以流行病學分析台灣大腸直腸癌之發生率

Epidemiology Analysis on the Incidence of Colorectal Cancer in Taiwan

羅傑明(Chieh-Ming Lo)

指導教授 ： 陳建良

國立暨南國際大學/管理學院/高階經營管理碩士學位學程/碩士(2021年)

https://doi.org/10.6837/ncnu202100188

摘要

癌症為當前我國 10 大死因之首。根據衛生福利部國民健康署民國 107 年癌
症登記報告，十大癌症中，大腸直腸癌的發生率排名，在男性為第一位，在女性
為第三位；死亡率排名，在男性為第三位，在女性為第四位。事實上，早期（0-I
期）大腸直腸癌 5 年存活率達 9 成，晚期（IV 期）大腸直腸癌 5 年存活率只剩
1 成；大腸直腸癌並不難預防，也非絕症。本論文透過大腸直腸癌性別發生率、
年齡別發生率、年齡別-年代別發生率的交叉分析，瞭解臺灣大腸直腸癌發生率
的長期變化，年齡別分層的趨勢，以及是否有隨著年代的不同而受影響。最後分
析癌症期別與年代別發生率，探究國民健康署在推動糞便潛血篩檢前後的差異，
以及之後實施擴大篩檢的差異。本論文主要的結論是，臺灣結腸癌和直腸癌標準
化發生率，男性和女性均隨著經濟成長而呈上升的趨勢，且男性發生率皆高於女
性。發生率隨著時間經過增加，主因可能是相關因子的改變而有增加的情形。此
外，本研究發現糞便潛血篩檢，顯著有助於找出更多早期（0-I 期）的病患

關鍵字

大腸直腸癌 ； 發生率 ； 長期趨勢

並列摘要

Cancer is the top 10 causes of death in Taiwan. According to the report of the
National Health Agency of the Ministry of Health and Welfare in the year of Republic
of China 107, colorectal cancer is the first commonly occurring cancer in men and
third in women. It is the third of leading cause of cancer death in men and fourth in
women. In fact, there is 90% of 5-year survival rate for early stage (stage 0-I) in
colorectal cancer but only 10% of 5-year survival rate for advanced stage (stage IV) in
colorectal cancer. Colorectal cancer is easy to prevent and is not a terminal illness.
Through the understanding of gender differences in incidence, the trend of yearly age
impact on gender, aged-adjusted and aged-specific incidence rate in colorectal cancer,
we studied the long-term and age-related changes in colorectal cancer incidence in
Taiwan. Furthermore, we also analyze the cancer incidence by stage and age and
investigate the differences in cancer incidence before and after the National Health
Administration launched fecal occult blood test and other subsequently added
screening tests as well. The main conclusion of this paper is that it is found that the
standardized incidence of colorectal cancer have an upward trend for men and
women with increasing economic growth of the years in Taiwan and men have higher
risk of developing colorectal cancer than women. As the time goes by and the rate
of colorectal cancer increasing, the main reason may be the increasing due to changes
in related factors. In addition, this study has found that the fecal occult blood
screening will significantly help to identify more (stage 0-I) patients in an early stage.

並列關鍵字

Colorectal cancer ； Incidence ； Long-term trend

參考文獻

一、中文文獻

TCOG大腸癌工作群編撰小組（2010）。大腸癌臨床診療指引。國家衛生研究院。

張展蔚（2017）。依照解剖學位置特性分析台灣結直腸癌(含肛門癌)發生率之流

行病學研究。國防醫學院公共衛生學研究所碩士論文。

劉奕志（2016）。大腸癌首發率之研究。真理大學財務與精算學系碩士論文。