Objective: To estimate the incidence trend and change in the age distribution of female breast cancer in cancer registry areas in China from 2000 to 2014. Methods: 22 cancer registries in China with continuous monitoring data from 2000 to 2014 were selected. All datasets were checked and evaluated based on data quality control criteria and were included in the analysis. The cancer registries covered 675 954 193 person-years, including 342 010 930 person-years of male and 333 943 263 person-years of female. Female breast cancer cases (International Classification of Diseases-10(th) Revision: C50) were extracted. Crude incidence rate (CR), age-standardized incidence rate by Chinese standard population(ASIRC), annual percent change (APC), crude and adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were calculated. Results: Female breast cancer incidence rate significantly increased from 31.90/100 000 in 2000 to 63.30/100 000 in 2014. Incidence rate increased rapidly from 2000 to 2008 (CR: APC=6.5%, 95%CI: 5.3%-7.8%; ASIRC: APC=4.6%, 95%CI: 3.6%-5.7%). Its increment slowed down from 2008-2014 (CR: APC=3.2%, 95%CI: 1.4%-5.1%; ASIRC: APC=1.4%, 95%CI:-0.1%-2.9%). The crude mean age at onset increased from 54.4 in 2000 to 57.0 in 2014. Adjusted mean age at onset remained around 54.3 in 2014. Crude mean age at onset increased significantly over time in all registry areas (β=0.192, P<0.001), urban (β=0.205, P<0.001) and rural (β=0.092, P=0.014) areas, while adjusted mean age at onset remained stable in all registry areas (β=0.009, P=0.289), urban (β=0.017, P=0.139) and rural (β=-0.054, P=0.109) areas. Conclusion: Female breast cancer incidence rate in China increased from 2000 to 2014. Aging of the population resulted in a significant increase in crude mean age at onset. After age adjustment, no significant changes in age distribution were found.
目的： 分析2000—2014年中国肿瘤登记地区女性乳腺癌发病趋势及年龄变化情况。 方法： 选取全国具有2000—2014年连续登记数据的肿瘤登记点，对上述登记点的肿瘤监测数据进行审核、整理，最终共纳入22个登记点的监测数据，覆盖人口675 954 193人年，其中男性342 010 930人年，女性333 943 263人年。提取数据库中《国际疾病分类（第10版）》（ICD-10）编码为C50的全部女性乳腺癌发病病例信息。计算各年份女性乳腺癌患者发病率、中国人口标化发病率（中标率）、年变化百分比（APC）、实际平均发病年龄及标化平均发病年龄，按地区、年龄组分层后描述各年份发病率。利用线性回归模型探讨平均发病年龄与年份之间的相关性。 结果： 肿瘤登记地区女性乳腺癌发病率由2000年的31.90/10万上升至2014年的63.30/10万；2000—2008年女性乳腺癌发病率呈上升趋势（发病率：APC=6.5%，95%CI：5.3%~7.8%；中标率：APC=4.6%，95%CI：3.6%~5.7%），2008—2014年发病率上升速度有所减缓（发病率：APC=3.2%，95%CI：1.4%~5.1%；中标率：APC=1.4%，95%CI：-0.1%~2.9%）。女性乳腺癌实际平均发病年龄由2000年的54.4岁增长至2014年的57.0岁，2014年调整平均发病年龄保持在54.3岁。所有肿瘤登记地区（β=0.192，P<0.001）、城市地区（β=0.205，P<0.001）、农村地区（β=0.092，P=0.014）女性乳腺癌实际发病年龄均随年份的增加而上升；对人口结构进行标化后，未发现所有肿瘤登记地区（β=0.009，P=0.289）、城市地区（β=0.017，P=0.139）、农村地区（β=-0.054，P=0.109）的标化平均发病年龄与年份之间存在关联。 结论： 2000—2014年我国女性乳腺癌发病率呈上升趋势；人口老龄化导致实际发病年龄增高；调整人口结构后，没有发现女性乳腺癌的年龄发病特征出现变化。.
Keywords: Age; Aging; Breast neoplasms; Cross-sectional studies; Trend.