2012-2023年山东省女性乳腺癌发病和死亡分析及流行趋势预测  

The spatio-temporal trend of female breast cancer incidence and mortality in Shandong Province from 2012 to 2023 and trend prediction

作　　者：姜帆 付振涛 王勤富 楚洁[1] 张丙银 鹿子龙[1] 郭晓雷[1] 徐爱强 Jiang Fan;Fu Zhentao;Wang Qinfu;Chu Jie;Zhang Bingyin;Lu Zilong;Guo Xiaolei;Xu Aiqiang(Department of Chronic and Non-communicable Disease Control and Prevention,Shandong Center for Disease Control and Prevention,Jinan 250014,China;Institute of Preventive Medicine of Shandong University,Jinan 250014,China;Department of Endemic Disease Control and Prevention,Jinan Center for Disease Control and Prevention,Jinan 250000,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制所,济南250014 [2]山东大学预防医学研究院,济南250014 [3]济南市疾病预防控制中心地方病防制所,济南250000

出　　处：《中华流行病学杂志》2025年第4期646-654,共9页Chinese Journal of Epidemiology

基　　金：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(202412051228,202012051127)。

摘　　要：目的分析2012-2023年山东省女性乳腺癌发病率和死亡率的时空变化并预测2024-2030年发展趋势。方法2012-2023年山东省女性乳腺癌发病、死亡资料来源于山东省肿瘤登记处,计算不同年度、城乡的乳腺癌发病率、年龄别发病率、死亡率、年龄别死亡率,标化率采用2000年中国标准人口年龄构成。采用Joinpoint 4.8.0.1软件计算率的平均年变化百分比(AAPC),采用GeoDa 1.12软件进行全局空间自相关和局部空间自相关分析,采用贝叶斯年龄-时期-队列模型预测2024-2030年女性乳腺癌发病死亡趋势。结果2012-2023年山东省女性乳腺癌标化发病率呈上升趋势,从2012年的30.48/10万上升至2023年的39.94/10万(AAPC=2.59%,P<0.001)。城市、农村女性乳腺癌标化发病率同样呈上升趋势,且农村标化发病率的上升趋势(AAPC=3.33%,P<0.001)高于城市(AAPC=1.83%,P=0.002)。乳腺癌发病高峰主要集中在45~64岁,随年份增加,发病高峰逐渐前移。2012-2023年山东省女性乳腺癌标化死亡率呈下降趋势,从2012年的6.89/10万下降至2023年的4.93/10万(AAPC=-3.12%,P<0.001)。城市、农村女性乳腺癌标化死亡率均呈下降趋势(城市:AAPC=-3.56%,P=0.007;农村:AAPC=-2.72%,P<0.001)。空间分析显示,2015-2023年,山东省女性乳腺癌发病率和死亡率的空间聚集区发生了明显变化。2015年标化发病率高-高聚集区主要包括威海市文登区,东营市东营区、垦利区、利津县、广饶县,以及济南市天桥区、市中区;2023年主要包括济宁市嘉祥县、梁山县、金乡县、汶上县、任城区,临沂市河东区,以及东营市广饶县。2015年标化死亡率高-高聚集区仅包括济宁市汶上县,2023年高-高聚集区明显增多,主要包括烟台市莱州市,临沂市莒南县、沂水县,聊城市高唐县,泰安市东平县、宁阳县。年龄-时期-队列模型预测结果显示,2024-2030年山东省女性乳腺癌标化发病率趋于平缓(AAPC=0.33%,P=0.001),而标Objective We aimed to analyze the spatio-temporal trend of breast cancer incidence and mortality in Shandong Province from 2012 to 2023 and predict the development trend from 2024 to 2030.Methods Data on the incidence and mortality of breast cancer in Shandong Province from 2012 to 2023 were obtained from the Shandong Cancer Registry.The incidence,age-specific incidence,mortality,and age-specific mortality in different years,as well as in urban and rural areas,were calculated,and the rates were standardized based on the age composition of the Chinese standard population in 2000.The average annual percent change(AAPC)rate was calculated using Joinpoint 4.8.0.1 software.The global and local spatial autocorrelation analysis were performed using GeoDa 1.12 software.The Bayesian age-period-cohort model was used to predict the trend of breast cancer incidence and mortality from 2024 to 2030.Results From 2012 to 2023,the breast cancer age-standardized incidence rate(ASIR)showed an increasing trend.The ASIR increased from 30.48/100000 in 2012 to 39.94/100000 in 2023(AAPC=2.59%,P<0.001).The ASIR of urban and rural females also showed an upward trend.Additionally,the ASIR in rural areas(AAPC=3.33%,P<0.001)increased more than that in urban areas(AAPC=1.83%,P=0.002).The incidence peak of breast cancer mainly concentrated in population aged 45-64 years,and with the increase of years,the incidence peak gradually moved forward.The age-standardized mortality rate(ASMR)showed a downward trend.The ASMR decreased from 6.89/100000 in 2012 to 4.93/100000 in 2023(AAPC=-3.12%,P<0.001).The ASMR of urban and rural females also showed a downward trend(urban:AAPC=-3.56%,P=0.007;rural:AAPC=-2.72%,P<0.001).The spatial analysis showed that from 2015 to 2023,the clustering areas of breast cancer incidence and mortality in Shandong had changed significantly.In 2015,the"High-high clusters"of ASIR mainly included Wendeng District in Weihai City,Dongying District,Kenli District,Lijin County,Guangrao County in Dongying City,Tianqiao District,Shizho

关 键 词：乳腺癌 发病率 死亡率 空间分析 预测 

分 类 号：R737.9[医药卫生—肿瘤]