1988--2010年林州市胃癌死亡率时间趋势及预测分析

Prediction of temporal trends in gastric cancer mortality in Linzhou city from 1988 to 2010

目的描述林州市1988--2010年胃癌死亡率时间变化趋势，并预测2016--2020年林州市胃癌死亡水平。方法选取林州市肿瘤登记处1988--2010年胃癌死亡数据，共11714例，覆盖人口22447073人年。按5年一个时期分别计算不同解剖亚部位、性别胃癌的死亡率，并根据1982年中国标准人口年龄构成计算标化死亡率。应用内在估计（IE）模型按解剖亚部位、性别对胃癌死亡趋势进行拟合，并预测林州市2016--2020年胃癌死亡水平。结果1988--2010年林州市胃癌死亡率为52．18／10万（11714／22447073），标化死亡率为49．23／10万；男性死亡率为67．02／10万（7678／11455512），标化死亡率为68．68／10万；女性死亡率为36．72／10万（4036／10991561），标化死亡率为32．12／10万。贲门癌死亡率为27．87／10万（6257／22447073），标化死亡率为26．37／10万；非贲门胃癌死亡率为24．31／10万（5457／22447073），标化死亡率为22．86／10万。1988--1990年胃癌标化死亡率为63．37／10万（1653例），到2006--2010年下降为45．41／10万（2622例），下降了28．34％。IE模型显示出生队列效应呈明显下降趋势，20世纪50年代后出生的人群贲门癌死亡风险呈明显下降趋势，而20世纪出生的人群非贲门胃癌死亡风险呈连续下降趋势。预测2016--2020年林州市30岁以上人群胃癌死亡3626例，较2006--2010年（2579例）上升40．60％；其中，贲门癌上升51．89％（2016--2020年预测2456例；2006--2010年为1617例），非贲门胃癌上升21．62％（2016—2020年预测1170例；2006--2010年为962例）。结论林州市居民胃癌死亡率在1988--2010年间呈下降趋势，主要归因于出生队列效应；预计2016--2020年林州胃癌的死亡水平仍会上升。

Objective To describe the temporal trends in the mortality rate of gastric cancer during the period of 1988 and 2010, and to predict the gastric cancer mortality between 2016 - 2020. Methods The data of gastric cancer mortality in Linzhou city between 1988 and 2010 was extracted from the cancer registry,including a total of 11 714 cases, covering 22 447 073 person-years. The mortality rate of gastric cancer of each 5-year period was calculated by sub-site and gender. Age-standardized rate （ASR） was calculated using the Chinese standard population in 1982. Intrinsic estimator （IE） model was used to fit the mortality trend by sub-site and gender,and to predict the mortality of gastric cancer in Linzhou city between 2016 and 2020. Results From 1988 to 2010, the gastric cancer mortality in Linzhou city was 52. 18/100 000（ 11 714/22 447 073 ）with the ASR at 49.23/100 000; the mortality in male was 67.02/100 000（ 7678/11 455 512 ）with ASR at 68.68/100 000 while the mortality in female was 36. 72/100 000（4036/10 991 561 ） with ASR at 32. 12/100 000. The mortality of cardia carcinoma was 27. 87/100 000 （6257/22 447 073 ）with the ASR at 26. 37/100 000; while the mortality of non-cardia carcinoma was 24. 31/100 000 （5457/22 447 073 ） with the ASR at 22. 86/100 000. The ASR of gastric cancer during 1988 - 1990 was 63.37/100 000 （ 1653 cases） and decreased by 28.34% ,to 45.41/100 000 （2622 cases） during 2006 -2010. The IE model showed that the birth cohort effect decreased greatly. The mortality risk of cardia carcinoma in population born after 1950s, decreased significantly; and the mortality risk of non-cardia carcinoma in population born in 20 century continually decreased. The death of gastric cancer among the population over 30 years old was predicted to be 3626 cases, increasing by 40. 60% compared with the number between 2006 and 2010 （2579 cases）. Among them, the mortality of eardia carcinoma increased by 51.89% （predicted number between 2016 and 2020 was 2456 cases,and 1617 cases between 2006 and 2010 ）, and the mortality of non-cardia carcinoma increased by 21.62% （predicted number between 2016 and 2020 was 1170 cases, and 962 cases between 2006 and 2010）. Conclusion The mortality rate of gastric cancer in Linzhou city showed a decreasing trend during the period of 1988 - 2010,being mainly attributed to the cohort effect. However, the mortality will still increase in the future, between 2016 and 2020.