2004―2018年中国消化道恶性肿瘤死亡趋势

贾善群; 周乾宇; 刘慧敏; 刘丹丹; 孙长青

doi:10.16462/j.cnki.zhjbkz.2021.09.006

2004―2018年中国消化道恶性肿瘤死亡趋势

doi: 10.16462/j.cnki.zhjbkz.2021.09.006

贾善群¹,
周乾宇¹,
刘慧敏¹,
刘丹丹¹,
孙长青^{1, 2, ,}

1.
450001 郑州，郑州大学公共卫生学院社会医学与卫生事业管理教研室
2.
450001 郑州，郑州大学护理与健康学院社区护理教研室

基金项目:

国家社会科学基金 20BRK041

详细信息

通讯作者:
孙长青, E-mail: suncq@zzu.edu.cn

中图分类号: R181.3;R73-31
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- 被引次数: 0
出版历程
- 收稿日期: 2021-01-16
- 修回日期: 2021-03-21
- 网络出版日期: 2021-10-23
- 刊出日期: 2021-09-10

The mortality trend of digestive tract malignant tumor in China from 2004 to 2018

1.
Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
2.
Department of Community Nursing, College of Nursing and Health, Zhengzhou University, Zhengzhou 450001, China

Funds:

National Social Science Foundation of China 20BRK041

More Information

Corresponding author: SUN Chang-qing, E-mail: suncq@zzu.edu.cn

摘要

摘要: 目的分析2004―2018年中国消化道恶性肿瘤死亡状况及变化趋势。方法收集2004―2018年全国疾病监测地区消化道恶性肿瘤死亡数据，计算各种消化道恶性肿瘤粗死亡率和标化死亡率，采用Joinpoint回归分析模型分析标化死亡率变化趋势。结果 2004―2018年，中国食管癌和胃癌标化死亡率呈下降趋势(AAPC_食管癌=-4.7%, AAPC_胃癌=-4.3%, 均有P＜0.05)，结直肠癌死亡率相对稳定(AAPC_结直肠癌=0.4%, P=0.733)。各种消化道恶性肿瘤死亡率随年龄增长不断上升，男性标化死亡率均高于女性，且男性年均下降幅度较小；农村食管癌和胃癌标化死亡率高于城市，但农村年均下降速度较快；东部地区食管癌死亡率最高，中部地区胃癌标化死亡率最高，且中部地区下降速度较快；西部地区结直肠癌死亡率呈缓慢上升趋势。结论 2004―2018年期间，中国食管癌和胃癌死亡状况有所好转，但西部地区结直肠癌死亡率仍呈上升趋势，应继续加大防治力度，以减轻消化道恶性肿瘤疾病负担。
- 消化道恶性肿瘤 /
- 死亡率 /
- 趋势分析
Abstract: Objective To analyze the mortality status and trend of digestive tract malignant tumors in China from 2004 to 2018. Methods The mortality data of digestive tract malignant tumors in the national disease surveillance areas from 2004 to 2018 were collected. The crude and standardized mortality rates with various digestive tract malignant tumors were calculated. The trend of standardized mortality was analyzed using Joinpoint regression model. Results From 2004 to 2018, the standardized mortality rates of esophageal cancer and gastric cancer in China showed a general downward trend, with an average annual percent change (AAPC) of -4.7% and -4.3%(all P < 0.05), respectively. The mortality rate of colorectal cancer showed no significant change(AAPC=0.4%, P=0.733). The mortality rates of various digestive tract malignant tumors increased with age. The standardized mortality rates of various digestive tract malignant tumors among males were higher than those of females, and the average annual decline was smaller. The standardized mortality rates of esophageal cancer and gastric cancer in rural areas were higher than those in urban areas, but the average annual decrease was larger. The standardized mortality rate of esophageal cancer in eastern areas was the highest. The standardized mortality rate of gastric cancer in central areas was highest, and the rate of decline was faster. The mortality rate of colorectal cancer in western areas increased slowly. Conclusions From 2004 to 2018, the mortality rates of esophageal cancer and gastric cancer had improved, but the mortality rate of colorectal cancer was still on the rise in western areas. The preventive measures of digestive tract malignant tumors should be strengthened to reduce the burden of digestive tract malignant tumors.
- Digestive tract malignant tumor /
- Mortality /
- Trend analysis

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图 1 2004―2018年中国消化道恶性肿瘤年龄别死亡率(/10万)

Figure 1. Age-specific mortality of digestive tract malignant tumor in China from 2004 to 2018 (/100 000)

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图 2 2004―2018年中国消化道恶性肿瘤年龄组死亡率变化情况(/10万)

Figure 2. Changes of age-specific mortality of digestive tract malignant tumor in China from 2004 to 2018 (/100 000)

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表 1 2004―2018年中国消化道恶性肿瘤死亡率(/10万)

Table 1. Mortality of digestive tract malignant tumor in China from 2004 to 2018 (/100 000)

