<b>2004</b>—<b>2018</b>年中国大陆地区城乡肺癌死亡趋势分析

柳东红; 蒋栋铭; 周鑫宇; 赵沛; 张丽娟; 曹广文

doi:10.19428/j.cnki.sjpm.2021.21077

摘要:

目的分析中国大陆地区2004—2018年城乡肺癌死亡率变化趋势。

方法收集2004—2018年我国死因监测数据集中符合《国际疾病分类第十版（ICD-10）》编码为C33~C34的大陆地区全部肺癌患者死亡资料，计算粗死亡率（CMR）、年龄标化死亡率（ASMR）和年度变化百分比（APC），分析城乡肺癌死亡率及其变化情况。

结果2004—2018年肺癌CMR为41.11/10万，ASMR为27.91/10万，无明显上升或下降趋势；城市肺癌CMR为46.03/10万，ASMR为30.33/10万，APC为-0.82%；农村肺癌CMR为38.54/10万，ASMR为26.66/10万，APC为1.73%；城市和农村肺癌CMR相比差异显著。城市东部、中部和西部地区肺癌CMR分别为50.27/10万、44.59/10万和40.64/10万，东部和中部城市肺癌标化死亡率分别下降了1.05%和1.08%；农村东部、中部和西部地区肺癌CMR分别为45.82/10万、38.26/10万和28.90/10万，农村地区肺癌ASMR整体呈上升趋势；东部、中部和西部地区城市和农村肺癌CMR相比差异显著。城市男性和女性肺癌CMR分别为63.17/10万和28.42/10万；农村男性和女性肺癌CMR分别为52.83/10万和23.62/10万；农村男性和女性肺癌ASMR分别上升了1.18%和1.09%，城市男性和女性肺癌ASMR分别下降了0.61%和1.35%；城市男性与农村男性相比肺癌CMR差异显著，城市女性与农村女性相比肺癌CMR差异显著。农村和城市肺癌ASMR随年龄增长呈递增趋势，≥60岁年龄段最高；城市肺癌ASMR在20~39和40~59岁年龄段呈下降趋势，农村地区肺癌ASMR在<60岁人群中呈下降趋势，但在≥60岁人群中呈上升趋势；农村和城市肺癌CMR相比，在0~19、40~59和≥60岁人群中差异显著。

结论2004—2018年我国大陆地区肺癌死亡率具有城乡差异性，可能受吸烟、人口老年化程度、工业化进程和性别因素影响，确定肺癌发生的危险因素，识别高危人群，进行早期干预有助于降低肺癌的死亡率。

Abstract:

ObjectiveTo analyze the trend of mortality from lung cancer in urban and rural areas of Chinese mainland from 2004 to 2018.

MethodsCancer cases from 2004 to 2018 coded as C33-C34 according to the International Classification of Diseases-10^th Revision （ICD-10） were collected from the Chinese national mortality surveillance system. The crude mortality rate （CMR）， age-standardized mortality （ASMR） and annual percentage change （APC） were calculated to analyze the mortality trend of lung cancer in rural and urban areas.

ResultsFrom 2004 to 2018， the CMR of lung cancer was 41.11/10⁵， and the ASMR was 27.91/10⁵， with no significant tendency of upward or downward. The CMR of lung cancer in urban areas was 46.03/10⁵， and the ASMR was 30.33/10⁵， with an APC of -0.82%. The CMR of lung cancer in rural areas was 38.54/10⁵， and the ASMR was 26.66/10⁵， with an APC of 1.73%. The difference between urban and rural CMR was significant. The CMR of lung cancer in urban eastern， central and western areas were 50.27/10⁵， 44.59/10⁵ and 40.64/10⁵， respectively. The APC of eastern and central urban areas were -1.05% and -1.08%， respectively. The CMR of lung cancer in rural eastern， central and western areas were 45.82/10⁵， 38.26/10⁵ and 28.90/10⁵， respectively， with an increasing trend. The CMR of lung cancer was significantly different between urban and rural areas of eastern， central and western areas of China. The CMR of lung cancer in urban males and females were 63.17/10⁵ and 28.42/10⁵， respectively. The CMR of lung cancer in rural males and females were 52.83/10⁵ and 23.62/10⁵， respectively. The ASMR of lung cancer in rural men and women increased by 1.18% and 1.09%， respectively. The ASMR of lung cancer in urban men and women decreased by 0.61% and 1.35%， respectively. The CMR of lung cancer between males and females in urban and rural was significantly different. The CMR rate of lung cancer increased with age， with the peak in the age group above 60 years old. The ASMR rate of lung cancer showed a decreasing trend in the group under 60 years old in both urban and rural areas. While in rural areas， the ASMR of lung cancer showed an increasing trend in the group over 60 years old. There were significant variations in lung cancer CMR between rural and urban areas in groups aged 0-19， 40-59， and over 60 years.

ConclusionThe CMR of lung cancer in China is different between urban and rural areas from 2004 to 2018， which may be affected by smoking， ageing， industrialization and gender. Identifying high-risk populations， especially those in rural areas and providing early intervention can help to reduce the mortality rate of lung cancer.

2004—2018年中国大陆地区城乡肺癌死亡趋势分析

Comparison of lung cancer mortality between rural and urban areas in the mainland of China from 2004 to 2018