西安市居民恶性肿瘤死亡特征及趋势分析

Epidemiological Characteristics and Trend of Malignant Tumor Mortality in Xi'an City

目的 了解西安市2002-2014年居民恶性肿瘤死亡特征及变化趋势,为恶性肿瘤防治提供依据。方法 采用西安市2002-2014年死因监测点居民恶性肿瘤死亡登记资料,用ICD-10进行死因分类,计算恶性肿瘤死亡率、标化死亡率、死亡构成比和年度变化百分比（annual percentage change,APC）等描述恶性肿瘤死亡分布特征和变化趋势的指标。结果 西安市2002-2014年死因监测点恶性肿瘤粗死亡率为129.10/10万,标化死亡率为100.19/10万,在全死因中居第3位,男性死亡率高于女性（χ~2=3086.45,P〈0.01）;恶性肿瘤死亡率标化后显示,全人群、男性和女性死亡率均呈下降趋势（P〈0.05）,APC分别为-3.732%、-4.094%和-3.153%;恶性肿瘤死因前5位的是肺癌、肝癌、胃癌、食管癌和肠癌,其中肝癌（APC为-3.369%）粗死亡率呈下降趋势,胃癌在2006-2014年粗死亡率呈上升趋势（APC=2.32%）;肺癌、肝癌、胃癌和食管癌标化死亡率呈下降趋势（P〈0.05）,APC分别为3.652%、-6.750%、-5.665%、-5.916%。结论 西安市居民恶性肿瘤标化死亡率呈下降趋势,但由于人口老龄化加剧,粗死亡率未表现出下降趋势,仍需加强监测和防治,特别是肺癌、肝癌、胃癌等主要恶性肿瘤的防控。

Objective To find out the characteristics and trend of cancer death among residents in Xi＇an city from 2002 to 2014 and to provide a basis for making cancer prevention policy. Methods Data was derived from the disease death surveillance database from 2002 to 2014. ICD-10 was used to classify death causes. Mortality rate, crude death rate（ CDR）, standardized mortality rate （SMR）, annual percent change （APC）were calculated. Results From 2002 to 2014, the crude mortality rate was 129. 10/105 , the standardized mortality rate was 100. 19/105 , which was the third in all death causes of residents. The mortality of male was significantly higher than that of female （X2 = 3086. 45, P 〈 0. 01 ）. The SMR for the whole population, male and female were all decreased（P 〈0. 05） ,APC were -3.732%, -4. 094% and -3.153%. The first 5 kinds mortality of malignant tumors were lung cancer, liver cancer, gastric cancer, esophageal cancer and colorectal cancer. The crude mortality rate of liver cancer was in decline, the APC of which was -3. 369%. The CDR of gastric cancer from 2006 to 2014 increased, the APC of which was 2. 32%. The SMR for lung cancer,liver cancer,gastric cancer and esophageal cancer decreased greatly during the 13 years, and APC were 3. 652%, - 6. 750%, - 5. 665%, - 5. 916%. Conclusion Although the standardized mortality rate of cancer in Xi＇an had a downward trend,the crude mortality rate was not in decline because of the aging population. There will be still need to set up the strengthen of monitoring and controlling, especially lung cancer, liver cancer, gastric cancer and so on.