江苏省昆山市1981-2014年胃癌死亡率趋势及率差分解分析

Gastric Cancer Mortality Trend and Difference Decomposition Analysis in Kunshan, Jiangsu Province, 1981-2014

目的探究江苏省昆山市1981—2014年胃癌死亡率变化趋势及定量估计影响因素。方法历年胃癌死亡病例来源于全人群死因监测,计算分性别和年龄组粗死亡率与年龄标化率,使用年度变化百分比(annual percentage change,APC)及其95%CI评价死亡率在1981—2014年时间趋势。采用率差别分解法分析人口因素对胃癌死亡率变化的贡献。结果胃癌年龄标化死亡率在男女合计(APC=-3.6%,95%CI:-3.9%^-3.3%)、男性(APC=-3.9%,95%CI:-4.3%^-3.5%)和女性(APC=-3.5%,95%CI:-4.0%^-3.0%)人群中呈明显的下降趋势。昆山市1981—2014年间胃癌死亡率0~74岁累积率在男性和女性人群中大幅下降(APC=-4.2%,95%CI:-4.7%^-3.7%)。胃癌死亡率的下降是人口因素与非人口因素作用结果,其中人口因素贡献在男女合计、男性及女性人群中分别为-124.92%、-154.61%和-117.52%。结论江苏省昆山市过去30年高水平胃癌死亡率在非人口因素作用下持续下降,但这种下降受到了人口因素的阻碍。

Objective To explore the gastric cancer mortality temporal trend and quantitatively estimate the influence factors in Kunshan, Jiangsu Province, 1981-2014. Methods Gastric cancer death cases were derived from population-based vital registry system. Crude rates and age standardized rate（ASR） were calculated according to sex and age. Annual percentage changes（APC） and 95% confidence intervals（CI） were obtained to estimate the temporal trend from 1981 to 2014. Difference decomposition method was applied to estimate the contribution of demographic and non-demographic factors for the change of mortality. Results The age standardized mortality of gastric cancer in both sex（APC=-3.6%, 95%CI：-3.9% to-3.3%）, male（APC=-3.9%, 95%CI：-4.3% to-3.5%） and female（APC=-3.5%, 95%CI：-4.0% to-3.0%） were decreased significantly, and cumulative mortality of 0-74 years old was declined significantly in both sex（APC=-4.2%, 95%CI：-4.7% to-3.7%）. The decrease of gastric cancer mortality was due to the effect of demographic and non-demographic factors, where the proportion of demography in both sex, male and female were-124.92%,-154.61%, and-117.52%, respectively. Conclusion The mortality of gastric cancer in Kunshan city has declined due to the effect of non-demographic factors over the past three decades, but the decline is hindered demographic factors.