<b>2004</b>—<b>2018</b>年全国膀胱癌死亡率的流行特征及变化趋势

鲁欣; 蒋栋铭; 周雄; 杨印辉; 张丽娟; 侯建国; 曹广文; 谭晓㛃

doi:10.19428/j.cnki.sjpm.2021.21083

摘要:

目的分析2004—2018年全国膀胱癌死亡情况的流行病学特征。

方法收集来自中国疾病预防控制中心定期公开发表的基于全国605个监测点的2004—2018年膀胱癌死亡病例数据集，并依照中国2000年的人口结构进行年龄标化，计算膀胱癌粗死亡率（CMR）、年龄标化死亡率（ASMR）、城乡ASMR比值（RR），分析膀胱癌死亡病例的年龄、性别、地区（城市/农村，东部/中部/西部）和时间的分布特征。

结果2004—2018年全国膀胱癌CMR为1.69/10万，ASMR为1.09/10万。2004—2018年全国膀胱癌CMR呈上升趋势（APC=2.91%，P<0.001）；ASMR有所下降（APC=-1.29，P=0.008）。男性膀胱癌CMR呈上升趋势（APC=3.29%，P<0.001），ASMR基本持平（APC=-0.83，P=0.070）；女性膀胱癌CMR略有上升（APC=2.12%， P<0.001），ASMR略有下降（APC=-1.94，P=0.008）。城市的膀胱癌CMR和ASMR高于农村（P<0.05），但城市膀胱癌ASMR呈下降趋势（APC=-2.05%，P=0.002），主要分布在东部、西部地区的城市，东部地区城市ASMR高于西部城市。农村地区膀胱癌ASMR无明显变化（P>0.05），且东、中、西部农村之间未见明显差异。东、西部地区的城乡差距在缩小（东部P<0.001，西部P=0.002）。虽然城市≥40岁年龄组ASMR下降趋势较为明显，但城市≥60岁年龄组人群膀胱癌ASMR远高于城市其他年龄组及农村各个年龄组。

结论城市≥60岁年龄组是膀胱癌防治的主要群体，应加强农村地区的膀胱癌筛查和诊断治疗。

Abstract:

ObjectiveTo analyze bladder cancer mortality in China from 2004 to 2018.

MethodsThe dataset of bladder cancer mortality from 2004 to 2018， based on 605 national surveillance sites and regularly published by the Chinese Center for Disease Control and Prevention， was collected and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR）， the age-standard mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）were calculated to analyze the distributions of the mortality of bladder cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time.

ResultsThe CMR of bladder cancer in China from 2004 to 2018 was 1.69/10⁵， and the ASMR was 1.09/10⁵. The temporal trend on the CMR of bladder cancer from 2004 to 2018 increased significantly （APC=2.91%，P<0.001）， whereas the trend on the ASMR decreased a little （APC=-1.29，P=0.008）. The temporal trend on the CMR of bladder cancer in the males increased （APC=3.29%，P<0.001）， whereas the trend on the ASMR did not change. The temporal trend on the CMR of bladder cancer in the female increased （APC=2.12%，P<0.001）， whereas the trend on the ASMR decreased （APC=-1.94，P=0.008）. Both the CMR and ASMR of urban areas were higher than those of rural areas （P<0.05）. However， the temporal trend on the ASMR of bladder cancer in the urban decreased significantly （APC=-2.05%，P=0.002）， mainly exhibited in eastern and western urban. The ASMR of eastern urban areas was higher than that of western urban areas. The temporal trend on the ASMR of bladder cancer in the rural did not change （P>0.05）， and no differences in the ASMR were detected between eastern， central and western rural areas. The gaps between rural and urban areas in the eastern （P<0.001） or western （P=0.002） region reduced. Although the temporal trend on the ASMR in urban people over 40 years old decreased significantly， the ASMR of urban people over 60 years old was much higher than that of other age groups in the urban or any age groups in rural areas.

ConclusionThe age group over 60 years old in the urban is the major target population for bladder cancer prevention and treatment. Screening， diagnosis and treatment for bladder cancer in rural should be strengthened.

2004—2018年全国膀胱癌死亡率的流行特征及变化趋势

Mortality and trend analysis of bladder cancer in China from 2004 to 2008