Objective: To analyze the survival of esophageal cancer cases in Qidong, Jiangsu Province from 1972 to 2016, and provide a basis for the prognosis evaluation and prevention of esophageal cancer patients. Methods: The data of esophageal cancer were obtained from the Qidong Cancer Registration and Reporting System, and the follow-up date ended December 31, 2021. Observed survival rate (OSR) and relative survival rate (RSR) were calculated by SURV 3.01 software, and Hakulinen's likelihood ratio test was used for statistical difference comparison. Joinpoint regression model was used to conduct the average annual percentage change (AAPC) in esophageal cancer survival rate, and the ARIMA model was used to predict the trend of esophageal cancer survival rate. Results: During 1972 to 2016, there were 5 112 new cases of esophageal cancer in Qidong. The OSR of esophageal cancer at 1, 5 and 10 years were 24.43%, 6.93% and 4.43%, and the RSR at 1, 5 and 10 years were 25.88%, 9.35% and 8.34%, respectively. Dividing 1972-2016 into 9 periods, compared with 1972-1976, the 5-year RSR from 2012-2016 increased from 4.47% to 17.85%, and the RSR trend of the 9 periods was statistically significant (χ(2)=263.43, P<0.001). The survival rate of female with esophageal cancer was slightly higher than that of male, however, there was no significant difference in RSR between male and female (χ(2)=9.40, P=0.401). The 5-OSR and 5-RSR for male were 6.73% and 9.11%, and for female were 7.37% and 9.87%, respectively. The 5-RSR for the age groups of 45-54, 55-64, 65-74, and over 75 years old were 11.99%, 11.21%, 8.17% and 7.08%, respectively. There was a statistically significant difference in RSR among different age groups (χ(2)=98.19, P<0.001). The time trend results showed that the overall AAPC of the 5-RSR of esophageal cancer in Qidong from 1972 to 2016 was 3.89% (t=11.98, P<0.001). The 5-RSR uptrend was consistent among different genders, and the uptrend was greater in female (AAPC=4.25% for male, and AAPC=5.72% for female, P<0.05). Furthermore, the 5-RSR of esophageal cancer in all age groups showed an upward trend, and the upward trend was statistically significant in the 55-64-year-old group (AAPC=4.23%, P<0.05) and the 65-74-year-old group (AAPC=6.82%, P<0.05), there was no statistical significance in the 45-54-year-old group (AAPC=2.17%, P>0.05) and more than 75 years old group (AAPC=1.82%, P>0.05). Survival rate prediction of esophageal cancer showed that by 2026, 5-RSR will increase to 24.79%. Conclusions: During 1972 to 2016, the overall survival rate of esophageal cancer in the whole population of Qidong has improved to a certain extent, but there is still a large room for improvement. More emphasis should be continued to strengthen on the early diagnosis and early treatment of esophageal cancer.
目的：分析1972—2016年江苏省启东市食管癌患者的生存情况，为食管癌患者预后评价和制定防控措施提供依据。 方法：食管癌资料来源于启东市肿瘤登记报告系统，随访截至2021年12月31日。采用SURV 3.01软件计算观察生存率(OSR)和相对生存率(RSR)，Hakulinen氏似然比检验法进行趋势检验。采用Joinpoint回归模型计算生存率平均年度变化百分比(AAPC)，采用ARIMA模型进行食管癌生存率趋势预测。 结果： 1972—2016年启东市食管癌新发病例共5 112例，食管癌1、5、10年OSR分别为24.43%、6.93%和4.43%，1、5、10年RSR分别为25.88%、9.35%和8.34%。将1972—2016年分为9个时期，与1972—1976年相比，2012—2016年的5年RSR从4.47%上升至17.85%，9个时期的RSR上升趋势有统计学意义(χ(2)＝263.43，P<0.001)。女性食管癌生存率略高于男性，男女RSR差异无统计学意义(χ(2)＝9.40，P＝0.401)，男性5年OSR为6.73%，女性7.37%；男性5年RSR为9.11%，女性9.87%。45~54岁、55~64岁、65~74岁和≥75岁年龄组的5年RSR分别为11.99%、11.21%、8.17%和7.08%，各年龄组之间RSR差异有统计学意义(χ(2)＝98.19，P<0.001)。时间趋势结果显示，1972—2016年启东市食管癌5年RSR总体AAPC为3.89%(t＝11.98，P<0.001)，不同性别5年RSR上升趋势一致，女性提升更大(男性AAPC＝4.25%，女性AAPC＝5.72%，均P<0.05)。各年龄组食管癌5年RSR均呈上升趋势，55~64岁组(AAPC＝4.23%)和65~74岁组(AAPC＝6.82%)上升趋势有统计学意义(均P<0.05)；45~54岁组(AAPC＝2.17%)和≥75岁组(AAPC＝1.82%)无统计学意义(均P>0.05)。食管癌生存率预测结果显示，2026年启东市食管癌5年RSR将上升至24.79%。 结论： 1972—2016年启东市全人群食管癌总体生存率有了一定的提高，但仍有较大上升空间，应当继续加强重视食管癌早诊早治。.
Keywords: Cancer registry; Esophageal neoplasms; Qidong; Survival rate; Trends.