2012-2017年潍坊市恶性肿瘤发病与死亡流行病特征及变化趋势分析
|
摘要
目的恶性肿瘤已成为严重影响居民健康的重大疾病,掌握其发病和死亡状况是开展肿瘤防治工作的基础和前提。本研究分析2012-2017年潍坊市恶性肿瘤发病、死亡特点及变化趋势,为制定肿瘤综合防治策略提供科学依据。方法收集2012-2017年潍坊市恶性肿瘤发病和死亡数据,通过计算粗发病率、粗死亡率、2000年中国人口标化发病率和标化死亡率描述发病和死亡现状,使用Joinpoint回归计算年度变化百分比(annual percent change,APC)和年度变化贡献率描述年度时间趋势。结果 2012-2017年潍坊市恶性肿瘤标化发病率和标化死亡率分别为201.53/10万人口和109.62/10万人口,发病率和死亡率随年龄增长而增加,均在80～84岁达到峰值。总人群恶性肿瘤标化发病率(APC=-3.09%,t=1.03,P=0.36)和标化死亡率(APC=-2.34%,t=0.80,P=0.47)呈下降趋势,但差异无统计学意义。2012-2017年潍坊市总人群结直肠癌粗发病率(APC=4.28%,t=3.54,P=0.03)和粗死亡率(APC=7.44%,t=11.10,P<0.001),甲状腺癌粗发病率(APC=13.16%,t=7.40,P<0.001)和标化发病率(APC=20.93%,t=3.89,P=0.02),宫颈癌标化发病率(APC=8.44%,t=3.23,P=0.03),膀胱癌粗死亡率(APC=7.24%,t=4.38,P=0.01)呈上升趋势,差异有统计学意义;胃癌(APC=-3.63%,t=9.92,P<0.001)和食管癌(APC=-3.78%,t=4.67,P=0.02)粗发病率呈下降趋势,差异有统计学意义。男性胃癌粗发病率(APC=3.18%,t=8.47,P<0.001),结直肠癌粗发病率(APC=5.62%,t=4.34,P=0.02)和粗死亡率(APC=9.48%,t=6.12,P<0.001),膀胱癌粗死亡率(APC=7.97%,t=3.60,P=0.02),前列腺癌粗发病率(APC=16.61%,t=4.36,P<0.001)呈上升趋势,差异有统计学意义;食管癌粗发病率(APC=-3.85%,t=18.37,P<0.001)呈下降趋势,差异有统计学意义。女性宫颈癌标化发病率(APC=8.44%,t=3.23,P=0.03),甲状腺癌粗发病率(APC=13.09%,t=5.65,P=0.01)、标化发病率(APC=21.92%,t=3.54,P=0.02)和粗死亡率(APC=18.70%,t=2.82,P=0.04),卵巢癌粗死亡率(APC=13.26%,t=6.24,P<0.001)呈上升趋势,差异有统计学意义;胃癌粗发病率(APC=-5.15%,t=9.50,P<0.001)呈下降趋势,差异有统计学意义。肺癌对标化发病率和标化死亡率下降贡献最大,贡献率分别为42.20%和54.88%。结直肠癌对标化发病率上升贡献最大,贡献率为22.43%。甲状腺癌对死亡率上升贡献最大,贡献率为16.53%。结论潍坊市恶性肿瘤发病、死亡下降不显著,仍处于较高水平,其中肺癌发病率和死亡率居高不下,甲状腺癌、结直肠癌和宫颈癌上升较为明显,需引起重视。
OBJECTIVE The malignant tumor has become one of the main diseases which is harmful to the public health.Understanding the incidence and mortality is the basis and prerequisite for prevention and control.The aims of this study were to analyze the incidence and mortality characteristics and trend of malignancies from 2012 to 2017 in Weifang city,in order to provide scientific evidence for making the comprehensive prevention and control strategy.METHODS Cancer incidence and mortality data collected from 2012 to 2017,were used to calculate the crude and agestandardized rate of incidence and mortality which calculated according to the 2000 Chinese standard population(ASR China).Joinpoint regression analysis was performed to obtain annual percentage changes(APC)and annual contribution(AC),so as to estimate the trend of incidence and mortality over the year from 2012 to 2017.RESULTS The ASR China of incidence and mortality were 201.53/100 000 and 109.62/100 000.Age-specific incidence and mortality increased along with age,and peaked among 80-84 age group.The ARS of incidence(APC=-3.09,t=1.03,P=0.36)and mortality(APC=-2.34,t=0.80,P=0.47)showed a decreasing trend which had no statistical significance.The crude incidence of colorectal cancer(APC=4.28%,t=3.54,P=0.03)and crude mortality rate(APC=7.44%,t=11.10,P<0.001)of Weifang total population from 2012 to 2017 had statistical significance.The crude incidence of thyroid cancer(APC=13.16%,t=7.40,P<0.001)and standardized incidence(APC=20.93%,t=3.89,P=0.02)had statistical significance.The standardized incidence of cervical cancer(APC=8.44%,t=3.23,P=0.03)had statistical significance.The crude mortality rate of bladder cancer(APC=7.24%,t=4.38,P=0.01)had statistical significance;the crude incidence of gastric