20042016年上海市普陀区户籍居民主要恶性肿瘤所致过早死亡趋势分析

Trends of premature mortality of major cancers in Putuo District, Shanghai from 2004 to 2016

  • 摘要:
    目的 了解上海市普陀区户籍居民主要恶性肿瘤所致过早死亡情况,为降低早死概率,实现早死概率控制目标提供参考。
    方法 收集2004—2016年上海市普陀区户籍居民恶性肿瘤发病、死亡资料,通过编制寿命表计算恶性肿瘤粗发病率、标化发病率、粗死亡率、标化死亡率、早死概率等指标,并采用年度变化百分比(APC)和平均年度变化百分比(AAPC)反映发病率、死亡率、早死概率的变化趋势。
    结果 2004—2016年上海市普陀区户籍居民恶性肿瘤粗发病率从383.51/10万上升至573.94/10万(APC=3.52%,P<0.01),标化发病率从223.20/10万变化至241.38/10万(AAPC=0.67%,P=0.11)。粗死亡率从229.99/10万变化至269.94/10万(APC=1.64%,P<0.01),标化死亡率从122.48/10万变化至87.49/10万(APC=-2.04%,P<0.01)。早死概率从7.14%变化至5.53%(AAPC=-2.29%,P<0.01),其中男性从8.73%变化至7.10%(AAPC=-1.74%,P=0.01),女性从5.54%变化至3.88%(AAPC=-2.88%,P=0.08)。早死概率顺位前10位肿瘤中,男、女性首位主要为气管、支气管和肺癌,男性肝癌(APC=-3.83%,P=0.01)、女性胃癌(APC=-4.17%,P<0.01)早死概率呈下降趋势,其余肿瘤变化趋势不明显(P>0.05)。男性鼻咽癌、女性宫颈癌死亡率列前10位以外,早死概率位列前10位。
    结论 恶性肿瘤所致早死概率总体呈下降趋势,但女性、居前10位的主要恶性肿瘤早死概率未下降,早死概率控制压力仍然较大。应从可防、可筛的主要致早死的肿瘤入手,使早死概率下降。

     

    Abstract:
    Objective To understand the premature mortality of the most common cancers in the residents in Putuo District, Shanghai for the goal to decrease the probability of premature cancer mortality.
    Methods Life table was used to calculate crude and age-standardized incidence rate, mortality, and the probability of premature mortality caused by cancers among Putuo residents from 2004 to 2016. The annual percent change was used to describe the change of these indexes.
    Results From 2004 to 2016, the crude incidence rate increased from 383.51/105 to 573.94/105 (APC=3.52%, P<0.01) while the age-standardized incidence rate changed from 223.20/105 to 241.38/105 (APC=3.52%, P<0.01). The crude mortality rate changed from 229.99/105 to 269.94/105 (APC=1.64%, P<0.01) while the age-standardized mortality rate changed from 122.48/105 to 87.49/105 (APC=-2.04%, P<0.01). The probability of premature mortality changed form 7.14% to 5.53% (AAPC=-2.29%, P<0.01). The probability of premature mortality for male changed from 8.73% to 7.10% (AAPC=-1.74%, P=0.01) while the female from 5.54% to 3.88% (AAPC=-2.88%, P=0.08). Trachea, bronchus and lung cancers were the top cancers causing premature mortality both for male and female. The probability of premature mortality showed a downward trend for both male liver cancer (APC=-3.83%, P=0.01) and female stomach cancer (APC=-4.17%, P<0.01). The other types cancers did not show the significant changes (P>0.05). Male nasopharyngeal carcinoma and female cervical carcinoma ranked top ten cancers causing probability of premature mortality but not the top ten cancers according to the crude mortality rate.
    Conclusion The premature death caused by cancers shows a downward trend in general, but not in the female and most common cancers. The burden to reduce the premature mortality is still heavy. More efforts should focus on those cancers that are preventable and detectable by screening in order to decrease the premature cancer mortality.

     

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