1989-2008年中国恶性肿瘤发病性别和城乡差异以及平均年龄趋势分析

Trend analysis of the changes of male/female, urban/rural incidences and average age of cancer patients in China 1989-2008

目的 分析1989-2008年间中国恶性肿瘤发病率的性别差异、城乡差异和年龄分布差异的变化趋势.方法 利用中国1989-2008年恶性肿瘤发病数据,按照不同性别（男女）、不同地区（城乡）和年龄（分别为0岁组、1～4岁组,5 ～ 84岁每5岁1组和≥85岁组,共19个年龄组）分层,运用Poisson回归模型,分析发病率性别比值、城乡比值和平均年龄的变化特征.结果 恶性肿瘤发病率男女比值由1989年的1.56下降到2008年的1.35.城乡比值由1989年的0.89上升到2008年的0.98.男性平均发病年龄1989年为61.96岁,2008年为64.87岁;女性平均发病年龄1989年为60.15岁,2008年为61.81岁.男女差异和城乡差异趋于平稳,平均发病年龄逐渐升高,变化趋势明显.结论 我国恶性肿瘤发病存在明显的性别和地区差异,近20年来差异逐渐缩小,年龄趋于老龄化,应针对不同情况开展更有效的肿瘤防治工作.

Objective To analyze the changes of male/female and urban/rural incidences and average age of cancer diagnosis over the period 1989-2008 in China.Methods All cancer incident cases from 1989 to 2008 in registration areas were retrieved from the National Central Cancer Registry database.Data were stratified by sex （male/female） and area （urban/rural） and age group （19 age groups,including 0,1-4,5-9,5-84 by 5,≥85）.Poisson regression was used to analyze the differences in incidence rates between males and females,urban and rural areas with 95％ confident intervals and P values adjusted by age.The average age of cancer diagnosis was calculated every year.All trends were analyzed by linear regression.Results The ratio of male to female cancer incidences was 1.56 in 1989 and 1.35 in 2008.The ratio of urban to rural incidences was 0.89 in 1998 and increased to 0.98 in 2008.The average age of cancer diagnosis was 61.96 years old for men and 60.15 for women in 1989,compared with 64.87 and 61.81 years in 2008,respectively.The disparities in sex and areas have been decreasing in recent 20 years.The cancer patients tend to getting older.These trends were all significant.Conclusions The cancer incidences in male/female populations and different areas have apparent disparities over the 1989-2008 period in China.However,the differences are narrowing and the average age is increasing.In the making of an efficient anti-cancer strategy,we should also take consideration of the differences of cancer burden in different population groups in our country.