摘要
目的随着生活方式和环境的改变,居民恶性肿瘤呈现不同的发展趋势。本研究分析1991-2011年中国居民肝癌死亡率的流行变化趋势,为制订肝癌防治策略提供参考。方法以1991-2011年中国15～84岁居民为研究对象,根据《中国卫生统计年鉴》的数据,采用年龄-时期-出生队列（age-period-cohort,APC）模型和Intrinsic Estimator算法估计肝癌死亡率的年龄效应、时期效应和出生队列效应。结果 1991-2011年,中国居民肝癌死亡率整体呈上升趋势,城市、农村全人群肝癌死亡率分别由1991年的19.63/10万和22.25/10万上升至2011年的23.61/10万和27.12/10万。APC模型结果显示,中国居民肝癌死亡风险的年龄效应总体上随年龄增加而增大,城市和农村80～84岁居民的死亡风险分别比15～19岁增加了74倍和44倍。时期效应随年代缓慢上升,城市和农村总死亡风险分别增加了38.54%和25.86%。出生队列效应波动较大,整体呈下降趋势。结论中国居民肝癌死亡风险的时期效应占主导地位,人口老龄化、代谢性疾病和不健康生活方式可能是肝癌死亡率时期效应上升的重要原因,在肝癌防治工作中重视这些方面的改善,有助于从整体上降低居民肝癌死亡率。
OBJECTIVE With the change of environment and life behavior,incidence of malignant tumors of residents showed different development trend.This study aimed to analyze the trends of hepatic carcinoma mortality among residents in China from 1991 to 2011,and providing a reference for prevention.METHODS Chinese residents aged 15to84 years old were recruited in this study from 1991 to 2011.Mortality data were extracted from ＂Chinese Health Statistics Yearbook＂. Age-period-cohort（APC） model and Intrinsic Estimator Algorithm were used for data analysis.RESULTS Mortality of hepatic carcinoma among Chinese residents increased from 1991 to 2011.Mortality of hepatic carcinoma among urban residents increased from 1.963 ppm in 1991 to 2.361 ppm in 2011,while mortality of hepatic carcinoma among rural residents increased from 2.225 ppm in 1991 to 2.712 ppm in 2011.APC model showed that age effect of hepatic carcinoma mortality risk increased with age,and mortality risk for 80-84 years resident in urban and rural increased by 74 times,44times respectively.Period effect of hepatic carcinoma mortality risk continued to rise with time,which increased by 38.54% and 25.86% for urban and rural during 1991 and 2011.Contrarily,the estimated cohort effect 1936 to 1991showed an overall declining trend.CONCLUSIONS The trend in overall hepatic carcinoma mortality in China since 2001 are primarily attributable to the increasing period effort.Population aging,metabolic diseases and unhealthy lifestyles play an important role in hepatic carcinoma mortality.Emphasis on improving those aspects during the prevention and treatment of hepatic carcinoma,could help to reduce mortality of hepatic carcinoma.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第22期1465-1469,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
APC模型
肝癌
死亡率
流行病学
age-period-cohort model
hepatic carcinoma
mortality
epidemiology
