安徽省灵璧县2005--2010年肝癌死亡聚集性分析

Analysis on the clustering of liver cancer mortality in Lingbi county, Anhui province, from 2005 to 2010

目的观察安徽省灵璧县30年肝癌死亡水平及其变化，并对2005--2010年肝癌死亡情况进行空间分析。方法使用1973—1975年和2005--2010年灵璧县死因数据，通过与全国和该县历史水平对比，观察灵璧县肝癌死亡水平及其变化。使用Poisson分布模型、BYM模型以及热点探测等方法，计算2005--2010年灵璧县各村肝癌标化死亡比（SMR）和RR值，并确定肝癌死亡的高聚集区。结果30年间灵璧县肝癌SMR上升223．7％，由1973—1975年低于全国水平的22．7％，上升至2005—2010年的74．1％，高出全国水平，并呈现沿奎濉河附近村庄较高水平分布的特点。聚集性分析发现，在5300m处存在有意义的显著空间正自相关。灵璧县肝癌死亡具有一个非常明显的热点区域，即分布在奎濉河沿岸尤其是在老濉河和新濉河分叉处的地区。结论30年间灵璧县肝癌死亡率明显上升，高发区域主要分布在奎濉河附近村落，提示可能存在促进肝癌发生的相同因素。

Objective To observe the mortality and its changes on liver cancer in the past 30 years as well as to describe the spatial distribution of liver cancer deaths between 2005 and 2010 in Lingbi, Anhui province. Methods Using the mortality data from 1973-1975 and from 2005 to 2010 in Lingbi to compare with the relative national and historical data, to observe the trend of rapid increase on liver cancer mortality in Lingbi. Using the Poisson model, BYM model and hotspot detection method, standardized mortality ratio （SMR）, relative risk （RR） value of liver cancer deaths of each village were calculated and the clustering of high liver cancer deaths was identified. Results Through an increase of 223.7% on the SMR of liver cancer in the past 30 years, the standardized mortality of liver cancer in Lingbi had an increase of 74.1 percent than the national level in 2005-2010 but it was 22.7% lower than the country level in 1973-1975. The SMR and RR values and their P values were higher in the villages which were located along the Kuisui River. Data from the clustering analysis showed that there had been significantly positive autocorrelation at the altitude of 5300 meters, and a very obvious hot spot of liver cancer deaths existing along the Kuisui River, especially at the bifurcation of the old Sui River and new Sui River was observed. Conclusion There was an alarming increase of liver cancer mortality in the past 30 years in Lingbi. The high mortality area mainly covered the villages along the Kuisui River, suggesting that there were common risk factors for hepatocellular carcinoma in the population at risk.