青岛市结直肠癌死亡率地理分布特征的趋势面分析

Trend-surface analysis of the geographical distribution of the colorectal cancer mortality in Qingdao

目的我国曾是结直肠癌的低发区,但近几十年来,随着生活方式、环境和人口老龄化等因素的变化,结直肠癌疾病负担越来越严重。本研究旨在通过分析青岛市结直肠癌死亡的地理分布和变化趋势,确定青岛市结直肠癌的重点防治区域。方法从青岛市死因监测系统获取2008-2012年各个登记点的结直肠癌死亡资料,进行描述性统计分析和地域趋势面分析以及残差值分析。结果 2008-2012年青岛市结直肠癌死亡4 058例,其中男2 388例,女1 670例;粗死亡率为10.61/10万,标化死亡率为8.13/10万,结直肠死亡率有性别差异,男性高于女性,男女性别比为1.43∶1;死亡率明显有城乡差异,城市高于农村,城乡死亡粗率比为2.33∶1;青岛市男、女性结直肠癌死亡率地区分布有明显的趋势性(男R2=0.559 5,P=0.025 0;女R2=0.704 0,P=0.004 2),男女性结直肠癌死亡趋势均由西北往东南逐渐升高。通过残差值分析,原市北区、原四方区、李沧区男性结直肠癌死亡率的残差值明显高于正残差值界值,即墨市男女结直肠癌死亡率的残差值均低于负残差值界值。结论青岛市结直肠癌的死亡水平稍高于我国的平均死亡水平,存在地区差异,东南部地区是结直肠癌重点防治区域。

OBJECTIVE Our country was a low area of colorectal cancer, but in recent decades, as the changes of the way of life, the environment and the population aging, the colorectal cancer disease burden is more and more serious in our country. The study aims to determine the key control colorectal cancer area of Qingdao, through the analysis of the geographical distribu- tion of the mortality of colorectal cancer in Qingdao. METHODS Utilizing the colorectal cancer mortality data from 2008--2012 of different regions obtained from the Qingdao Mortality Surveillance System, the descriptive statistics analysis and trend-surface analysis were performed. RESULTS Among 4 058 cases of colorectal cancer deaths between 2008 and 2012, 2 388 cases were males and 1 670 cases were females; the crude mortality rate of colorectal cancer was 10.61 per 100 000, and the standardized mortality rate was 8.13 per 100 000. In addition, colorectal cancer mortality disparity varies by age and obvious difference between urban and rural areas. Both sex had geographical distribution trends in Qingdao （Male R2 =0. 559 5, P=0. 025 0; Female R2 =0. 704 0, P=0. 004 2）. Colorectal cancer mortality increased gradually from north-west to south-east in both sex. The male colorectal cancer mortality residual values of Shibei, Sifang and Licang districts are obviously higher than the positive limited residual value by the analysis of the residual value. Both the male and female colorectal cancer mortality residual values of Jimo are lower than negative limited residual value. CONCLUSIONS The colorectal cancer death level of Qingdao is slightly higher than the average death in china, and varied geographically in Qingdao. The southeast area of Qingdao is the key area for prevention and treatment of colorectal cancer.