2012-2022年山东省肝癌发病与死亡趋势及其年龄-时期-队列分析  

Analysis for incidence and mortality trend and age-period-cohort of liver cancer in Shandong Province from 2012 to 2022

作　　者：姜帆 付振涛[1] 鹿子龙[1] 楚洁[1] 郭晓雷[1] 马吉祥 JIANG Fan;FU Zhentao;LU Zilong;CHU Jie;GUO Xiaolei;MA Jixiang(Department for Chronic and Non-communicable Disease Control and Prevention,Shandong Center for Disease Control and Prevention,Jinan,Shandong 250014,China;Institute of Preventive Medicine in Shandong University(Shandong Academy of Preventive Medicine),Jinan,Shandong 250014,China)

机构地区：[1]山东省疾病预防控制中心慢性非传染性疾病防治所,山东济南250014 [2]山东大学预防医学研究院(山东省预防医学科学院),山东济南250014

出　　处：《中华肿瘤防治杂志》2024年第5期280-291,共12页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家重点研发计划精准医学重点研究专项(2016YFC0901300);山东省泰山学者工程专项(ts201511105);山东省重点研发计划(2016GSF201231);山东省医药卫生科技发展计划(202012051127)。

摘　　要：目的分析2012-2022年山东省肝癌发病及死亡变化趋势,并估计其年龄-时期-队列效应。方法基于2012-2022年山东省肿瘤登记地区肝癌新发和死亡病例资料,采用Joinpoint回归分析其发病率及死亡率变化趋势,计算平均年度变化百分比(AAPC)。拟合年龄-时期-队列模型分析≥20岁人群肝癌发病、死亡风险的年龄效应、时期效应及队列效应。结果2012-2022年山东省肝癌标化发病率呈显著下降趋势,每年下降6.0%(AAPC=-6.0%,95%CI:-6.9%~-5.1%,P<0.05);男性下降5.9%(AAPC=-5.9%,95%CI:-6.9%~-4.9%,P<0.05),女性下降6.0%(AAPC=-6.0%,95%CI:-6.7%~5.2%,P<0.05);城市下降6.6%(AAPC=-6.6%,95%CI:-8.0%~-5.3%,P<0.05),农村下降4.9%(AAPC=-4.9%,95%CI:-5.9%~-3.9%,P<0.05)。2012-2022年山东省肝癌标化死亡率呈显著下降趋势,每年下降5.1%(AAPC=-5.1%,95%CI:-5.9%~-4.4%,P<0.05);男性下降4.9%(AAPC=-4.9%,95%CI:-5.6%~-4.2%,P<0.05),女性下降5.5%(AAPC=-5.5%,95%CI:-6.6%~4.4%,P<0.05);城市下降4.6%(AAPC=-4.6%,95%CI:-6.0%~3.1%,P<0.05),农村下降4.8%(AAPC=-4.8%,95%CI:-6.1%~3.6%,P<0.05)。肝癌发病和死亡风险均随年龄增加而增大,发病和死亡时期效应和队列效应均随年份推移而减小。结论2012-2022年山东省肝癌发病和死亡均呈下降趋势。年龄是增加肝癌发病和死亡风险重要因素,未来肝癌疾病负担仍然较重。应重视肝癌高危人群早诊早治,同时加强病因学探索性研究,为肝癌防控策略提供参考依据。Objective To analyze the trend of incidence and mortality of liver cancer in Shandong from 2012 to 2022 and estimate the related age,period and cohort effect,respectively.Methods We used joinpoint regression to analyze the trend of incidence and mortality,and calculate the average annual percentage change(AAPC)based on the data of liver cancer cases from 2012 to 2022.The age-period-cohort model was used to analyze the age-effect,time-effect and cohort-effect of liver cancer risk in the population aged over 20 years.Results From 2012 to 2022,the standardized incidence of liver cancer in Shandong Province showed a significant decreasing trend,with an annual decrease of 6.0%(AAPC=-6.0%,95%CI:-6.9%--5.1%,P<0.05).The decrease was 5.9%in men(AAPC=-5.9%,95%CI:-6.9%--4.9%,P<0.05)and 6.0%in women(AAPC=-6.0%,95%CI:-6.7%-5.2%,P<0.05).The decrease was6.6%in urban areas(AAPC=-6.6%,95%CI:-8.0%--5.3%,P<0.05)and 4.9%in rural areas(AAPC=-4.9%,95%CI:-5.9%--3.9%,P<0.05).From 2012to 2022,the standardized mortality rate of liver cancer in Shandong province showed a significant downward trend,with an annual decrease of 5.1%(AAPC=-5.1%,95%CI:-5.9%--4.4%,P<0.05),and a decrease of 4.9%(AAPC=-4.9%,95%CI:-5.6%--4.2%,P<0.05)in men,5.5%in women(AAPC=-5.5%,95%CI:-6.6%-4.4%,P<0.05).The decrease was 4.6%in urban areas(AAPC=-4.6%,95%CI:-6.0%-3.1%,P<0.05)and 4.8%in rural areas(AAPC=-4.8%,95%CI:-6.1%-3.6%,P<0.05).The relative risk of incidence and mortality of liver cancer increased with age,and the period effect and cohort effect decreased with years.Conclusion The incidence and mortality of liver cancer in Shandong have showed a decreasing trend in the past decade.Age is an important factor affecting the risk of incidence and mortality.The disease burden of liver cancer is still serious in the future.We should pay attention to the early diagnosis and treatment of highrisk groups,and in addition,strengthen the exploratory research of its etiology,to provide reference for liver cancer prevention and control strategies.

关 键 词：肝癌 发病率 死亡率 Joinpoint 年龄-时期-队列模型 

分 类 号：R735.7[医药卫生—肿瘤]