山东省恶性肿瘤疾病负担研究

Estimating the Burden of Malignant Neoplasm in Shandong Province

目的:首次应用伤残调整寿命年(DALY)对山东省居民恶性肿瘤疾病负担进行综合评价。方法:以2000—2005年山东省疾病监测系统的恶性肿瘤死亡资料和2005年山东省恶性肿瘤发病监测系统的发病资料为基础,利用世界卫生组织提供的专门公式,计算恶性肿瘤的YLLs、YLDs和DALYs,以此评价恶性肿瘤的疾病负担。结果:山东省每千人每年因恶性肿瘤造成20.60个DALYs损失(男性25.30,女性15.74),其中,94.3%为早死所致,5.7%因残疾所致;恶性肿瘤主要导致45￣59岁人群的DALYs损失,占31.93%;恶性肿瘤疾病负担前10位依次为肺癌、肝癌、胃癌、食道癌、肠癌、乳腺癌、白血病、脑癌、胰腺癌和宫颈癌;山东省肺癌、肝癌等主要癌症疾病负担高于全球和全国水平。结论:恶性肿瘤疾病负担主要由早死所致,肺癌、肝癌、胃癌和食道癌等主要癌症的防制地位十分突出。

Objective To make a comprehensive estimation of the burden of malignant neoplasm in Shandong province by the means of disability-adjusted life year （DALY） for the first time. Methods DALYs were calculated following the procedures developed for the Global Burden of Disease （GBD） study to ensure comparability. We measured YLLs using the cancer mortality data of 19 Disease Surveillance Points （DSPs） in Shandong Province during 2000 and 2005. YLDs were estimated based on the cancer morbidity data of 6 Cancer Incidence Surveillance Points in Shandong Province in 2005. Results All cancers were responsible for 20.60 DALYs for every thousand population in Shandong Province （25.30 for men and 15.74 for women） . 94.3% of the losses were due to premature death and 5.7% to disability. 31.9% of the DALYs happened among 45～59 age group. The top 10 cancers for DALYs were lung cancer, liver cancer, stomach cancer, oesophagus cancer, colon/rectum cancer, breast cancer, leukemia, brain cancer, pancreas cancer and cervix uteri cancer in turn. The burden of major cancers such as lung cancer and liver cancer in Shandong were heavier than the global and national level Conclusions The burden of disease of malignant neoplasm is mainly because of premature death. Lung cancer, liver cancer, stomach cancer and oesophagus cancer are the major cancers in Shandong Province and should be paid more attention to their prevention and control.