cancer(APC=-3.63%,t=9.92,P<0.001)and esophageal cancer(APC=-3.78%,t=4.67,P=0.02)had statistical significance.Crude morbidity of male gastric cancer(APC=3.18%,t=8.47,P<0.001),colorectal cancer(APC=5.62%,t=4.34,P=0.02)and crude mortality(APC=9.48,t=6.12,P<0.001),bladder cancer(APC=7.97%,t=3.60,P=0.02),prostate cancer(APC=16.61%,t=4.36,P<0.001)increased significantly,the crude incidence of esophageal cancer(APC=-3.85%,t=18.37,P<0.001)decreased significantly.Standardized incidence of cervical cancer(APC=8.44%,t=3.23,P=0.03),crude incidence of thyroid cancer(APC=13.09%,t=5.65,P=0.01),standardized incidence(APC=21.92%,t=3.54,P=0.02)and crude mortality(APC=18.70%,t=2.82,P=0.04),crude mortality of ovarian cancer(APC=13.26%,t=6.24,P<0.001)increased significantly;crude incidence of gastric cancer(APC=-5.15%,t=9.50,P<0.001)downward trend had statistical significance.According to the calculated annual change contribution rate,lung cancer made the greatest contribution to the decrease of the incidence(42.20%)and mortality(54.88%),whereas colorectal cancer made the greatest contribution(22.43%)to the increase of incidence rate and thyroid carcinoma made the greatest contribution(16.53%)to the increase of morality,respectively.CONCLUSIONS The incidence and mortality of malignant tumor in Weifang are not decreasing significantly,which are still in the higher level.The incidence and mortality of thyroid cancer,colorectal cancer,cervical cancer and breast cancer are significantly increased,which need to pay more attention.
OBJECTIVE The malignant tumor has become one of the main diseases which is harmful to the public health.Understanding the incidence and mortality is the basis and prerequisite for prevention and control.The aims of this study were to analyze the incidence and mortality characteristics and trend of malignancies from 2012 to 2017 in Weifang city,in order to provide scientific evidence for making the comprehensive prevention and control strategy.METHODS Cancer incidence and mortality data collected from 2012 to 2017,were used to calculate the crude and agestandardized rate of incidence and mortality which calculated according to the 2000 Chinese standard population(ASR China).Joinpoint regression analysis was performed to obtain annual percentage changes(APC)and annual contribution(AC),so as to estimate the trend of incidence and mortality over the year from 2012 to 2017.RESULTS The ASR China of incidence and mortality were 201.53/100 000 and 109.62/100 000.Age-specific incidence and mortality increased along with age,and peaked among 80-84 age group.The ARS of incidence(APC=-3.09,t=1.03,P=0.36)and mortality(APC=-2.34,t=0.80,P=0.47)showed a decreasing trend which had no statistical significance.The crude incidence of colorectal cancer(APC=4.28%,t=3.54,P=0.03)and crude mortality rate(APC=7.44%,t=11.10,P<0.001)of Weifang total population from 2012 to 2017 had statistical significance.The crude incidence of thyroid cancer(APC=13.16%,t=7.40,P<0.001)and standardized incidence(APC=20.93%,t=3.89,P=0.02)had statistical significance.The standardized incidence of cervical cancer(APC=8.44%,t=3.23,P=0.03)had statistical significance.The crude