1990—2019年江苏省乙型肝炎病毒感染相关肝癌发病和死亡趋势分析

刘德; 陈培培; 娄培安; 乔程; 李婷; 张盼; 江宜雪; 董宗美; 朱璇; 俞浩

doi:10.16462/j.cnki.zhjbkz.2023.10.016

1990—2019年江苏省乙型肝炎病毒感染相关肝癌发病和死亡趋势分析

doi: 10.16462/j.cnki.zhjbkz.2023.10.016

刘德¹,
陈培培¹,
娄培安¹,
乔程¹,
李婷¹,
张盼¹,
江宜雪¹,
董宗美¹,
朱璇¹,
俞浩^2, ,

1.
徐州市疾病预防控制中心慢病科，徐州 221000
2.
江苏省疾病预防控制中心慢病所，南京 210009

基金项目:

江苏省卫生计生委医学科研课题 H2017018

详细信息

通讯作者:
俞浩, E-mail：yuh@jscdc.cn

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2022-08-05
- 修回日期: 2023-07-05
- 网络出版日期: 2023-10-23
- 刊出日期: 2023-10-10

Incidence and mortality trends of hepatitis B virus infection-related liver cancer in Jiangsu Province from 1990 to 2019

1.
Department of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221000, China
2.
Department of Chronic Non-Communicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China

Funds:

Medical Research Progect of Jiangsu Health and Family Planning Commission H2017018

More Information

Corresponding author: YU Hao, E-mail: yuh@jscdc.cn

摘要

摘要: 目的分析全球健康数据交换(Global Health Data Exchange，GHDx) 数据库中1990—2019年江苏省乙型肝炎病毒(hepatitis B virus, HBV)感染相关肝癌发病和死亡的现状及时间变化趋势。方法收集GHDx数据库中1990—2019年江苏省HBV感染相关肝癌发病和死亡数据，使用Joinpoint软件分析年龄标化发病率或死亡率的时间变化趋势。使用年龄-时期-队列模型，评估年龄、时期、队列因素对年龄标化发病率或死亡率变化的影响。结果 1990—2019年江苏省HBV感染相关肝癌的年龄标化发病率、死亡率均呈波动变化，整体呈下降趋势，年均变化百分比分别下降-4.7%、-5.3%(均P＜0.001)。年龄-时期-队列(age-period-cohort, APC)模型结果显示，HBV感染相关肝癌年龄标化发病、死亡风险随出生队列的增长而下降(P＜0.001)，随年龄及时期的增长呈现先增加后下降的趋势(P＜0.001)。结论 1990—2019年江苏省HBV感染相关肝癌发病和死亡率整体呈大幅下降趋势，发病、死亡风险随出生队列的增长而下降，随年龄及时期的增长呈现先增加后下降趋势，建议在高危成人中接种乙型肝炎疫苗(乙肝疫苗)，同时加强老年人群的健康教育，进一步降低未来江苏省肝癌疾病负担。
- 乙型肝炎病毒 /
- 肝癌 /
- 趋势分析 /
- 江苏省 /
- 年龄-时期-队列模型
Abstract: Objective To analyze the current status and the temporal trend of hepatitis B virus (HBV) infection-related liver cancer incidence and mortality in Jiangsu Province from 1990 to 2019 based on the Global Health Data Exchange (GHDx) database. Methods The incidence and mortality data of HBV infection-related liver cancer in Jiangsu Province from 1990 to 2019 were collected from the GHDx database. The temporal trend of age-standardized incidence/mortality rates was analyzed by Joinpoint software. The effect of age, period and cohort factors on age-specific incidence/mortality changes was assessed using an age-period-cohort model. Results From 1990 to 2019, the age-standardized incidence and mortality of HBV infection-related liver cancer in Jiangsu Province showed fluctuations. The overall trend showed a significant downward trend, with the average annual percent change decreasing by -4.7% and -5.3% (all P < 0.001), respectively. The results of the age-period-cohort model indicated that the age-standardized incidence and mortality of HBV infection-related liver cancer decreased with the increase of the birth cohort (P < 0.001), and showed a trend of increasing and then decreasing with the increase of age and period (P < 0.001). Conclusions From 1990 to 2019, the incidence and mortality of HBV infection-related liver cancer in Jiangsu Province showed a significant downward trend. The risk of incidence and mortality decreased with the growth of the birth cohort and showed a trend of increasing followed by decreasing with age and period. Vaccinating hepatitis B among high-risk adults and strengthening health education for the elderly population, could further reduce the future disease burden of liver cancer in Jiangsu Province.
- Hepatitis B virus /
- Liver cancer /
- Trend analysis /
- Jiangsu Province /
- Age-period-cohort model

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图 1 1990—2019年江苏省HBV感染相关肝癌年龄标化发病率和死亡率的变化趋势

Figure 1. Temporal trends of age-standardized incidence and mortality of HBV infection-related liver cancer by sex in Jiangsu Province from 1990 to 2019

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图 2 1990—2019年江苏省HBV感染的肝癌年龄标化发病率APC模型分析

Figure 2. Age-period-cohort model of age-standardized incidence rates of HBV infection-related liver cancer in Jiangsu Province from 1990 to 2019

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图 3 1990—2019年江苏省HBV感染相关肝癌年龄标化死亡率APC模型分析

Figure 3. Age-period-cohort model of age-standardized mortality rates of HBV infection-related liver cancer in Jiangsu Province from 1990 to 2019.

