2013—2018年山东省肥城市主要恶性肿瘤的早死概率和疾病负担分析

Analysis of Probability of Premature Mortality and Disease Burden Caused by Major Malignant Tumors from 2013 to 2018 in Feicheng City,Shandong Province

[目的]分析2013—2018年山东省肥城市户籍居民主要恶性肿瘤的早死概率、疾病负担,以及变化趋势,为实现早死概率下降的目标及恶性肿瘤的防控提供数据支持。[方法]2013—2018年肥城市户籍居民全死因登记资料、人口资料和肿瘤发病登记资料由肥城市疾控、当地公安局及肿瘤登记处提供,计算主要恶性肿瘤的死亡率、早死概率、伤残调整寿命年(DALY)和年度变化百分比(APC)等指标,采用2010年全国第六次人口普查数据进行标化。[结果]2013—2018年肥城市居民恶性肿瘤死亡率为221.55/10万,标化死亡率为166.37/10万。标化死亡率于2013—2014年上升,随后逐年下降,男性恶性肿瘤的死亡率高于女性;恶性肿瘤死亡前5位依次为肺癌、食管癌、胃癌、肝癌和女性乳腺癌;恶性肿瘤的早死概率为8.98%,呈逐年下降趋势,APC为-2.47%(t=-3.10,P<0.05)。女性变化幅度大于男性。2013—2018年食管癌的早死概率逐年减少,APC为-6.67%(t=-3.01,P<0.05),男性肺癌的早死概率逐年增加,APC为1.51%(t=-3.10,P<0.05),女性乳腺癌的早死概率在0.44%~0.67%之间波动,在女性恶性肿瘤排名中跃居第3位;2013—2018年肥城市恶性肿瘤造成的伤残调整寿命年率、早死寿命损失年(YLL)率和伤残寿命损失年(YLD)率分别为40.07/千人、39.29/千人和0.78/千人,恶性肿瘤的DALY率变化较为平稳,男性恶性肿瘤DALY率排名中食管癌升至首位;2013—2018年肺癌的DALY率逐年增加,APC为3.25%(t=6.05,P<0.05),男性结直肠癌DALY率逐年增加,APC为7.14%(t=3.37,P<0.05),男性食管癌DALY率在10.81%~13.34%之间波动。[结论]肥城市肺癌、食管癌和女性乳腺癌的疾病负担较为严峻,具体应针对不同恶性肿瘤的特点采取有效措施进行防控。

[Purpose]To analyze the probability of premature mortality,disease burden and changing trend of major malignant tumors of Feicheng City residents from 2013 to 2018 in Shandong Provine,and to provide data support to promote the goal of reducing early death and strengthening prevention and control of malignant tumors.[Methods]The data of all death causes,census data and records of tumor incidence registration of the residents in Feicheng City from 2013 to 2018 were provided by the Center for Disease Control and Prevention,local Public Security Bureau and Cancer Registry.Mortality,probability of premature mortality,disability adjusted life year,annual percentage change and other indicators of major malignant tumors were calculated.The sixth national census data of 2010 was used for standardization.[Results]During 2013-2018,the mortality rate of malignant tumors in Feicheng City residents was 221.55/105,and the standardized mortality rate was 166.37/105.The standardized mortality rate increased in 2013-2014,and then decreased year by year.The mortality rate of malignant tumors in males was higher than that in females.The top 5 major malignant tumors leading to death were lung cancer,esophageal cancer,stomach cancer,liver cancer and female breast cancer.The probability of premature mortality of malignant tumor was 8.98%,showing a downward trend year by year,APC was-2.47%(t=-3.10,P<0.05),the range change of female was greater than that of male.The probability of premature mortality of esophageal cancer decreased from 2013 to 2018,and the APC was-6.67%(t=-3.01,P<0.05).The premature death probability of male lung cancer increased year by year,and the APC was 1.51%(t=-3.10,P<0.05).The premature death probability of female breast cancer fluctuated between0.44%and 0.67%,which ranked the third among malignant tumors in females.The DALYR,YLLR and YLDR caused by malignant tumors in Feicheng City from 2013 to 2018 were 40.07,39.29 and 0.78 per thousand person,respectively,and the DALYR of malignant tumors was relatively stable.Esophageal cancer ranked the first in male malignant tumors in terms of DALYR.The DALYR of lung cancer increased year by year during 2013-2018,and the APC was 3.25%(t=6.05,P<0.05).The DALYR of male colorectal cancer increased year by year,and the APC was7.14%(t=3.37,P<0.05).The DALYR of male esophageal cancer fluctuated between 10.81%and 13.34%.[Conclusion]The disease burden of lung cancer,esophageal cancer and female breast cancer was severe in Feicheng City.Effective measures should be taken to prevent and control the different malignant tumors based on their own characteristics.