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摘要:
目的 了解2008—2016年广西居民恶性肿瘤的死亡状况及时间变化趋势，为制定恶性肿瘤防治策略提供科学依据。 方法 采集死因监测系统中广西7个国家监测点居民因恶性肿瘤死亡的数据，计算粗死亡率、标化死亡率、构成比；用Joinpoint模型对恶性肿瘤死亡率数据进行时间趋势分析。 结果 2008—2016年广西居民恶性肿瘤粗死亡率为128.60/10万，标化死亡率为129.80/10万。标化死亡率男女比为1.94：1，城乡比为1.25：1。恶性肿瘤死亡率随年龄增长呈上升趋势。死因顺位前5位依次为肝癌、肺癌、胃癌、结直肠癌和鼻咽癌。Joinpoint模型分析显示，2008—2016年恶性肿瘤死亡率总体呈先上升后缓慢下降趋势，2008—2010年呈上升趋势，年度变化百分比（annual percent change，APC）为23.38%，2011—2016年存在缓慢下降趋势（APC=-0.62%）。男性恶性肿瘤死亡率呈先上升后缓慢下降趋势，女性死亡率相对稳定；城市居民恶性肿瘤死亡率呈持续上升趋势；农村呈先上升后缓慢下降趋势。男女和城乡的肺癌（APC=4.73%）死亡率和结直肠癌（APC=6.31%）死亡率均呈持续上升趋势。肝癌、胃癌、鼻咽癌死亡率保持相对稳定。 结论 广西居民恶性肿瘤死亡率仍处于全国较高水平，城市居民恶性肿瘤死亡率及肺癌、结直肠癌死亡率呈持续上升趋势。 -
关键词:
- 恶性肿瘤 /
- 死亡率 /
- Joinpoint模型
Abstract:Objective To observe the mortality and trend of malignant cancers in Guangxi from 2008 to 2016, so as to provide evidence for formulating strategies for preventing and treating malignant cancers. Methods Data on deaths from malignant cancers in Guangxi residents was collected from seven national monitoring sites in death cause monitoring system. The crude mortality rate, standardized mortality rate, constituent ratio were calculated. The trend of cancer mortality was analyzed with Joinpoint model. Results The crude mortality rate of cancer was 128.60/100 000, and the standardized mortality rate was 129.80/100 000 in Guangxi from 2008 to 2016. The standardized male-female mortality ratio was 1.94:1 and the urban-rural ratio was 1.25:1. The mortality of malignant cancers had increased with age. The top five causes of death were liver cancer, lung cancer, stomach cancer, colorectal cancer, and nasopharyngeal cancer. Joinpoint model analysis revealed that the mortality rate of malignant cancers had increased first and then decreased slowly from 2008 to 2016. It had a tendency to increase from 2008 to 2010, with the annual percent change (APC) of 23.38%, but showed a slowly declined trend from 2011 to 2016 (APC=-0.62%). The mortality rate of cancer had increased first and then decreased slowly in males, but it changed not obviously in females. The mortality rate of cancer showed an increasing trend in urban areas, and in rural areas it rose first and then slowly declined. The mortality rate of lung cancer (APC=4.73%) and colorectal cancer (APC=6.31%) showed an increased trend, for both male and female in urban and rural areas. The mortality rates of liver cancer, stomach cancer, and nasopharyngeal cancer were relatively stable. Conclusion The mortality rate caused by cancer in Guangxi is still at a relatively high level in China. Particularly, the mortality rate of urban residents and the mortality of lung cancer and colorectal cancer shows an increased trend. -
Key words:
- Cancer /
- Mortality /
- Joinpoint model
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图 1 2008—2016年广西居民恶性肿瘤年龄别死亡率(/10万)
Figure 1. Age-specific mortality of cancer in Guangxi from 2008 to 2016 (/100 000)
表 1 2008—2016年广西居民恶性肿瘤死亡率(/10万)
Table 1. Mortality of cancer in Guangxi from 2008 to 2016 (/100 000)