年份	食管癌		胃癌		结直肠癌		标化率比^a
年份	粗率	标化率	粗率	标化率	粗率	标化率	标化率比^a
2004	15.46	18.43	25.23	29.99	7.31	8.66	2.13∶3.46∶1
2005	14.95	17.83	24.19	28.68	7.53	8.88	2.01∶3.23∶1
2006	12.81	14.93	18.87	21.85	7.17	8.28	1.80∶2.64∶1
2007	13.68	15.49	21.23	23.99	7.96	9.00	1.72∶2.67∶1
2008	13.20	14.40	20.64	22.45	8.07	8.77	1.64∶2.56∶1
2009	13.06	14.20	21.24	22.97	8.54	9.32	1.52∶2.46∶1
2010	12.05	13.03	20.39	21.90	8.27	9.11	1.43∶2.40∶1
2011	12.03	12.04	19.58	19.60	8.48	8.64	1.39∶2.37∶1
2012	11.84	11.09	20.01	18.77	8.81	8.26	1.34∶2.27∶1
2013	12.54	10.99	20.41	17.98	9.02	7.96	1.38∶2.26∶1
2014	12.84	11.03	21.10	18.24	9.65	8.33	1.32∶2.19∶1
2015	12.57	10.82	20.92	18.09	10.19	8.81	1.23∶2.05∶1
2016	12.51	10.07	20.51	16.64	10.47	8.49	1.19∶1.96∶1
2017	12.49	9.99	19.92	16.10	10.99	8.86	1.13∶1.82∶1
2018	12.36	9.44	19.69	15.22	11.58	8.95	1.05∶1.70∶1
合计	12.74	11.30	20.66	18.41	9.67	8.61	1.31∶2.14∶1
AAPC(%)	-1.30	-4.70	-1.70	-4.30	3.30	0.40
P值	0.008	＜0.001	0.003	＜0.001	＜0.001	0.733
注：^a参考项为结直肠癌标化死亡率。

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表 2 2004―2018年中国消化道恶性肿瘤死亡趋势变化^a

Table 2. Death trends of digestive tract malignant tumor in China from 2004 to 2018 ^a

分类	变化趋势1^a		变化趋势2^a		变化趋势3^a		AAPC(95% CI)值
分类	年份	APC(95% CI)值	年份	APC(95% CI)值	年份	APC(95% CI)值	AAPC(95% CI)值
男性
食管癌	2004―2018	-4.1(-4.6~-3.7) ^b					-4.1(-4.6~-3.7) ^b
胃癌	2004―2018	-4.1(-4.8~-3.4) ^b					-4.1(-4.8~-3.4) ^b
结直肠癌	2004―2018	0.1(-0.5~0.8)					0.1(-0.5~0.8)
女性
食管癌	2004―2018	-6.2(-7.1~-5.4) ^b					-6.2(-7.1~-5.4) ^b
胃癌	2004―2018	-4.7(-5.7~-3.8) ^b					-4.7(-5.7~-3.8) ^b
结直肠癌	2004―2009	1.4(-0.3~3.1)	2009―2012	-4.6(-11.6~2.9)	2012―2018	1.1(-0.2~2.4)	-0.1(-1.5~1.5)
城市
食管癌	2004―2011	-6.2(-7.5~-4.9) ^b	2011―2014	6.0(-5.6~19.0)	2014―2018	-1.9(-5.3~1.7)	-2.5(-4.7~-0.2) ^b
胃癌	2004―2016	-15.1(-25.2~-3.6) ^b	2016―2018	-2.4(-3.3~-1.5) ^b			-4.3(-6.0~-2.6) ^b
结直肠癌	2004―2018	-0.4(-0.9~0.1)					-0.4(-0.9~0.1)
农村
食管癌	2004―2018	-5.7(-6.4~-5.1) ^b					-5.7(-6.4~-5.1) ^b
胃癌	2004―2018	-4.7(-5.5~-4.0) ^b					-4.7(-5.5~-4.0) ^b
结直肠癌	2004―2018	0.4(-0.5~0.6)					0.4(-0.5~0.6)
东部
食管癌	2004―2012	-6.2(-7.6~-4.8) ^b	2012―2015	4.4(-10.6~21.8)	2015―2018	-6.6(-13.9~1.2)	-4.1(-7.0~-1.0) ^b
胃癌	2004―2006	-12.2(-24.5~2.1)	2006―2018	-2.7(-3.7~-1.6) ^b			-4.1(-6.0~-2.1) ^b
结直肠癌	2004―2018	0.1(-0.5~0.6)					0.1(-0.5~0.6)
中部
食管癌	2004―2018	-6.7(-7.4~-6.0) ^b					-6.7(-7.4~-6.0) ^b
胃癌	2004―2018	-5.1(-6.0~-4.3) ^b					-5.1(-6.0~-4.3) ^b
结直肠癌	2004―2018	-1.4(-2.4~-0.5) ^b					-1.4(-2.4~-0.5) ^b
西部
食管癌	2004―2018	-3.4(-4.2~-2.7) ^b					-3.4(-4.2~-2.7) ^b
胃癌	2004―2018	-4.7(-5.7~-3.6) ^b					-4.7(-5.7~-3.6) ^b
结直肠癌	2004―2018	1.3(0.4~2.2) ^b					1.3(0.4~2.2) ^b
注：^a基于最佳模型中连接点出现的个数和年份确定变化趋势列数及时间区间，变化趋势1、2、3分别代表不同时间区间内死亡率的变化趋势；^bP＜0.05。

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