2002-2021年中国城乡居民胃癌死亡趋势年龄-时期-队列模型分析  

Age period cohort model analysis of the mortality trend of gastric cancer among urban and rural residents in China from 2002 to 2021

作　　者：蔡迎彬 刘广超 梁智超 地力亚尔·吾斯曼江 张闻烙 王岩[2] CAI Yingbin;LIU Guangchao;LIANG Zhichao;Diliyaer·Wusimanjiang;ZHANG Wenluo;WANG Yan(Tumor Hospital Af filiated to Xinjiang Medical University,Urumqi,Xinjiang 83001l,China;Public Health Institute of Xinjiang Medical University,Urumqi,Xinjiang 83001l,China)

机构地区：[1]新疆医科大学附属肿瘤医院内镜诊疗中心,新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院医务部,新疆乌鲁木齐830011 [3]新疆医科大学公共卫生学院,新疆乌鲁木齐830011

出　　处：《中华肿瘤防治杂志》2024年第8期478-485,共8页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家重点研发计划(2022YFC2505100)。

摘　　要：目的分城乡阐述中国居民胃癌死亡率变化趋势及死亡风险与年龄、时期、队列的关系,为胃癌的防治研究提供参考依据.方法基于2002-2021年全国城乡胃癌死亡率数据,应用Joinpoint回归模型分析胃癌死亡率的变化趋势,应用年龄-时期-队列模型分析年龄、时期、队列对死亡率变化的影响.结果2002-2021年,城乡居民的中标死亡率分别从2002年的24.10/10万和28.88/10万下降到2021年的10.75/10万和13.10/10万,平均年度变化百分比(AAPC)分别为-2.96%(95%CI:-3.74%~-2.18%,P<0.001)和-4.14%(95%CI:-4.73%~-3.55%,P<0.001).年龄-时期-队列模型分析结果显示:城乡居民胃癌死亡风险随着年龄的增加而升高,分别在55~60和45~50岁年龄组开始快速增高;城乡居民80~84岁年龄组发生死亡的风险是20~24岁的97.00和128.50倍.城乡居民胃癌死亡风险均在2016年开始出现转折,城乡2016年风险系数分别为1.11和0.88.城乡居民普遍出生队列越早死亡风险越高,2001-2005年出生的人相比1926-1930年出生的人胃癌死亡风险分别减少了90%和86%.结论2002-2021年全国胃癌死亡率呈下降趋势,农村死亡率高于城市但差距在逐渐缩小.人群胃癌死亡风险受年龄与出生队列影响较大,农村地区的中老年人将是今后胃癌防治的重点人群.Objective To illustrate the trend of gastric cancer mortality and the relationship between mortality risk and age-period-cohort among Chinese residents in urban and rural areas,in order to provide a reference for gastric cancer preven-tion and treatment research.Methods Based on national urban and rural gastric cancer mortality data from 2002 to 2021,the trend of gastric cancer mortality was investigated using the Joinpoint regression model.The effect of age,period,and cohort on mortality change was analyzed with the age-period-cohort model.Results During the period 2002-2021,the ASMRC for urban and rural residents decreased from 24.10 per 100000 and 28.88 per 100000 in 2002 to 10.75 per 100000 and 13.10 per 100000 in 2021,with an average annual percent change(AAPC)of-2.96%(95%CI:-3.74%to-2.18%,P<0.001)and-4.14%(95%CI:-4.73%to-3.55%,P<0.001),respectively.According to the re-sults of age-period-cohort model analyses,the risk of death from gastric cancer increased with age and began to rise rapid-ly in the 55-60 and 45-50 age groups,respectively.The risks of death from gastric cancer among urban and rural resi-dents in the 80-84 age group were 97.00 and 128.50 times higher than that of those in the 20-24 age group.With risk coefficients of 1.11 and 0.88 in urban and rural areas,respectively,the risk of death from gastric cancer started to experi-ence a turning point in 2016.For both urban and rural populations,the risk of death was higher in the earlier birth cohort;besides,the chance of death from gastric cancer was reduced by 90%and 86%,respectively,for those born in 2001-2005 compared to those born in 1926-1930.Conclusions The national mortality rate for gastric cancer exhibited a declining trend between 2002 and 2021,with rural areas having a greater mortality rate than urban areas,albeit the difference is rapidly narrowing.Age and birth cohort have a significant impact on the risk of death from gastric cancer in a community,and middle-aged and elderly residents in rural areas will be a priority demographic for

关 键 词：胃癌 死亡率 Joinpoint回归模型 年龄-时期-队列模型 疾病趋势 

分 类 号：R735.2[医药卫生—肿瘤]