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表 1 1990年和2019年江苏省老年人群跌倒疾病负担情况

Table 1. Changes in the incidence and mortality of HBV infection-related liver cancer in Jiangsu Province from 1990 to 2019

变量Variable	发病率Incidence rate				变化率/% Rate of change /%	死亡率Mortality rate				变化率/% Rate of change /%
	1990		2019			1990		2019
	人数Number	ASR /%	人数Number	ASR %		人数Number	ASR /%	人数Number	ASR %
男性Male	11 056.01	36.05	5 851.54	9.54	73.55	10 564.75	35.4	4 693.85	7.67	78.35
女性Female	1 466.65	4.65	681.04	0.99	78.63	1 459.71	4.69	598.85	0.86	81.78
合计Total	12 522.66	19.88	6 532.57	5.09	74.41	12024.46	19.39	5292.7	4.07	79.01

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表 2 1990—2019年江苏省HBV感染相关肝癌的Joinpoint回归分析

Table 2. Joinpoint regression analysis of HBV infection-related liver cancer in Jiangsu Province from 1990 to 2019

变量Variable	性别Gender	年份Period	APC值value (95% CI)	AAPC值value	t值value	P值value
发病率Incidence rate	男性Male	1990—1995	3.56(2.88~4.25) ^①	-4.6	-31.9	＜0.001
		1995—2001	-3.23(-3.87~-2.59) ^①
		2001—2005	-22.29(-23.43~-21.14) ^①
		2005—2014	-4.34(-4.64~-4.03) ^①
		2014—2019	1.59(0.92~2.26) ^①
	女性Female	1990—1995	2.70(2.23~3.16) ^①	-5.2	-38.0	＜0.001
		1995—2001	-2.87(-3.31~-2.43) ^①
		2001—2005	-17.24(-18.07~-16.39) ^①
		2005—2011	-6.59(-7.01~-6.16) ^①
		2011—2014	-9.39(-11.21~-7.53) ^①
		2014—2019	-1.13(-1.57~-0.68) ^①
	合计Total	1990—1995	3.60(2.95~4.25) ^①	-4.7	-34.4	＜0.001
		1995—2001	-3.21(-3.82~-2.60) ^①
		2001—2005	-21.94(-23.03~-20.84) ^①
		2005—2014	-4.81(-5.11~-4.52) ^①
		2014—2019	1.42(0.78~2.05) ^①
死亡率Mortality rate	男性Male	1990—1996	2.68(1.94~3.43) ^①	-5.2	-22.9	＜0.001
		1996—2000	-2.81(-4.88~-0.70) ^①
		2000—2004	-21.91(-23.58~20.21) ^①
		2004—2013	-6.92(-7.35~-6.48) ^①
		2013—2019	0.70(-0.03~1.44)
	女性Female	1990—1996	2.06(1.74~2.38) ^①	-5.7	-48.7	＜0.001
		1996—2000	-2.90(-3.80~-1.99) ^①
		2000—2004	-17.18(-17.95~-16.40) ^①
		2004—2009	-7.01(-7.55~-6.46) ^①
		2009—2013	-11.66(-12.48~-10.83) ^①
		2013—2019	-1.72(-2.03~-1.41) ^①
	合计Total	1990—1996	2.69(1.94~3.44) ^①	-5.3	-23.4	＜0.001
		1996—2000	-2.85(-4.92~-0.73) ^①
		2000—2004	-21.51(-23.18~-19.80) ^①
		2004—2013	-7.36(-7.79~-6.92) ^①
		2013—2019	0.56(-0.17~1.29)
注：APC, 年度变化百分比; AAPC, 年均变化百分比。 ① P < 0.05。 Note: APC, annual percent change; AAPC, average annual percent change. ① P < 0.05.

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表 3 1990—2019年江苏省HBV感染相关肝癌的APC模型及Wald χ²检验

Table 3. The Wald χ² test of estimable function in APC models of HBV infection-related liver cancer in Jiangsu Province from 1990 to 2019

变量Variable	零假设Null hypothesis	男性Male		女性Female		合计Total
变量Variable	零假设Null hypothesis	χ²值value	P值value	χ²值value	P值value	χ²值value	P值value
发病率Incidence rate
	全局变化Net Drift=0	3 578.47	＜0.001	1 300.24	＜0.001	4 603.31	＜0.001
	全时期RR All Period RR=1	4 469.48	＜0.001	1 530.61	＜0.001	5 685.26	＜0.001
	全队列RR All Cohort RR=1	7 403.97	＜0.001	2 307.97	＜0.001	9 242.98	＜0.001
	所有局部变化=全局变化All Local Drifts=Net Drift	243.47	＜0.001	9.98	0.695	249.48	＜0.001
死亡率Mortality rate
	全局变化Net Drift=0	4 530.36	＜0.001	1 064.27	＜0.001	5 920.58	＜0.001
	全时期RR All Period RR=1	5 792.73	＜0.001	1 298.43	＜0.001	7 488.14	＜0.001
	全队列RR All Cohort RR=1	10 845.21	＜0.001	2 393.36	＜0.001	13 827.29	＜0.001
	所有局部变化=全局变化All Local Drifts=Net Drift	244.90	＜0.001	7.42	0.879	251.29	＜0.001

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