中国2004--2005年全国死因回顾抽样调查肝癌死亡率分析

Analysis of liver cancer mortality in the national retrospective sampling survey of death causes in China,2004 - 2005

目的分析中国肝癌死亡率特征及变动趋势。方法采用2004-2005年全国死因回顾抽样调查158个样本点的资料，覆盖2年人口总规模为142660482人年，其中城市人口47899806人年、农村人口94760676人年；按区域分类东部人口52556694人年、中部人口49781225人年、西部人口40322563人年。用1982年全国人口构成计算标化死亡率（简称中标率）、用1985年世界标准人口计算世界标化死亡率（简称世标率）。与1973-1975年（第1次）、1990-1992年（第2次）全国死因回顾（抽样）调查资料作历史纵向比较；与全球部分国家的肝癌死亡率资料作横向比较。结果158个样本点2004-2005年肝癌死亡37465例，粗死亡率为26．26／10万（男性死亡27398例，粗死亡率为37．55／10万；女性死亡10067例，粗死亡率为14．45／10万），仅次于肺癌而居恶性肿瘤死因的第2位（19．33％，37465／193841）；93．04％（147／158）的样本点肝癌粗死亡率在10．00／10万一39．00／10万之间。肝癌中标率为17．86／10万（男性为26．44／10万，女性为9．20／10万），世标率为23．48／10万（男性为34．61／10万，女性为12．34／10万）。城市肝癌死亡11945例，粗死亡率为24．94／10万，中标率为15．34／10万；农村肝癌死亡25520例，粗死亡率为26．93／10万，中标率为19．32／10万。男女肝癌死亡率比例为2．60：1，其中城市为2．68：1，农村为2．56：1。东、中和西部地区的肝癌死亡数分别为t4909、13349及9207例，粗死亡率分别为28．37／10万、26．82／10万及22．83／10万，中标率分别为17．53／10万、19．09／10万及16．92／10万。本次资料与全国第1次资料（10．75／10万）相比，肝癌粗死亡率增长了89．77％；与全国第2次资料（20．37／10万）相比，肝癌粗死亡率增长了28．73％。其中第1次和第2次城市肝癌粗死亡率分别为12．42／10万和19．50／10万；农村肝癌粗死亡率分别为10．12／10万和20．67／10万，均呈现上升趋势。与全球172个国家（地区）资料比较，中国肝癌粗死亡率男性排在第6位，女性排在第5位；世标率则分别排在第9位和第7位。结论肝癌在我国恶性肿瘤死因排位中为第2位。肝癌粗死亡率呈升高态势，但标化死亡率已显示升高幅度趋缓。肝癌防治应当继续成为我国肿瘤防控的重点。

[Abstract ] Objective To analyze the patterns and changes of liver cancer mortality in China. Methods Data of national retrospective sampling survey for the years of 2004 - 2005 from 158 counties/cities/districts was used for the settings, covering a 2-year＇ s population of 142 660 482 person years, in which 47 899 806 in urban areas, and 94 760 676 in rural areas. Furthermore, the areas of Eastern, Central,and Western were divided into the subsets, with populations of 52 556 694,49 781 225 and 40 322 563 person years; respectively. The crude rate （CR） and the age-standardized rate by Chinese population of 1982 （CASR） and by world＇s population of 1985 （WASR） were calculated. The historical comparisons with the national survey data of 1973 - 1975 （First time） and with the sampling survey of 1990- 1992 （Second time） were made, and the global comparisons with some selected countries were performed. Results A total of 37 645 death cases with liver cancer were recorded from the 158 samples in the year 2004 - 2005,with the CR of 26. 26 per 100 000 （males： 27 398 cases,37.55 per 100 000,and females： 10 067 cases, 14. 45 per 100 000 ） , which ranked the second after lung cancer, accounted for 19. 33% of all sites of cancers （37 465/193 841 ）. 93.04% of the sampling districts （147/158） showed the CRs amongst 10. 00 to 39.00 per 100 000. The CASR was 17.86 per 100 000 （ males： 26.44, females： 9. 20） ,and the WASR was 23.48 per 100 000 （males： 34. 61 ,females： 12. 34）. In the urban areas,the CR of liver cancer was 24. 94 per 100 000 （ 11 945 cases, CASR： 15.34） , and 26. 93 per 100 000 （25 520 cases,CASR- 19. 32） in the rural areas. The sex ratio of the male to female mortality rate was 2. 60：1 （2. 68：1 in urban areas,and 2. 56：1 in rural areas）. The death cases in the Eastern,Central ,and Western areas were 14 909,13 349 and 9 207, with CRs of 28.37,26. 82, and 22. 83 per 100 000, respectively. The CR was increased by 89. 77% compared with the data from the First time （ 1973 - 1975 ： 10. 75 per 100 000） ,and increased by 28.73% compared with the data of the Second time （ 1990 - 1992 ： 20. 37 per 100 000）. In addition,the CR from 12.42 （the First） increased to 19. 50 per 100 000 （the Second） in the urban areas, and from 10. 12 （the First） increased to 20. 67 per 100 000 （the Second） in the rural areas. Global comparison showed that the CR for the liver cancer in China ranked the sixth for men, and fifth for women; and it ranked the ninth, and seventh according to the WASR amongst the top-rate countries. Conclusion Liver cancer is the second leading site of cancer death-cause in Chinz. The CR has been rising, while the trend for the standardized rate is not so apparent. Control of the liver cancer should be still the priority of all anti-cancer activities in China.