mortality rate of bladder cancer(APC=7.24%,t=4.38,P=0.01)had statistical significance;the crude incidence of gastric cancer(APC=-3.63%,t=9.92,P<0.001)and esophageal cancer(APC=-3.78%,t=4.67,P=0.02)had statistical significance.Crude morbidity of male gastric cancer(APC=3.18%,t=8.47,P<0.001),colorectal cancer(APC=5.62%,t=4.34,P=0.02)and crude mortality(APC=9.48,t=6.12,P<0.001),bladder cancer(APC=7.97%,t=3.60,P=0.02),prostate cancer(APC=16.61%,t=4.36,P<0.001)increased significantly,the crude incidence of esophageal cancer(APC=-3.85%,t=18.37,P<0.001)decreased significantly.Standardized incidence of cervical cancer(APC=8.44%,t=3.23,P=0.03),crude incidence of thyroid cancer(APC=13.09%,t=5.65,P=0.01),standardized incidence(APC=21.92%,t=3.54,P=0.02)and crude mortality(APC=18.70%,t=2.82,P=0.04),crude mortality of ovarian cancer(APC=13.26%,t=6.24,P<0.001)increased significantly;crude incidence of gastric cancer(APC=-5.15%,t=9.50,P<0.001)downward trend had statistical significance.According to the calculated annual change contribution rate,lung cancer made the greatest contribution to the decrease of the incidence(42.20%)and mortality(54.88%),whereas colorectal cancer made the greatest contribution(22.43%)to the increase of incidence rate and thyroid carcinoma made the greatest contribution(16.53%)to the increase of morality,respectively.CONCLUSIONS The incidence and mortality of malignant tumor in Weifang are not decreasing significantly,which are still in the higher level.The incidence and mortality of thyroid cancer,colorectal cancer,cervical cancer and breast cancer are significantly increased,which need to pay more attention.
引文
[1]郑荣寿,顾秀瑛,李雪婷,等.2000-2014年中国肿瘤登记地区癌症发病趋势及年龄变化分析[J].中华预防医学,2018,52(6):593-600.
[2]王庆生,陈万青,郑荣寿,等.癌症年龄别发病率的Joinpoint线性回归分析及其在癌症防控中的意义[J].中国肿瘤,2013,23(3):180-185.
[3]陈万青,孙可欣,郑荣寿,等.2014年中国分地区恶性肿瘤发病和死亡分析[J].中国肿瘤,2018,1(27):1-14.
[4]付振涛,徐爱强,赵滢,等.2013年山东省恶性肿瘤发病和死亡水平分析[J].中华肿瘤防治杂志,2017,24(18):1261-1267.
[5]兰蓝,赵飞,蔡玥,等.中国居民2015年恶性肿瘤死亡率流行病学特征分析[J].中华流行病学杂志,2018,39(1):32-34.
[6]朱晓云,熊伊然,陈磊,等.上海市金山区2002-2013年恶性肿瘤发病趋势分析[J].中国肿瘤,2017,26(9):696-701.
[7]Cronin KA,Lake AJ,Scott S,et al.Annual report to the nation on the status of cancer,partⅠ:National cancer statistics[J].Cancer,2018,124(13):2785-2800.
[8]乔冬菊,王良友,刘初令,等.2010~2014年浙江省台州市恶性肿瘤发病趋势分析[J].中国肿瘤,2018,27(6):426-432.
[9]Chen W,Zheng R,Zuo T,et al.National cancer incidence and mortality in China,2012[J].Chin J Cancer Res,2016,28(1):1-11.
[10]李桂刚,翟玉庭,张发学,等.山东省招远市2008-2012年胃癌发病与死亡分析[J].中国肿瘤,2017,26(7):515-518.
[11]曹玉,李东方,陈志峰,等.磁县1988-2011年食管癌死亡趋势分析[J].中华肿瘤防治杂志,2016,23(3):142-145.
[12]蔡慧,吕超,丁一波,等.2004-2011年上海市原卢湾区居民甲状腺癌的发病率及死亡率分析[J].中国临床医学,2017,24(5):728-731.
[13]Son H,Lee H,Kang K,et al.The risk of thyroid cancer and obesity:A nationwide population-based study using the Korea National Health Insurance Corporation cohort database[J].Surg Oncol,2018,27(2):166-171.
[14]Li Z,Yang L,Du C,et al.Characteristics and comparison of colorectal cancer incidence in Beijing with other regions in the world[J].Oncotarget,2017,8(15):24593-24603.
[15]葛付存,张华,孙晓辉,等.青岛市结直肠癌死亡率地理分布特征的趋势面分析[J].中华肿瘤防治杂志,2016,23(4):213-217.
[16]胡文斌,张婷,秦威,等.2006-2013年江苏省昆山市居民结直肠癌发病与死亡趋势分析[J].中华肿瘤防治杂志,2016,23(1):5-9.
