Analysis of the mortality trend of female reproductive system cancer in China from 2004 to 2016
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摘要:
目的 研究分析2004-2016年中国女性生殖系统恶性肿瘤的死亡率水平及其变化趋势,为癌症预防和控制措施的制定与实施提供科学依据。 方法 从全国疾病监测系统死因监测数据中选取宫颈癌、宫体癌、卵巢癌的死亡数据,分别计算不同时间的粗死亡率与标化死亡率,采用Joinpoint软件分析年度变化趋势。 结果 2004-2016年,中国女性宫颈癌死亡率明显增加,2011年之后死亡趋势明显加快(annual percent change,APC=13.7%),且中国女性宫颈癌死亡率农村高于城市(P < 0.05);宫体癌死亡率相对稳定,2013年之后呈现出下降趋势(APC=-23.5%);卵巢癌死亡率有所增加,但其死亡趋势无统计学意义。 结论 2004-2016年,中国女性宫体癌死亡情况有所好转,宫颈癌死亡情况仍较为严重,且存在城乡差异。 Abstract:Objective To describe and analyze the level and variation trend of mortality of female genital malignancies in China from 2004 to 2016, so as to provide scientific evidence for the formulation and implementation of cancer prevention and control measures. Methods The mortality data of cervical cancer, corpus cancer and ovarian cancer were selected from the mortality monitoring data of the national disease monitoring system, the crude mortality and standardized mortality rates were calculated respectively, the annual change trend was analyzed by Joinpoint software. Results From 2004 to 2016, the mortality rate of cervical cancer in Chinese women increased significantly. The mortality trend obviously accelerated after 2011(annual percent change, APC=13.7%), and the mortality rate in rural areas was higher than that in urban areas. The mortality rate of corpus cancer was relatively stable, and showed a downward trend after 2013(APC=-23.5%). Ovarian cancer mortality rate slightly increased, but the death trend was not statistically significant. Conclusions From 2004 to 2016, the mortality of corpus cancer in Chinese women had improved, the mortality of cervical cancer was still relatively serious, and there were differences between urban and rural areas. -
Key words:
- Reproductive system /
- Malignant tumor /
- Mortality rate /
- Trend analysis
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表 1 2004-2016年中国女性生殖系统恶性肿瘤死亡情况
Table 1. Death rate of female reproductive system cancer in China from 2004 to 2016
年份 宫颈癌(n=32 948) 宫体癌(n=24 046) 卵巢癌(n=15 808) 死亡人数(人) 粗死亡率(1/10万) 中标率(1/10万) 死亡人数(人) 粗死亡率(1/10万) 中标率(1/10万) 死亡人数(人) 粗死亡率(1/10万) 中标率(1/10万) 2004 976 2.81 3.20 1 510 4.34 4.92 507 1.46 1.64 2005 1 019 2.92 3.30 1 511 4.33 4.92 501 1.43 1.64 2006 765 2.37 2.64 1 036 3.21 3.56 460 1.42 1.60 2007 1 027 2.94 3.20 1 244 3.56 3.91 576 1.65 1.81 2008 961 2.66 2.78 1 384 3.83 4.03 623 1.72 1.82 2009 1 067 2.90 2.92 1 371 3.73 3.75 682 1.86 1.88 2010 1 117 2.89 2.86 1 483 3.84 3.80 736 1.91 1.87 2011 1 082 2.85 2.68 1 361 3.58 3.35 677 1.78 1.65 2012 1 118 2.95 2.71 1 347 3.56 3.24 728 1.92 1.76 2013 3 648 3.27 2.87 4 027 3.61 3.13 2 089 1.87 1.62 2014 6 103 4.91 4.26 2 839 2.28 1.94 2 458 1.98 1.71 2015 6 721 5.30 4.59 2 552 2.01 1.73 2 642 2.08 1.80 2016 7 344 5.65 4.79 2 381 1.83 1.52 3 129 2.41 2.02 表 2 2004-2016年中国女性生殖系统恶性肿瘤死亡趋势变化
Table 2. The changes of the death trend of cancer in the reproductive system of Chinese women from 2004 to 2016
