山东省1970-2013年居民白血病死亡率变化趋势分析

Trend of leukemia mortality among residents in Shandong Province from 1970 to 2013

目的研究显示,白血病发病与环境中的某些有害因素有关联,观察分析环境污染与白血病的发生或死亡可为病因学研究提供基础。本研究分析山东省1970-2013年白血病死亡率的变化趋势,以便为该病的病因学研究及预防措施评估提供基础资料。方法检索发表在国内杂志及出版专业书籍中关于山东省1970-1974年、1985-1989年、1990-1992年、2004-2005年和2011-2013年白血病死亡率资料,采用Joinpoint回归模型分析年均变化速率(annual percentage change,APC)。结果1970-1974年、1985-1989年、1990-1992年、2004-2005年和2011-2013年5个时期白血病死亡率分别为1.97/10万、3.63/10万、3.96/10万、4.36/10万和3.9/10万。男女5个时期年龄组的死亡率曲线呈波动性增加趋势,其中0~4岁组的变化尤其明显,从1985-1989年开始增加,至2004-2005年上升达到高峰,到2011-2013年则下降至1970-1974年的水平。男女合计、男性、女性白血病死亡率的APC均呈上升趋势,APC值分别为3.24%(P=0.0217)、3.37%(P=0.0126)和2.98%(P=0.0721),均呈上升趋势,而女性白血病死亡率虽然也呈上升趋势但差异无统计学意义。Joinpoint回归分析参数显示,3个时期男女APC的变化方向相同,即1970-1992年上升,1992-2005年缓慢抬高,而2005-2013年则稍微下降。结论山东省居民44年期间白血病死亡率呈现缓慢上升,而近期有下降趋势,其中0~4岁组变化很大。这种现象需要进一步观察并开展环境方面的病因学研究。

OBJECTIVE Studies have shown that the incidence of leukemia is related to some harmful factors in the environment.The observation and analysis of environmental pollution and the occurrence or death of leukemia can provide a basis for etiological research.This study analyzed the trend of leukemia mortality in Shandong Province from 1970 to 2013,in order to provide basic data for the etiology research and preventive measures evaluation of the disease.METHODS Based on the data of leukemia mortality in Shandong Province from 1970 to 1974,1985 to 1989,1990 to 1992,2004 to 2005 and 2011 to 2013 published in domestic journals and professional books were searched.The Annual percentage change(APC)was calculated by Joinpoint 3.1.RESULTS The mortality rates of leukemia in the five periods of 1970-1974,1985-1989,1990-1992,2004-2005 and 2011-2013 were 1.97/100000,3.63/100000,3.96/100000,4.36/100000 and 3.9/100000,respectively.The mortality curve of the age groups of men and women in the five periods showed a fluctuating increasing trend,especially in the 0-4 age group,which increased from 1985-1989,reached a peak in 2004-2005,and decreased to 1970-1974 level in 2011-2013.The APCs of leukemia mortality in males and females showed an upward trend,with APC values of 3.24%(P=0.0217),3.37%(P=0.0126)and 2.98%(P=0.0721),respectively,while in females the upward trend showed no statistical significance.According to Joinpoint regression analysis in,the change direction of APC of men and women in three periods rised in 1970-1992,slowly rised in 1992-2005 and slightly declined in 2005-2013.CONCLUSIONS In the past 44 years,the mortality rate of leukemia in Shandong Province has been increasing slowly,but it has a downward trend recently,especially in the 0-4 age group.This phenomenon provides a basis for further etiological research.