人口居民进行上消化道癌症危险因素调查和风险评估，对评估的高危人群进行内镜筛查。分析上消化道癌症筛查和早诊早治项目的检出率、早诊率、早治率。 结果： 2000—2013年间，肥城市食管癌和胃癌新发病例26 569例，食管癌发病率从2000年的76.06/10万（575/756 005）上升至2010年的118.76/10万（852/717 429），APC为4.3%（95%CI：2.7%~5.9%），然后开始呈现下降趋势，APC为-7.1%(95%CI：-15.8%~2.5%)，但无统计学意义。胃癌发病率自2000年的37.70/10万（285/756 005）上升至2013年的54.59/10万（538/985 512），APC为3.3%（95%CI：2.1%~4.5%）。2000—2013年食管癌和胃癌死亡率均呈现相对平稳的趋势，食管癌、胃癌死亡率APC分别为0.1%(95%CI：-1.3%~1.5%)、0.8%(95%CI：-0.5%~2.0%)。2006—2015年，共完成问卷评估206 105名，58 579例40~69岁人群接受内镜癌筛查且数据完整，检出病例1 124例，检出率为1.92%；其中早期病例941例，早诊率为83.72%。接受治疗患者1 000例，治疗率为88.97%。 结论： 肥城市上消化道癌症发病、死亡水平较高，防控形势严峻，筛查和早诊早治对上消化道癌的控制具有重要意义。.
Keywords: Esophageal neoplasms; Mortality; Screening; Treatment outcome; Trend analysis.