分类 肿瘤类型 时间区段 APC(%) 下限 上限 监测范围 宫颈癌 2004 2011 -2.9 -10.1 4.8 2011 2016 13.7a 6.5 21.4 宫体癌 2004 2013 -5.1a -7.3 -2.9 2013 2016 -23.5a -34.0 -11.4 卵巢癌 2004 2008 3.3 -2.0 8.8 2008 2016 -0.4 -3.3 2.5 城市 宫颈癌 2004 2011 -0.9 -8.7 7.6 2011 2016 12.0a 4.1 20.4 宫体癌 2004 2013 -4.8a -7.1 -2.5 2013 2016 -17.1a -27.9 -4.8 卵巢癌 2004 2014 -1.9a -3.5 -0.2 2014 2016 7.1 -5.8 21.8 农村 宫颈癌 2004 2011 -3.8 -10.9 3.9 2011 2016 14.0a 7.2 21.2 宫体癌 2004 2012 -3.7a -7.1 -0.1 2012 2016 -22.2a -30.0 -13.6 卵巢癌 2004 2012 1.6 -0.7 4.0 2012 2016 9.0a 6.5 11.5 注:a:代表计算得到的APC值具有统计学意义,P<0.05。 -
[1] Chen WQ, Zheng RS, Zhang SW, et al. Report of cancer incidence and mortality in China, 2010[J]. Ann Transl Med, 2014, 2(7): 61. DOI: 10.3978/j.issn.2305-5839.2014.04.05. [2] 陈万青, 郑荣寿, 张思维. 中国恶性肿瘤的动态变化[J]. 科技导报, 2014, 32(26): 65-71. DOI: 10.3981/j.issn.1000-7857.2014.26.009.Chen WQ, Zheng RS, Zhang SW. Dynamic changes of malignant tumors in China[J]. Science & Technology Review, 2014, 32(26): 65-71. DOI: 10.3981/j.issn.1000-7857.2014.26.009. [3] 中国疾病预防控制中心慢性非传染性疾病预防控制中心. 中国死因监测数据集2016[M]. 北京: 中国科学技术出版社, 2016.Center for the prevention and control of chronic noncommunicable diseases of Chinese Center for Disease Prevention and Control. China cause of death monitoring data in 2016[M]. Beijing: China Science and Technology Press, 2016. [4] 朱继存. 2004-2016年中国城乡人口死亡模式及水平变化分析[D]. 郑州: 郑州大学, 2018.Zhu JC. Analysis on the death patterns and death levels between urban and rural population in China from 2004 to 2016[D]. Zhengzhou: Zhengzhou University, 2018. [5] Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates[J]. Stat Med, 2000, 19(3): 335-351. doi: 10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z [6] 周薇, 张志将, 王丽君, 等. 中国子宫颈癌1987-2014年死亡趋势的Joinpoint回归分析[J]. 中国癌症杂志, 2017, 27(8): 634-640. DOI: 10.19401/j.cnki.1007-3639.2017.08.006.Zhou W, Zhang ZJ, Wang LJ, et al. Joinpoint regression analysis of cervical cancer death trends in China from 1987 to 2014[J]. China Oncology, 2017, 27(8): 634-640. DOI: 10.19401/j.cnki.1007-3639.2017.08.006. [7] 胡尚英, 郑荣寿, 赵方辉, 等. 1989至2008年中国女性子宫颈癌发病和死亡趋势分析[J]. 中国医学科学院学报, 2014, 36(2): 119-125. DOI: 10.3881/j.issn.1000-503X.2014.02.001.Hu SY, Zheng RS, Zhao FH, et al. Trends of cervical cancer incidence and death in Chinese women from 1989 to 2008[J]. Acta Academiae Medicinae Sinicae, 2014, 36(2): 119-125. DOI: 10.3881/j.issn.1000-503X.2014.02.001. [8] 王亮, 夏劲节, 何燕, 等. 2011-2015年成都市恶性肿瘤死亡流行特征及变化趋势分析[J]. 中华疾病控制杂志, 2017, 21(5): 531-533. DOI: 10.16462/j.cnki.zhjbkz.2017.05.024.Wang L, Xia JJ, He Y, et al. Analysis of characteristics and trends of malignant tumor death prevalence in Chengdu from 2011 to 2015[J]. Chin J Dis Control Prev, 2017, 21(5): 531-533. DOI: 10.16462/j.cnki.zhjbkz.2017.05.024. [9] 董航, 刘华章, 林国桢, 等. 广州市2000-2011年宫颈癌发病趋势及年龄分布特征[J]. 中华疾病控制杂志, 2015, 19(5): 451-453. DOI: 10.16462/j.cnki.zhjbkz.2015.05.006.Dong H, Liu HZ, Lin GZ, et al. The incidence trend and age distribution of cervical cancer in Guangzhou from 2000 to 2011[J]. Chin J Dis Control Prev, 2015, 19(5): 451-453. DOI: 10.16462/j.cnki.zhjbkz.2015.05.006. [10] 祁志宇, 张丽倩, 何英杰, 等. 承德地区HPV感染及危险因素分析[J]. 中国公共卫生, 2016, 32(12): 1669-1673. DOI: 10.11847/zgggws2016-32-12-17.Qi ZY, Zhang LQ, He YJ, et al. Analysis of HPV infection and risk factors in Chengde area[J]. Chinese Journal of Public Health, 2016, 32(12): 1669-1673. DOI: 10.11847/zgggws2016-32-12-17. [11] 常艳红, 田林. 宫颈癌及癌前病变危险因素的病例对照研究[J]. 中国卫生统计, 2016, 33(1): 120-122. