癌症年龄别发病率的Joinpoint线性回归分析及其在癌症防控中的意义

Joinpoint Linear Regression Analysis of Cancer Age-specific Incidence Rate and Its Significance for Cancer Control

[目的]应用Joinpoint线性回归分析恶性肿瘤年龄别发病率的内在趋势及变化规律。[方法]根据全国肿瘤登记中心汇总的72个登记处上报的2009年肿瘤登记数据,应用Join-point线性回归分析中国主要恶性肿瘤的年龄别发病率的转折点和年龄别变化趋势。主要包括癌症合计和鼻咽癌、食管癌、胃癌、结肠癌、肝癌、胰腺癌、肺癌、肾癌、膀胱癌、脑肿瘤、前列腺癌、女性乳腺癌、子宫颈癌、卵巢癌等。[结果]不同部位的恶性肿瘤的年龄发病特点区别很大。全部恶性肿瘤的年龄别发病变化区段有4个,年龄别发病率在0～37岁期间为低发期,37～62岁为升高期,62～77岁为快速升高期,其后为下降期。性别的不同会影响癌症合计的发病年龄段划分和变化程度,男性的低发期为0～42岁,女性为0～32岁,其他各段与男女性合计的结果一致。男、女性间的年龄别发病率变化曲线有显著差异(P<0.01)。[结论]Joinpoint线性回归是分析恶性肿瘤年龄别发病率的新方法,其分析结果对于肿瘤预防具有重要的意义,并能有效地确定高发年龄段,针对高危人群有重点地开展防治措施,提高肿瘤控制项目的经济效益。

[Purpose] To investigate the trend of cancer age-specific incidence rate by Joinpoint linear regression analysis. [Methodsl Based on the cancer registration data from 72 cancer registries,the Joinpoint linear regression analysis was applied to analyze trend of the age-specific rates for 14 cancer sites,including cancers of nasopharynx,esophagus,stomach,colon,liver,panereas, lung,kidney,bladder,brain,prostate,female breast,cervix,ovarian plus all sites. [Results] The number of joinpoints ranged from one to three and the slops were different by cancer sites. The re- sults of each site showed that different parts of the malignant tumor of the characteristics of the age difference was very big. For the cancer of all sites,there were 3 joinpoints and 4 segments, those were 0～37 years old,37～62 years old,62 ～77 years old and 77＋ years old. Compared by gender,the low incidence segment ranged from 0-42 years old in male,0-32 years old in female. The curve of age-specific incidence rate between male and female was significantly different （P〈 0.01）. [Conclusion] Joinpoint linear regression analysis is a new and important tool to analyze the cancer age-specific incidence rates. The results will aim the cancer prevention programs in means of improving the cost-benefit ratio.