[17]顾秀瑛,郑荣寿,张思维,等.2000-2014年中国肿瘤登记地区前列腺癌发病趋势及年龄变化分析[J].中华预防医学杂志,2018,52(6):586-592.
[18]Palma A,Lounsbury DW,Schlecht NF,et al.A system dynamics model of serum prostate-specific antigen screening for prostate cancer[J].Am J Epidemiol,2016,183(3):227-236.
[19]刘付东,刘荣海,孙晓凯,等.2011-2014年盐城市女性乳腺癌和官颈癌流行趋势分析[J].中华肿瘤防治杂志,2017,24(16):1109-1112.
[20]Harper DM,DeMars LR.HPV vaccines-A review of the first decade[J].Gynecol Oncol,2017,146(1):196-204.
[2]王庆生,陈万青,郑荣寿,等.癌症年龄别发病率的Joinpoint线性回归分析及其在癌症防控中的意义[J].中国肿瘤,2013,23(3):180-185.
[3]陈万青,孙可欣,郑荣寿,等.2014年中国分地区恶性肿瘤发病和死亡分析[J].中国肿瘤,2018,1(27):1-14.
[4]付振涛,徐爱强,赵滢,等.2013年山东省恶性肿瘤发病和死亡水平分析[J].中华肿瘤防治杂志,2017,24(18):1261-1267.
[5]兰蓝,赵飞,蔡玥,等.中国居民2015年恶性肿瘤死亡率流行病学特征分析[J].中华流行病学杂志,2018,39(1):32-34.
[6]朱晓云,熊伊然,陈磊,等.上海市金山区2002-2013年恶性肿瘤发病趋势分析[J].中国肿瘤,2017,26(9):696-701.
[7]Cronin KA,Lake AJ,Scott S,et al.Annual report to the nation on the status of cancer,partⅠ:National cancer statistics[J].Cancer,2018,124(13):2785-2800.
[8]乔冬菊,王良友,刘初令,等.2010~2014年浙江省台州市恶性肿瘤发病趋势分析[J].中国肿瘤,2018,27(6):426-432.
[9]Chen W,Zheng R,Zuo T,et al.National cancer incidence and mortality in China,2012[J].Chin J Cancer Res,2016,28(1):1-11.
[10]李桂刚,翟玉庭,张发学,等.山东省招远市2008-2012年胃癌发病与死亡分析[J].中国肿瘤,2017,26(7):515-518.
[11]曹玉,李东方,陈志峰,等.磁县1988-2011年食管癌死亡趋势分析[J].中华肿瘤防治杂志,2016,23(3):142-145.
[12]蔡慧,吕超,丁一波,等.2004-2011年上海市原卢湾区居民甲状腺癌的发病率及死亡率分析[J].中国临床医学,2017,24(5):728-731.
[13]Son H,Lee H,Kang K,et al.The risk of thyroid cancer and obesity:A nationwide population-based study using the Korea National Health Insurance Corporation cohort database[J].Surg Oncol,2018,27(2):166-171.
[14]Li Z,Yang L,Du C,et al.Characteristics and comparison of colorectal cancer incidence in Beijing with other regions in the world[J].Oncotarget,2017,8(15):24593-24603.
[15]葛付存,张华,孙晓辉,等.青岛市结直肠癌死亡率地理分布特征的趋势面分析[J].中华肿瘤防治杂志,2016,23(4):213-217.
[16]胡文斌,张婷,秦威,等.2006-2013年江苏省昆山市居民结直肠癌发病与死亡趋势分析[J].中华肿瘤防治杂志,2016,23(1):5-9.
[17]顾秀瑛,郑荣寿,张思维,等.2000-2014年中国肿瘤登记地区前列腺癌发病趋势及年龄变化分析[J].中华预防医学杂志,2018,52(6):586-592.
[18]Palma A,Lounsbury DW,Schlecht NF,et al.A system dynamics model of serum prostate-specific antigen screening for prostate cancer[J].Am J Epidemiol,2016,183(3):227-236.
[19]刘付东,刘荣海,孙晓凯,等.2011-2014年盐城市女性乳腺癌和官颈癌流行趋势分析[J].中华肿瘤防治杂志,2017,24(16):1109-1112.
[20]Harper DM,DeMars LR.HPV vaccines-A review of the first decade[J].Gynecol Oncol,2017,146(1):196-204.