江苏省启东市1972-2021年白血病发病趋势及年龄-时期-队列模型分析  

Trends and age-period-cohort analysis of leukemia incidence in Qidong from 1972 to 2021

作　　者：朱健[1] 陈永胜 王军 张永辉[1] 丁璐璐 徐源佑 严永锋[1] 陈建国 蔡红[2] Zhu Jian;Chen Yongsheng;Wang Jun;Zhang Yonghui;Ding Lulu;Xu Yuanyou;Yan Yongfeng;Chen Jianguo;Cai Hong(Department of Etiology,Qidong People's Hospital,Qidong Liver Cancer Institute,the Affiliated Qidong Hospital of Nantong University,Qidong 226200,China;Department of Respiratory,Qidong Liver Cancer Institute,Qidong People's Hospital,the Affiliated Qidong Hospital of Nantong University,Qidong 226200,China)

机构地区：[1]启东市人民医院、启东肝癌防治研究所、南通大学附属启东医院病因室,启东226200 [2]启东市人民医院、启东肝癌防治研究所、南通大学附属启东医院呼吸科,启东226200

出　　处：《中华肿瘤杂志》2024年第10期961-967,共7页Chinese Journal of Oncology

基　　金：南通市“十四五”科教强卫工程(通卫科技[2021]15号);南通市卫生健康委员会科研课题(MS2023121)。

摘　　要：目的分析启东市1972—2021年白血病发病流行特征及变化趋势,为制定白血病的防控措施与政策提供依据。方法根据启东市1972—2021年白血病发病登记数据和历年人口资料,计算白血病发病粗率、中国人口标化发病率(ASRC)、世界人口标化发病率(ASRW)、35~64岁截缩率、0~74岁累积率、累积风险,应用Joinpoint 4.9.1.0统计软件分析白血病发病粗率、ASRC、ASRW的平均年度变化百分比(AAPC);利用年龄-时期-队列模型分析年龄、时期和出生队列对白血病发病趋势变化的影响。结果1972—2021年,启东市白血病发病例数2948例,占全部恶性肿瘤发病的2.00%,发病粗率为5.26/10万,ASRC为4.34/10万,ASRW为4.35/10万,35~64岁截缩发病率为5.29/10万,0~74岁累积发病率为0.40%,累积风险为0.40%。男性发病1608例,发病粗率、ASRC、ASRW分别为5.81/10万、4.88/10万、4.85/10万;女性发病1340例,发病粗率、ASRC、ASRW分别为4.71/10万、3.86/10万、3.91/10万。1972—2021年白血病ASRC的AAPC值为1.41%(男性为1.15%,女性为1.73%;均P<0.001)。年龄-时期-队列模型分析显示,所有年龄组白血病发病率的净漂移值为1.57%(95%CI:1.24%~1.89%),局部漂移值在80~岁组达到最大值3.20%(95%CI:1.63%~4.78%)。年龄效应中发病风险随年龄的增长而增加。随着时期的推移,白血病发病风险逐渐增加,以1992—1996年时期组为对照组[时期率比(RR)值为1.00],发病风险RR值由1972—1976年时期组的0.70上升到2017—2021年时期组的1.57。与较早出生的队列相比,较晚出生的队列白血病发病风险更高,以1952—1956年出生队列为对照组(出生队列RR值为1.00),发病风险由1892—1896年出生队列组的0.24上升到2017—2021年出生队列组的2.73。结论1972—2021年(50年)启东市白血病的发病率呈上升趋势,发病率随年龄增长而升高,白血病发病风险的时期、队列效应均呈上升趋势,需进一步开展针对白血病相关危险因素的Objective To describe the epidemiological characteristics and trends of leukemia incidence in Qidong between 1972 and 2021,and provide guidelines for prevention and control measures and strategies.Methods The cancer registry data was collected and analyzed on leukemia incidence during 1972—2021 in Qidong by sex,age and time.Crude incidence rate(CR),China age-standardized rate(ASRC),world age-standardized rate(ASRW),and average annual change percentage(AAPC)was calculated by Joinpoint software.Age-period-cohort(APC)model was used to analyze the influence of age,period and birth cohort on the changes in the incidence trend of leukemia patients.Results From 1972 to 2021,there were 2948 patients with leukemia in Qidong,accounting for 2.00%of all cancer new cases,CR of leukemia was 5.26/105,ASRC was 4.34/105,ASRW was 4.35/105.The truncated incidence of 35—64 years old was 5.29/105,the cumulative incidence rate between the ages of 0 and 74 years old was 0.40%,the cumulative risk was 0.40%.There were 1608 male patients,the CR,ASRC,and the ASRW were 5.81/105,4.88/105 and 4.85/105.The number of female patients were 1340,and the CR,ASRC,and the ASRW were 4.71/105,3.86/105 and 3.91/105,respectively.Temporal trends indicated significant upward trends in ASRC among both gender,males and females with AAPC values of 1.41%(P<0.001),1.15%(P<0.001),and 1.73%(P<0.001),respectively.The results of the APC model showed that the average net drift value of leukemia incidence in all age groups was 1.57%(95%CI,1.24%-1.89%),and the highest value of local drift was 3.20%(95%CI,1.63%-4.78%)in the 80~years old group.The incidence of leukemia increased with age.With the passage of time,the risk of leukemia incidence increased gradually compared with the rate ratio of leukemia incidence(risk ratio[RR],1.00)in 1992—1996,the RR of leukemia incidence increased from 0.70 during 1972—1976 to 1.57 during 2017—2021.The later the cohort was born,the greater the risk of leukemia incidence compared with the relative risk of leukemia incidence(R

关 键 词：白血病 发病率 流行趋势 年龄-时期-队列模型 启东市 

分 类 号：R733.7[医药卫生—肿瘤]