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT201601038.htmChang YH, Tian L. Case-control study on risk factors of cervical cancer and precancerous lesions[J]. Chinese Journal of Health Statistics, 2016, 33(1): 120-122. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT201601038.htm [12] 葛锁风. 农村妇女宫颈癌筛查认知情况调查分析[J]. 中国药物与临床, 2018, 18(7): 1107-1109. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201807012.htmGe SF. Investigation and analysis on the cognition of cervical cancer screening in rural women[J]. Chinese Remedies & Clinics, 2018, 18(7): 1107-1109. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201807012.htm [13] 丁贤彬, 吕晓燕, 毛德强. 2006至2014年重庆市宫颈癌发病趋势分析[J]. 重庆医科大学学报, 2016, 41(3): 282-285. DOI: 10.13406/j.cnki.cyxb.000802.Ding XB, Lv XY, Mao DQ. Analysis of the incidence trend of cervical cancer in Chongqing from 2006 to 2014[J]. Journal of Chongqing Medical University, 2016, 41(3): 282-285. DOI: 10.13406/j.cnki.cyxb.000802. [14] 林仲秋. 《FIGO 2015妇癌报告》解读连载一——宫颈癌诊治指南解读[J]. 中国实用妇科与产科杂志, 2015, 31(11): 981-985. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201511003.htmLin ZQ. Interpretation of Gynecological Cancer Report of FIGO in 2015, Part 1, Interpretation of guidelines for diagnosis and treatment of cervical cancer[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2015, 31(11): 981-985. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201511003.htm [15] 关明飞, 黄萍, 朱安娜, 等. 早期巨块型宫颈癌淋巴结转移的规律及其与预后的关系[J]. 中山大学学报(医学科学版), 2016, 37(5): 728-732. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSYK201605014.htmGuan MF, Huang P, Zhu AN, et al. Lymph mode metastasis pattern in early-stage bulky cervical carcinoma and its relationship with patients' prognosis[J]. Journal of Sun Yat-sen University(medical science edition), 2016, 37(5): 728-732. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSYK201605014.htm [16] 魏矿荣, 梁智恒, 欧志雄. 中国女性宫体癌流行概况[J]. 实用预防医学, 2014, 21(9): 1150-1152. DOI: 10.3969/j.issn.1006-3110.2014.09.046.Wei KR, Liang ZH, Ou ZX. The prevalence of uterine carcinoma in Chinese women[J]. Practical Preventive Medicine, 2014, 21(9): 1150-1152. DOI: 10.3969/j.issn.1006-3110.2014.09.046. [17] Siegel RL, Miller KD, Jemal A, et al. Cancer statistics, 2015[J]. Ca A Cancer Journal for Clinicians, 2010, 60(5): 277-300. DOI: 10.3322/caac.20073. [18] 张桂萍, 廖颖, 李祖茂. 女性生殖系统肿瘤9529例病理资料分析[J]. 实用医学杂志, 2016, 32(14): 2364-2367. DOI: 10.3969/j.issn.1006-5725.2016.14.033.Zhang GP, Liao Y, Li ZM. Pathological analysis of 9529 cases of female reproductive system tumors[J]. The Journal of Practical Medicine, 2016, 32(14): 2364-2367. DOI: 10.3969/j.issn.1006-5725.2016.14.033. [19] Sant M, Chirlaque Lopez MD, Agresti R, et al. Survival of women with cancers of breast and genital organs in Europe 1999-2007: results of the EUROCARE-5 study[J]. Eur J Cancer, 2015, 51(15): 2191-2205. DOI: 10.1016/j.ejca.2015.07.022. [20] 林仲秋. 《FIGO 2015妇癌报告》解读连载二——子宫内膜癌诊治指南解读[J]. 中国实用妇科与产科杂志, 2015, 31(11): 986-991. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201511005.htmLin ZQ. Interpretation of Gynecological Cancer Report of FIGO in 2015, Part 2, Interpretation of guidelines for diagnosis and treatment of endometrial cancer[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2015, 31(11): 986-991. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201511005.htm