天津市1999—2021年肝癌死亡率及疾病负担的变化趋势  

Analysis on trends of mortality rate and disease burden of liver cancer in Tianjin,China from 1999 to 2021

作　　者：王德征[1] 张爽[1] 张辉[1] 沈成凤[2] 王冲[2] 寻鲁宁 郑文龙[2] 江国虹[1] Wang Dezheng;Zhang Shuang;Zhang Hui;Shen Chengfeng;Wang Chong;Xun Luning;Zheng Wenlong;Jiang Guohong(Department of Vital Statistics,Institution of Non-Communicable Disease Control and Prevention,Tianjin Centers for Diseases Control and Prevention,Tianjin 300011,China;Department of Cancer Registration,Institution of Non-Communicable Disease Control and Prevention,Tianjin Centers for Diseases Control and Prevention,Tianjin 300011,China)

机构地区：[1]天津市疾病预防控制中心非传染病预防控制所生命统计科,天津300011 [2]天津市疾病预防控制中心非传染病预防控制所肿瘤登记科,天津300011

出　　处：《中华肿瘤杂志》2024年第11期999-1008,共10页Chinese Journal of Oncology

基　　金：天津市卫生计生高层次人才选拔培养工程项目;天津市医学重点学科(专科)建设项目(TJYXZDXK-051A);天津市深化医药卫生体制改革研究项目(2023YG05)

摘　　要：目的了解1999—2021年天津市居民的肝癌死亡率和疾病负担及其变化趋势,探讨不同特征人群中肝癌死亡率和疾病负担的分布和变化特点,为肝癌的防治提供依据。方法利用天津市疾病预防控制中心收集的居民全死因监测数据和来自天津市公安局的户籍人口数据,统计天津市居民1999—2021年各年份的肝癌死亡率、寿命损失年(YLL)率、失能生存年(YLD)率和伤残调整生命年(DALY)率,并分析其在不同性别、年龄以及城乡地区居民中的分布,采用Segi's世界标准人口构成进行标化,采用Joinpoint回归分析肝癌死亡率和疾病负担指标的变化趋势。结果天津市居民肝癌死亡率2021年较1999年累计下降46.75%,但有明显的阶段性特点。1999—2010年肝癌标化死亡率为12.62/10万~11.64/10万,有逐年下降趋势(P=0.003),年度变化百分比(APC)为-1.32%。2010—2021年肝癌标化死亡率为11.64/10万~6.72/10万,有明显的逐年下降趋势(P<0.001),APC=-3.89%。<35岁组和35~岁组肝癌死亡率下降速度较快,1999—2021年<35岁组APC为-5.07%(P<0.001),35~岁组以2007年为界,前后两个阶段APC分别为0.63%(P=0.707)和-8.21%(P<0.001)。天津市居民肝癌标化DALY率2021年较1999年累计下降50.63%,也有明显的阶段性特点。1999—2010年肝癌标化DALY率为388.67/10万~349.38/10万,有逐年下降的趋势(APC=-1.35%,P=0.002)。2010—2021年肝癌标化DALY率为349.38/10万~191.88/10万,下降趋势更为明显(APC=-4.43%,P<0.001)。1999—2021年各年份肝癌标化死亡率、标化DALY率男性明显高于女性(均P<0.01),1999—2007年城市地区高于农村地区(P<0.05),2008年后则与农村地区接近。1999—2021年各年份天津市肝癌死亡的中位年龄为64~68岁,男性低于女性(均P<0.05),农村地区低于城市地区(均P<0.05),肝癌死亡年龄总体呈上升趋势,以2014年为界,APC分别为0.11%(P=0.047)和0.51%(P=0.005)。天津市居民肝癌DALY以YLL为主,占比达99%。结论1999�Objective To explore the trends and distribution of liver cancer between sexes,ages,and urban-rural areas in Tianjin,China from 1999 to 2021,and provide data for targeted prevention and control strategies of liver cancer in Tianjin.Methods Liver cancer mortality data of Tianjin during 1999-2021 were from the Tianjin population based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention(CDC),and the population data of permanent Tianjin residents were from Tianjin Municipal Public Security Bureau.Liver cancer mortality,years of life lost(YLL),years lived with disability(YLD),and disability adjusted life years(DALY)were calculated using the cause of death surveillance data collected by Tianjin Centers for Disease Control and Prevention.The distributions of these data among residents of different sexes,ages,and regions were analyzed.Segi's world standard population was used for standardization.Joinpoint regression was used for trend analysis on the mortality rate of liver cancer and the disease burden.Results The liver cancer mortality rate in Tianjin decreased by 46.75%from 1999 to 2021,with distinct phased characteristics.From 1999 to 2010,the age-sex-standardized mortality rate(SMR)decreased from 12.62/100000 to 11.64/100000 with an annual percent change(APC)of-1.32%(P=0.003).From 2010 to 2021,the SMR decreased from 11.64/100000 to 6.72/100000(APC=-3.89%,P<0.001).The age-sex-standardized DALY rates(SDR)decreased by 50.63%from 1999 to 2021,also with distinct phased characteristics.From 1999 to 2010,the SDR decreased from 388.67/100000 to 349.38/100000(APC=-1.35%,P=0.002).From 2010 to 2021,the SDR decreased from 349.38/100000 to 191.88/100000(APC=-4.43%,P<0.001).The liver cancer mortality rate declined most rapidly in the age group under 45 years;the APC for those under 35 years was-5.07%(P<0.001),and for those aged 35-44 years,the APC was 0.63%(P=0.707)and-8.21%(P<0.001)before and after 2007,respectively.Both SMR and SDR were significantly higher in males than in females

关 键 词：肝肿瘤 死亡率 寿命损失年 失能生存年 伤残调整生命年 天津 

分 类 号：R735.7[医药卫生—肿瘤]