基于年龄-时期-队列模型的中国妇科肿瘤发病和死亡分析及趋势预测  

Analysis and prediction of incidence and mortality of gynecological tumors in China based on age-period-cohort model

作　　者：王榆平 李妮 郑文娟 思美丽 刘玉锋 Wang Yuping;Li Ni;Zheng Wenjuan;Si Meili;Liu Yufeng(Department of Obstetric and Gynecology,Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,Yulin 719000,China;Department of Research and Education,Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,Yulin 719000,China)

机构地区：[1]西安交通大学第一附属医院榆林医院妇产科,榆林719000 [2]西安交通大学第一附属医院榆林医院科教科,榆林719000

出　　处：《肿瘤研究与临床》2024年第9期652-658,共7页Cancer Research and Clinic

摘　　要：目的统计1990-2019年中国妇科肿瘤的发病和死亡情况,探讨年龄、时期和出生队列对妇科肿瘤发病和死亡的影响,并对妇科肿瘤的发病和死亡趋势进行预测,为妇科肿瘤的预防和控制策略制订提供参考。方法利用2019年全球疾病负担研究(GBD 2019)数据,采用Joinpoint回归模型分析中国子宫颈癌、子宫体癌和卵巢癌标化发病率、标化死亡率的变化趋势;采用R软件,基于年龄-时期-队列模型分析这3种妇科肿瘤发病和死亡的年龄、时期和队列效应。采用灰色预测模型(GM)(1,1)对这3种妇科肿瘤的发病率及死亡率趋势进行拟合,预测2020-2034年的发病率及死亡率。结果1990-2019年中国子宫颈癌、子宫体癌和卵巢癌的标化发病率均呈上升趋势,标化发病率分别从1990年的8.41/10万、5.13/10万、2.56/10万上升至2019年的11.01/10万、6.39/10万、4.54/10万;平均年度变化百分比(AAPC)分别为0.9%(95%CI:0.8%~1.1%)、0.8%(95%CI:0.6%~1.0%)、2.0%(95%CI:1.9%~2.1%),差异均有统计学意义(均P<0.001)。卵巢癌的标化死亡率呈逐年上升的趋势,标化死亡率从1990年的1.76/10万升至2019年的2.77/10万,AAPC为1.6%(95%CI:1.4%~1.7%);而子宫体癌和子宫颈癌的标化死亡率呈逐年下降的趋势,标化死亡率分别从1990年的2.38/10万、5.85/10万降至2019年的1.17/10万、5.13/10万,AAPC分别为-2.4%(95%CI:-2.6%~-2.3%)、-0.4%(95%CI:-0.6%~-0.3%),差异均有统计学意义(均P<0.001)。年龄效应分析显示,子宫颈癌、子宫体癌和卵巢癌的发病率及死亡率均整体上呈现随年龄的增长逐渐上升的趋势,在≥85岁组达到峰值。时期效应分析显示,子宫颈癌和子宫体癌发病风险呈现先降低后上升然后再降低的趋势,发病风险分别在1990-1994年(RR=1.04,95%CI:0.86~1.27)、2005-2009年(RR=1.08,95%CI:0.88~1.31)最高,卵巢癌发病风险呈现先升高后降低的趋势,发病风险在2000-2004年最高(RR=0.96,95%CI:0.71~1.30);子宫颈癌死亡风险呈ObjectiveTo investigate the incidence and mortality of gynecological tumors in China from 1990 to 2019,and explore the impact of age,period and birth cohort on the incidence and mortality of gynecological tumors,and predict the incidence and mortality trends of gynecological tumors,so as to provide references for formulating the prevention and control strategies of gynecological tumors.MethodsBased on the Global Burden of Disease Study 2019(GBD 2019)database,the Joinpoint regression model was used to analyze the change trends of standardized incidence rates and mortality rates of cervical cancer,uterine cancer and ovarian cancer in China.The age,period and cohort effects of the incidence and mortality of 3 gynecological tumors were analyzed by using R software based on age-period-cohort model.The grey forecast model(GM)(1,1)was used to fit the trends of incidence rates and mortality rates of 3 gynecological tumors,and predict the incidence rates and mortality rates from 2020 to 2034.ResultsFrom 1990 to 2019,the standardized incidence rates of cervical cancer,uterine cancer and ovarian cancer showed upward trends in China,the standardized incidence rates increased from 8.41/100000,5.13/100000 and 2.56/100000 in 1990 to 11.01/100000,6.39/100000 and 4.54/100000 in 2019,the average annual percent changes(AAPC)were 0.9%(95%CI:0.8%-1.1%),0.8%(95%CI:0.6%-1.0%)and 2.0%(95%CI:1.9%-2.1%),respectively,and the differences were statistically significant(all P<0.001).The standardized mortality rate of ovarian cancer showed an increasing trend year by year,the standardized mortality rate increased from 1.76/100000 in 1990 to 2.77/100000 in 2019,with the AAPC of 1.6%(95%CI:1.4%-1.7%),while the standardized mortality rates of uterine cancer and cervical cancer showed decreasing trends year by year,the standardized mortality rates decreased from 2.38/100000 and 5.85/100000 in 1990 to 1.17/100000 and 5.13/100000 in 2019,with the AAPC of-2.4%(95%CI:-2.6%--2.3%)and-0.4%(95%CI:-1.6%--0.3%),respectively,and the differences were statist

关 键 词：生殖器肿瘤 女(雌)性 发病率 死亡率 年龄-时期-队列模型 

分 类 号：R737.3[医药卫生—肿瘤]