年份 性别 城乡 合计 男 女 城市 农村 粗率 标化率 粗率 标化率 粗率 标化率 粗率 标化率 粗率 标化率 2008 108.78 108.21 56.69 59.20 113.66 115.26 76.12 77.48 84.12 85.53 2009 160.61 160.41 79.21 83.07 137.93 141.18 117.72 120.17 122.06 124.68 2010 176.12 176.05 89.00 93.67 156.89 160.56 128.77 131.73 134.78 137.90 2011 186.32 181.61 92.14 95.09 163.25 164.51 135.89 135.70 141.76 141.88 2012 179.17 176.35 84.19 86.84 135.38 136.77 133.91 134.57 134.23 135.04 2013 169.31 165.91 79.28 82.11 156.61 157.29 118.64 119.28 126.88 127.54 2014 178.50 175.23 82.89 85.78 151.39 152.24 128.07 128.82 133.21 133.99 2015 185.28 179.50 91.84 93.56 174.31 171.57 131.49 130.82 140.99 139.86 2016 180.51 175.44 90.60 92.79 179.42 176.70 125.90 125.93 137.86 137.27 合计 169.63 166.84 82.97 85.92 152.65 152.21 121.93 119.48 128.60 129.80 χ2值 3 803.11 423.04 P值 < 0.001 < 0.001 
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表 2 2008—2016年广西居民主要恶性肿瘤构成比及死因顺位
Table 2. Constituent ratio and cause of death of major cancer in Guangxi from 2008 to 2016
年份 性别 城乡 合计 男 女 城市 农村 死因 构成比(%) 死因 构成比(%) 死因 构成比(%) 死因 构成比(%) 死因 构成比(%) 1 肝癌 34.12 肺癌 21.37 肺癌 24.07 肝癌 30.29 肝癌 28.66 2 肺癌 25.70 肝癌 16.23 肝癌 23.96 肺癌 24.49 肺癌 24.38 3 胃癌 9.87 胃癌 11.54 结直肠癌 9.20 胃癌 11.06 胃癌 10.38 4 结直肠癌 5.59 乳腺癌 7.82 胃癌 8.40 结直肠癌 5.18 结直肠癌 6.21 5 鼻咽癌 3.99 结直肠癌 7.64 白血病 3.95 鼻咽癌 3.86 鼻咽癌 3.68 6 食管癌 3.00 宫体癌 4.74 鼻咽癌 3.15 脑恶性肿瘤 3.20 白血病 3.12 7 白血病 2.70 白血病 4.10 乳腺癌 3.11 白血病 2.84 脑恶性肿瘤 2.89 8 脑恶性肿瘤 2.49 宫颈癌 3.85 食管癌 2.65 食管癌 2.73 食管癌 2.71 9 骨和关节软骨恶性肿瘤 1.48 脑恶性肿瘤 3.79 胰腺癌 2.06 乳腺癌 2.24 乳腺癌 2.46 10 前列腺癌 1.07 鼻咽癌 2.97 脑恶性肿瘤 1.97 骨和关节软骨恶性肿瘤 1.93 骨和关节软骨恶性肿瘤 1.61
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表 3 2008—2016年广西居民恶性肿瘤死亡率Joinpoint回归模型分析
Table 3. Joinpoint regression model analysis of mortality of cancer in guangxi from 2008 to 2016
性别/地区 时间区段 APC(%) t值 P值 男性 2008—2010 24.30 3.769 0.020 2011—2016 -0.62 -0.761 0.489 女性 2008—2016 2.43 1.549 0.165 城市 2008—2016 3.39 2.825 0.026 农村 2008—2010 26.97 3.027 0.039 2011—2016 -1.44 -1.305 0.262 合计 2008—2010 23.38 3.024 0.039 2011—2016 -0.62 -0.630 0.563
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表 4 2008—2016年广西居民恶性肿瘤死亡率(/10万)
Table 4. Mortality of cancer in Guangxi from 2008 to 2016 (/100 000)
年份 肝癌 肺癌 胃癌 结直肠癌 鼻咽癌 粗率 标化率 粗率 标化率 粗率 标化率 粗率 标化率 粗率 标化率 2008 23.70 24.64 19.71 19.82 8.80 8.82 8.80 5.30 3.20 3.34 2009 36.91 38.46 26.83 27.10 13.78 13.85 13.78 6.39 4.83 5.03 2010 41.99 43.71 29.19 29.54 15.25 15.40 15.25 7.38 5.52 5.75 2011 39.89 41.02 34.38 33.68 16.80 16.56 16.80 8.32 5.04 5.16 2012 39.86 41.19 32.50 32.22 14.19 14.10 14.19 7.34 5.13 5.31 2013 34.20 35.22 31.93 31.68 12.48 12.38 12.48 7.91 4.53 4.70 2014 36.56 37.71 35.40 35.04 12.03 11.90 12.03 8.97 4.65 4.84 2015 39.90 40.92 37.22 36.08 13.85 13.41 13.85 9.02 5.03 5.19 2016 38.46 39.54 34.25 33.21 13.00 12.78 13.00 9.89 4.63 4.77
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表 5 2008—2016年广西居民主要恶性肿瘤死亡率Joinpoint回归模型分析
Table 5. Joinpoint regression model analysis of mortality of major cancer in guangxi from 2008 to 2016
死因 性别 城乡 合计 男 女 城市 农村 APC(%) t值 P值 APC(%) t值 P值 APC(%) t值 P值 APC(%) t值 P值 APC(%) t值 P值 肝癌 1.84 0.943 0.377 1.16 0.556 0.595 0.37 0.185 0.858 2.11 1.056 0.326 1.73 0.888 0.404 肺癌 4.73 3.007 0.020 4.68 3.105 0.017 4.29 3.426 0.011 4.84 2.761 0.028 4.73 3.212 0.015 胃癌 -0.05 -0.021 0.984 -0.31 -0.136 0.895 2.03 0.682 0.517 -0.57 -0.235 0.821 -0.14 -0.059 0.954 结直肠癌 7.50 5.340 0.001 4.42 2.723 0.030 7.19 4.437 0.003 5.18 2.561 0.038 6.31 6.068 0.001 鼻咽癌 1.79 0.940 0.378 -1.66 -0.502 0.631 -0.28 -0.105 0.919 1.34 0.576 0.582 0.94 0.498 0.634
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