中国部分地区经济发展水平与癌症发病和死亡情况相关性分析

曹巍; 李峰; 梁雨卿; 喻达

doi:10.16462/j.cnki.zhjbkz.2023.02.014

中国部分地区经济发展水平与癌症发病和死亡情况相关性分析

doi: 10.16462/j.cnki.zhjbkz.2023.02.014

曹巍¹,
李峰²,
梁雨卿¹,
喻达^1, ,

1.
100021 北京，国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院
2.
311251 杭州，杭州市萧山区第三人民医院

曹巍和李峰为共同第一作者

基金项目:

中国医学科学院肿瘤医院管理研究课题 LC2021D13

国家重点研发计划 2016YFC1302502

详细信息

通讯作者:
喻达，E-mail：yuda@cicams.ac.cn

中图分类号: R730.1
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- 被引次数: 0
出版历程
- 收稿日期: 2021-06-16
- 修回日期: 2022-10-22
- 网络出版日期: 2023-02-20
- 刊出日期: 2023-02-10

Association between regional economic development and cancer incidence and mortality in China

CAO Wei¹,
LI Feng²,
LIANG Yu-qing¹,
YU Da^{1
, ,}

1.
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
2.
The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou 311251, China

CAO Wei and LI Feng contributed equally to this article

Funds:

Administrative Research Fund, Cancer Hospital, Chinese Academy of Medical Sciences LC2021D13

National Key Research and Development Program of China 2016YFC1302502

More Information

Corresponding author: YU Da, E-mail: yuda@cicams.ac.cn

摘要

摘要: 目的分析人均国内生产总值(gross domestic product, GDP)和地区癌症发病率、死亡率相关性。方法研究数据来源于《2018中国肿瘤登记年报》和《2016中国统计年鉴》。采用分层随机抽样法选取55个地区，利用线性相关、限制性立方样条和多元线性回归分析解析地区人均GDP和癌症发病(死亡)率的关系。并按男性和女性的前三位高发癌种，分别进行相关性分析。结果地区人均GDP与总体世标发病率(r=0.61, P＜0.001)和死亡率(r=0.49, P＜0.001)呈正相关；立方样条拟合显示，人均GDP较高的地区，癌症发病和死亡水平上升趋势减缓。回归分析显示，在人均GDP较高的地区，总体世标发病率(β=12.08/10⁵, 95% CI: 7.57~16.59/10⁵)和世标死亡率(β=5.56/10⁵, 95% CI: 2.70~8.42/10⁵)较高；男性中肺癌世标发病率(β=3.63/10⁵, 95% CI: 1.87~5.40/10⁵)和死亡率(β=3.47/10⁵, 95% CI: 2.00~4.93/10⁵)较高，而男性肝癌世标发病率较低(β=-1.47/10⁵, 95% CI: -2.78~ -0.16/10⁵)；女性乳腺癌、肺癌、结直肠癌的世标发病率和世标死亡率水平均较高，差异有统计学意义。结论社会经济发展水平是中国癌症负担的重要相关因素。各地区可参考经济发展水平与不同高发癌种流行特征的关系，制定实施因地制宜的癌症防控措施。
- 人均国内生产总值 /
- 癌症发病率 /
- 死亡率 /
- 相关性
Abstract: Objective To examine the association between gross domestic product (GDP) per capita and the cancer burden across different regions. Methods We used data from the 2018 China Cancer Registry Annual Report and 2016 China Statistical Yearbook. A stratified random sampling method was conducted and a total of 55 regions were included. Linear correlation, restricted cubic splines (RCS), and multiple linear regressions were performed to fit the associations between regional GDP per capita and cancer incidence (mortality) rates. Subgroup analyses were conducted for the three most common cancers in males (lung, stomach, and liver cancers) and females (breast, lung, and colorectal cancers), separately. Results Regional GDP per capita was positively correlated with the age-standardized incidence and mortality rates (ASIR: r=0.61, ASMR: r=0.49; P < 0.001) of all-site cancers. RCS fitting showed that in regions with a higher GDP per capita, the rising trends of cancer incidence and mortality slowed down. Multivariable regression models found that in regions with a higher GDP per capita, ASIR (β=12.08/10⁵, 95% CI: 7.57-16.59/10⁵) and ASMR (β=5.56/10⁵, 95% CI: 2.70-8.42/10⁵) of all-site cancers were higher; Among males, the ASIR (β=3.63/10⁵, 95% CI: 1.87-5.40/10⁵) and ASMR (β=3.47/10⁵, 95% CI: 2.00-4.93/10⁵) of lung cancer increased, while the ASIR of liver cancer decreased (β=-1.47/10⁵, 95% CI: -2.78--0.16/10⁵); Among females, the ASIR and ASMR of breast cancer, lung cancer, and colorectal cancer were significantly higher. Conclusions Economic development is one of the significant factors related to the heavy cancer burden in China. The formulation and implementation of targeted cancer prevention and control strategies could refer to each region's economic development and cancer profile.
- GDP per capita /
- Cancer incidence /
- Mortality /
- Association

HTML全文

图 1 55个地区癌症总体发病和死亡情况及其与人均GDP相关性分析

Figure 1. All-site cancer incidence and death in selected 55 regions and its correlation with GDP per capita

下载: 全尺寸图片幻灯片

图 2 男性肺癌、胃癌、肝癌世标发病(死亡)率和地区人均GDP相关性分析

Figure 2. Correlation analyses between age-standardized incidence (mortality) rates of the three most common cancer types in males and regional GDP per capita

下载: 全尺寸图片幻灯片

图 3 女性乳腺癌、肺癌、结直肠癌世标发病(死亡)率和地区人均GDP相关性分析

Figure 3. Correlation analyses between age-standardized incidence (mortality) rates of the three most common cancer types in females and regional GDP per capita

下载: 全尺寸图片幻灯片

表 1 地区人均GDP与癌症世标发病(死亡)率相关性分析及回归分析

Table 1. Correlation and regression analyses of regional GDP per capita on age-standardized incidence (mortality) rates by the Segi's population

	发病			死亡
	Pearson相关系数	P值	线性回归β (95% CI)值	Pearson相关系数	P值	线性回归β (95% CI)值
总体 ^a	0.61	＜0.001	12.08 (7.57, 16.59)	0.49	＜0.001	5.56 (2.70, 8.42)
男性 ^b
肺癌	0.48	＜0.001	3.63 (1.87, 5.40)	0.55	＜0.001	3.47 (2.00, 4.93)
胃癌	-0.04	0.753	-0.26 (-2.85, 2.33)	-0.30	0.123	-0.11 (-1.66, 1.43)
肝癌	-0.32	0.025	-1.47 (-2.78, -0.16)	-0.08	0.812	-0.80 (-1.73, 0.12)
女性 ^c
乳腺癌	0.55	＜0.001	3.20 (1.97, 4.44)	0.36	0.004	0.63 (0.23, 1.04)
肺癌	0.48	＜0.001	2.05 (0.89, 3.20)	0.40	0.003	1.31 (0.40, 2.22)
结直肠癌	0.70	＜0.001	2.27 (1.60, 2.95)	0.52	＜0.001	1.25 (0.71, 1.79)
注: 世标率: Segi’s世界人口标准化率；^a全人群模型中纳入协变量包括：性别比、城镇人口比重、吸烟率、乙肝感染率；^b男性肺癌和胃癌回归模型中纳入协变量包括：城镇人口比重、吸烟率；肝癌模型中纳入协变量包括：城镇人口比重、吸烟率、乙肝感染率；^c女性各癌种的回归模型中纳入协变量包括：吸烟率、城镇人口比重。

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