2004—2018年中国大陆地区城乡居民结直肠癌死亡趋势分析  

Trends in colorectal cancer mortality between rural and urban areas in China's Mainland from 2004 to 2018

作　　者：魏志敏 蒋栋铭 赵沛 柳东红 张丽娟[2] 谭晓㛃 王颢[5] 余红平 曹广文 WEI Zhimin;JIANG Dongming;ZHAO Pei;LIU Donghong;ZHANG Lijuan;TAN Xiaojie;WANG Hao;YU Hongping;CAO Guangwen(Department of Epidemiology,The Second Military Medical University;Tongji University School of Medicine,Shanghai 200433,China;Guangxi Medical University Cancer Hospital,Nanning 530021,China;The Third Affiliated Hospital of Second Military Medical University;The First Affiliated Hospital of Second Military Medical University,Shanghai 200433,China)

机构地区：[1]第二军医大学海医系流行病学教研室,上海200433 [2]同济大学医学院 [3]广西医科大学附属肿瘤医院,南宁530021 [4]第二军医大学第三附属医院肝外科,上海200433 [5]第二军医大学第一附属医院肛肠外科

出　　处：《中国癌症防治杂志》2021年第5期447-451,共5页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：国家重点基础研究发展计划(973计划)(2015CB554000);上海市公共卫生重点学科(GWV⁃10.1⁃XK17)。

摘　　要：目的分析我国城乡2004—2018年结直肠癌死亡流行病学特征,为预防控制结直肠癌发病与死亡提供科学依据。方法分析中国疾病预防控制中心发布的全国605个监测点的2004—2018年结直肠癌死亡病例,根据年龄、性别和地区进行分层,计算结直肠癌粗死亡率(crude mortality rate,CMR)、年龄标化死亡率(age⁃standardized mortality rate,ASMR)及其年度变化百分比(annual percent change,APC)。结果2004—2018年我国结直肠癌死亡病例共213513例,CMR为9.67/10万,ASMR为6.52/10万。15年间我国结直肠癌CMR呈上升趋势(APC=3.30%,P<0.001)。城市地区结直肠癌ASMR无明显变化,但东、西部农村地区结直肠癌ASMR呈上升趋势(APC=1.13%,P=0.020;APC=1.80%,P=0.004),中部农村地区结直肠癌ASMR呈下降趋势(APC=-1.22%,P=0.010)。城乡地区男性结直肠癌CMR均高于女性(P<0.001),城市地区女性结直肠癌ASMR呈下降趋势(APC=-1.10%,P<0.001)。城市地区20~39岁和40~59岁年龄组的结直肠癌ASMR呈下降趋势(APC=-3.04%,P=0.007;APC=-1.98%,P=0.002);农村地区≥60岁年龄组结直肠癌ASMR呈上升趋势(APC=0.86%,P=0.030)。结论我国结直肠癌死亡率逐年上升,城乡地区人群结直肠癌死亡率在年龄、性别、地区等各层均存在显著差异,未来应加大对农村地区人群结直肠癌的防控,以早期发现、诊断和治疗。Objective To elucidate the epidemiological characteristics of colorectal cancer mortality from 2004 to 2018,and to pro⁃vide useful data for the prevention and control of colorectal cancer morbidity and mortality.Methods The data of colorectal cancer deaths from 605 surveillance sites were collected from the Chinese Center for Disease Control and Prevention from 2004 to 2018.The data were stratified according to age,sex,and area and then used to calculate crude mortality rate(CMR),age⁃standardized mortality rate(ASMR),and the annual percent change(APC).Results A total of 213,513 patients died of colorectal cancer from 2004 to 2018,with the CMR and ASMR of 9.67/10^(5) and 6.52/10^(5),respectively.From 2004 to 2018,the CMR of colorectal cancer in China showed an increasing trend(APC=3.30%,P<0.001).There was no significant change in the ASMR of colorectal cancer in cities.The ASMR of colorectal cancer showed an increasing trend in eastern and western rural areas(APC=1.13%,P=0.020;APC=1.80%,P=0.004),whereas the ASMR of colorectal cancer in central rural areas showed a decreasing trend(APC=-1.22%,P=0.010).The CMR of colorectal cancer in males was higher than that in females(P<0.001).The ASMR of colorectal cancer in urban females showed a decreasing trend(APC=-1.10%,P<0.001).The ASMR of colorectal cancer in urban residents aged 20⁃39 and 40⁃59 years showed decreasing trends(APC=-3.04%,P=0.007;APC=-1.98%,P=0.002).The ASMR of colorectal cancer in residents≥60 years in rural areas showed an increasing trend(APC=0.86%,P=0.030).Conclusions The mortality rate of colorectal cancer keeps increasing in China's Mainland,and the mortality rate differ in populations with different age group,gender and geographic areas.Prevention and control of colorectal cancer in rural areas should be strengthened in the future.

关 键 词：结直肠癌 死亡率 流行趋势 中国大陆地区 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]