2006-2020年中国20岁及以上人群胰腺癌死亡分析及趋势预测  

Mortality analysis and trends of people aged 20 and above with pancreatic cancer in China between 2006 and 2020

作　　者：陈宏森 杨之雨 蒋栋铭 胡明 牛喆昀 王瑞华 曹广文 CHEN Hongsen;YANG Zhiyu;JIANG Dongming;HU Ming;NIU Zheyun;WANG Ruihua;CAO Guangwen(Department of Epidemiology,Naval Medical University,Key Laboratory for Biosecurity of Education Ministry,Shanghai Key Laboratory for Medical Protection,Shanghai 200433,China;Department of Epidemiology,Jinan University,Guangzhou 510632,China;School of Medicine,TongjiUniversity,Shanghai 200092,China)

机构地区：[1]海军军医大学流行病学教研室,生物安全防御教育部重点实验室,上海市医学防护重点实验室,上海200433 [2]暨南大学流行病学教研室,广东广州510632 [3]同济大学医学院,上海200092

出　　处：《中华肿瘤防治杂志》2023年第12期699-707,共9页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(81520108021,91529305,81673250,81072377);上海市“公卫”体系建设三年行动计划(GWV-10.1-XK17)。

摘　　要：目的 分城乡和性别阐明中国≥20岁人群胰腺癌死亡变化特征及未来趋势。方法 基于中国死因监测数据集,采用局部加权回归和Joinpoint回归,明确2006-2020年胰腺癌的死亡趋势,通过年龄时期队列模型分析、预测胰腺癌死亡趋势。结果 2006-2020年,胰腺癌粗死亡率为6.320/10万,年龄标化死亡率(ASMR)为4.551/10万。城市和农村人群ASMR分别为5.643/10万和3.976/10万,男性和女性分别为5.485/10万和3.653/10万。胰腺癌死亡持续增加,农村人群每年上升3.684%(t=18.609,P<0.001),高于城市人群的0.173%,t=0.800,P=0.438。男性和女性ASMR每年增加基本一致,分别为1.834%(t=7.456,P<0.001)和1.994%(t=8.055,P<0.001)。年龄效应随年龄增长而增加,60岁以后所有人群年龄效应增长趋势放缓。时期效应随着时间推移而上升,城市和农村人群死亡风险15年间分别增加了57.054%和112.852%,男性和女性则各增加了79.803%和87.989%。队列效应随时期而下降,1976年以后出现反弹。预测未来20年,男性、女性胰腺癌ASMR仍会增长。结论 中国≥20岁人群胰腺癌死亡趋势持续上升,呈现城市死亡增加高于农村,男性高于女性的特征。预测发现,在未来20年胰腺癌死亡趋势仍会持续上升。Objective To elucidate and speculate the changes in the mortality and trend of pancreatic cancer in urban and rural populations in China.Methods Based on the mortality surveillance data set of the National Disease Surveillance System, we analyzed trends in the mortality of pancreatic cancer in China from 2006 to 2020,using locally weighted regression and joinpoint regression, and speculated the mortality trend by using the age period cohort model.Results The crude mortality rate(CMR) and age-standardized mortality rate(ASMR) of pancreatic cancer in Chinese adults from 2006 to 2020 were 6.320/10~5 and 4.551/10~5,respectively.The ASMR in urban and rural populations was 5.643/10~5 and 3.976/10~5,respectively.The ASMR in the male and female populations was 5.485/10~5 and 3.653/10~5,respectively.The mortality of pancreatic cancer showed an increasing trend, with an annual percentage increase of 3.684%(t=18.609,P<0.001) in rural areas, higher than that in urban areas with a percentage of 0.173%(t=0.800,P=0.438).The annual percentage increase of the ASMR in males was approximately the same as that in females,1.834%(t=7.456,P<0.001)vs 1.994%(t=8.055,P<0.001).The age effect of pancreatic cancer death increased with aging,but it slowed down for people over the age of 60.The period effect increased over time.During the 15 years,the mortality risk in urban and rural populations increased by 57.054% and 112.852%,respectively.The risk in males and females increased by 79.803% and 87.989%,respectively.The cohort effect generally declined over time,and the growth trend slowed down since 1976.The ASMR of pancreatic cancer in both sex was speculated to increase in the next 20 years and might double by 2040,according to the speculation.Conclusions The trend in pancreatic cancer mortality in China keeps increasing,showing a higher increase in deaths in urban than in rural areas and in men than in women.According to the speculation,the trend of pancreatic cancer deaths will continue to rise in the next 20 years.

关 键 词：胰腺癌 死亡 成年人 Joinpoint回归 局部加权回归 年龄时期队列模型 趋势分析与预测 

分 类 号：R735.9[医药卫生—肿瘤]