湖北省2008-2012年恶性肿瘤死因谱构成及变化趋势

Spectrum of death cause and its trends of cancer in Hubei Province,2008-2012

目的近年来,我国因恶性肿瘤发病和死亡所致的疾病负担已经成为一个严峻的公共卫生问题。本研究分析湖北省居民2008-2012年恶性肿瘤死因谱构成及变化趋势,为制定恶性肿瘤防治策略提供科学依据。方法对湖北省2008-2012年死亡监测数据,采用死亡率、标化死亡率、年度变化率进行描述,并进行Poisson回归分析。结果湖北省2008-2012年恶性肿瘤粗死亡率为141.67/10万。男性恶性肿瘤死因顺位为肺癌(中国人口标化死亡率为69.04/10万)、肝癌(52.15/10万)、胃癌(36.92/10万)、食管癌(18.40/10万)、结直肠癌和肛门癌(14.32/10万)。女性恶性肿瘤死因顺位为肺癌(21.29/10万)、肝癌(17.28/10万)、胃癌(16.21/10万)、结直肠癌和肛门癌(9.27/10万)、乳腺癌(8.05/10万)。其中肺癌、结直肠癌和肛门癌的死亡风险,农村男性低于城市男性(OR值分别为0.93和0.83);男性肝癌、胃癌和食管癌死亡风险表现为农村高于城市(OR值分别为1.74、1.96和1.39)。女性肺癌和乳腺癌的死亡风险城乡差异无统计学意义,肝癌、结直肠癌和肛门癌的死亡风险表现为农村女性低于城市(OR值分别为0.51和0.68),而胃癌是农村女性的死亡风险高于城市(OR值为2.48)。2008-2012年,男性鼻咽癌、结直肠和肛门癌与女性鼻咽癌死亡率分别增加2.03%、4.07%和21.99%,男女其他主要恶性肿瘤死亡率均呈现下降趋势。结论肺癌、肝癌和胃癌是湖北省居民恶性肿瘤死亡的主要原因,男性前五位恶性肿瘤的死亡风险存在城乡差异,女性肺癌和乳腺癌的死亡风险无显著城乡差异,主要恶性肿瘤死亡率呈现下降趋势。今后应当结合城乡实际情况有重点地开展肿瘤防治工作。

OBJECTIVE The cancer incidence and mortality caused disease burden, which had become a serious problem of public health. The aim of study was to analyze the trends of mortality and the spectrum regarding causes of death in Hubei Province and to provide scientific evidence for prevention and disease control. METHODS Descriptive analysis and Poisson regression analysis were adopted to analyze the data from disease surveillance points（DSPs） in Hubei Province during 2008-2012. The index included crude and age-standardized mortality rates, percent change（PC） and site-specific contributions to the overall floating trend. RESULTS The crude mortality of cancer was 141.67/105 in Hubei Province during 2008--2012. The top five causes of death in male were lung（age standardized mortality by Chinese standard population was 69.04/10s）, liver（52. 15/105）, stomach（36. 92/105）, esophageal（18. 40/105 ） and colorectal cancer （14.32/10s ）. The top five causes of death in female were lung（21.29/105）, liver （17.28/105）, gastric（16.21/ 105 ）, colorectal（9.27/105 ） and breast cancer（8.05/10^5 ）. Compared with urban males, rural males had lower mortality risks of lung and colorectal cancer （the relative risk was 0.93 and 0.83 respectively）. For males in rural population cancer mortality of liver and colorectal were higher than those in urban population（ORs were 1.74,1.96 and 1.39 respectively）. For females in rural population cancer mortality of liver, gastric and esophageal were higher than those in urban population（ORs were 0.51 and 0.68 respectively） whereas the mortality risk of stomach cancer was higher in rural females than that in urban population（OR was 2.48）. The difference of mortality risk of lung and breast cancer between urban and ru ral females did not have statistical significance. The PC of mortality of nasopharyngeal carcinoma in males and females were 2.03% and 21.99% respectively. There was also an increase in male colorectal cancer mortality by 4.07% during the period. Between 2008-2012, the decreasing trend was observed in the rest common cancers in men and women. CON- CLUSIONS Lung, liver and stomach cancer are the leading causes of death in Hubei Province. There are differences of top 5 cancer mortality risks between urban and rural males. Cancer mortality differences of lung and breast are not significant between rural and urban females. Declining trends are observed among predominant cancer mortality in Hubei Province. Prevention and treatment should be carried out according to the practical situation.