2004—2005年中国居民子宫颈癌死亡情况及30年变化趋势

Cervical cancer mortality in 2004 -2005 and changes during last 30 years in China

目的分析我国2004--2005年子宫颈癌死亡率的地区和人群分布特征及其30年的变化趋势。方法人口资料与子宫颈癌死亡资料均来自2004--2005年全国第3次死因回顾抽样调杏，样本由经多阶段分层整群抽样的我国内地31个省、自治区、直辖市的158个县（市）样本单位构成。其中，城市61个，农村97个；东部地区52个，中部地区49个，西部地区57个。两年合计总人年数为142660482，其中，男性72970241人年，女性69690241人年。计算子宫颈癌的粗死亡率和年龄别死亡率等指标。采用2000年人口普查的数据，将每5岁作为1个年龄组进行标化，计算中国人口标化死亡率（简称中标率），并与1973--1975、1990--1992年我国女性子宫颈癌的死亡情况进行比较分析。结果2004--2005年全国第3次死因调查样本地区子宫颈癌粗死亡率2．86／10万（1995／69690241），占肿瘤死因的2．86％（1995／69667），在女性人口恶性肿瘤死因顺位中居第9位。农村和城市子宫颈癌粗死亡率分别为2．88／10万（1326／46091419）和2．83／10万（669／23598822），中标率分别为2．01/10万和1．67／10万。1973--1975、1990--1992年子宫颈癌死亡分别占肿瘤死因的17．91％、4．86％，中标率分别为11．10／10万和3．25／10万。2004--2005年样本地区子宫颈癌粗死亡率随年龄的增加而增加，从40岁歼始增加较明显，到85岁达到峰值，为20．83／10万（82／393624）。35～44岁组子宫颈癌死亡率比90年代同年龄组的死亡率高。2004--2005年我国中部、西部和东部地区子宫颈癌粗死亡率分别为3．41／10万（827／24225738）、3．25／10万（636／19563647）和2．05／10万（532／25900856），中西部地区中标率约为东部地区的2倍（中部2．35／10万，西部2．38／10万，东部1．19／10万）。结论2004--2005年我国农村女性子宫颈癌死亡率略高于城市，中、西部明显高于东部地区。与1973--1975、1990--1992年相比，子宫颈癌的危害呈年轻化的趋势；子宫颈癌死亡率及在女性肿瘤死因中的构成比继续下降。

Objective To analyze the cervical cancer mortality and distribution profiles by areas and population in 2004 - 2005 and the changes in the last 30 years. Methods The demographic information and cervical cancer death data came from the Third National Retrospective Sampling Survey of Death Causes which including 158 sampling areas （including 61 cities and 97 villages; 52 in the east region,49 in the middle region and 57 in the west region ） covered 31 province-level regions in the interior of China by multiple stage stratified clustering sampling. The total number of the samples were 142 660 482 person years （72 970 241 person years in male and 69 690 241 person years in female）. The crude and age-specific death rate was calculated. The standardized death rate was calculated by using 5 years interval from the census data of 2000. In addition ,the mortality data was compared with the two previous national death surveys in 1970＇s and 1990＇s,respectively. Results In the sampling region of the third retrospective death causes survey from 2004 to 2005, the crude death rate of cervical cancer was 2. 86/100 000 （ 1995/69 690 241 ）, which accounting for 2. 86% （ 1995/69 667） and ranking 9th of all cancer death causes in female population. The crude death rates of cervical cancer were 2. 88/100 000 （1326/46 091 419 ） and 2. 83/100 000 （669/23 598 822） for rural areas and urban areas, respectively, the Chinese population adjusted death rates of rural and urban areas were 2.01/100 000 and 1.67/100 000 ,respectively. The standardized death rates of cervical cancer in 1973 - 1975 and 1990 - 1992 were 11.10//100 000 and 3.25/100 000 ,respectively ,which accounting for 17.91% and 4. 86% , respectively ; in 2004 - 2005, the crude death rates increased by age, rose remarkably from the age of 40 and arrived the peak of 20. 83/100 000 （ 82/393 624 ） at the age of 85. The mortality among 35 -44 year-old group was higher than those in 1990＇s. The crude death rates of the middle ,west and east areas were 3.41/100 000 （ 827/24 225 738 ）, 3. 25/100 000 （ 636/19 563 647 ） and 2.05/100 000 （532/25 900 856 ） , respectively, the Chinese population adjusted death rates of the middle and west areas were about twice that of the east （2. 35/100 000 in the middle,2. 38/100 000 in the west,and 1.19/100 000 in the east）. Conclusion The mortality of cervical cancer was higher in rural areas than that in urban, as well as higher in the middle and west areas than that in east area in the interior of China in 2004 -2005. Younger trend of cervical cancer death was observed; the mortality of cervical cancer and constituent ratio in the female tumor death continued to decline compared to those in 1973 - 1975 and 1990 - 1992.