江苏省启东市1972-2016年白血病死亡特征分析

Analysis of leukemia mortality in Qidong City,Jiangsu Province,1972-2016

目的:分析江苏省启东市1972-2016年白血病死亡特征及时间趋势。方法:收集整理启东市1972-2016年白血病死亡病例,分别计算启东市白血病的粗死亡率、中国人口标准化死亡率(简称:中标率)、世界人口标准化死亡率(简称:世标率)、35~64岁截缩率和0~74岁累积率等指标;利用年龄-时期-队列模型分析年龄、时期和出生队列对白血病患者死亡趋势变化的影响;应用Joinpoint 4.7.0.0统计学软件分析白血病死亡率年度变化百分比(annual percent change,APC)。结果:1972-2016年启东市白血病死亡共2150例,在全部癌症死亡病例中所占百分比为2.17%;年均粗死亡率为4.25/10万(其中男性4.73/10万,女性3.79/10万),中标率为3.69/10万,世标率为3.69/10万,35~64岁截缩死亡率为4.39/10万,0~74岁累积死亡率为0.34%,累积死亡风险为0.34%。年龄-时期-队列模型分析显示,年龄、时期和队列效应对白血病死亡率均有统计学意义(P值均<0.05);0~岁组、15~岁组和65~岁组白血病死亡率的APC分别为-5.80%、1.35%和2.50%,分别呈现下降、上升和上升趋势(P值均<0.05)。白血病男女合计粗死亡率、中标率和世标率的APC分别为2.32%[95%可信区间(confidence interval,CI):1.91%~2.73%]、0.77%(95%CI:0.32%~1.21%)和0.72%(95%CI:0.26%~1.18%),均呈上升趋势(P值均<0.05);其中,男性粗死亡率、中标率和世标率的APC分别为2.27%(95%CI:1.68~2.87)、0.55%(95%CI:0.01%~1.09%)和0.53%(95%CI:-0.03%~1.09%);女性粗死亡率、中标率和世标率的APC则是2.48%(95%CI:1.89%~3.08%)、0.89%(95%CI:0.18%~1.61%)和0.74%(95%CI:0.00%~1.48%)。结论:启东市白血病死亡率呈上升趋势,男性死亡率高于女性,男性和老年人群应为白血病死亡防控的重点关注对象。

Objective:To analyze the characters and trends of mortality of leukemia from 1972 to 2016 in Qidong City of Jiangsu Province.Methods:The data of leukemia were collected from Qidong Cancer Registry.The leukemia crude mortality rate,age-standardized rate(ASR)by China population and ASR by Segi’s world standard population,35-64-year-old truncated rate and 0-74-year-old cumulative accumulation rate were calculated.The age-period-cohort model was used to analyze the effects of age,period and birth cohort on the trend of mortality patients with leukemia.Joinpoint 4.7.0.0 was used to analyze the annual percentage change(APC)of leukemia mortality.Results:During 1972 to 2016,a total of 2150 deaths occurred due to leukemia,accounting for 2.17%of all cancers deaths.The crude mortality rate,ASR-China,ASR-World,truncated rate of 35-64-year-old,cumulative rate of 0-74-year-old,and cumulative risk were 4.25/10^(5)(male 4.73/10^(5),female 3.79/10^(5)),3.69/10^(5),3.69/10^(5),4.39/10^(5),0.34%and 0.34%,respectively.Age-period-cohort analysis performed that age,period and cohort effect have significant significance on the mortality of leukemia(all P<0.05).The APC of the 0-year-old group,15-year-old group,and 65-year-old group were-5.80%,1.35%,and 2.50%,respectively,showing a downward,upward,and upward trend respectively(all P<0.05).The APC of crude mortality rate,ASR-China,ASR-World of leukemia were 2.32%[95%confidence interval(CI):1.91%-2.73%],0.77%(95%CI:0.32%-1.21%)and 0.72%(95%CI:0.26%-1.18%),respectively,all showed an upward trend(all P<0.05).For male,the APC of crude mortality rate,ASR-China,ASR-World were 2.27%(95%CI:1.68-2.87),0.55%(95%CI:0.01%-1.09%)and 0.53%(95%CI:-0.03%-1.09%),respectively.For female,the APC of crude mortality rate,ASR-China,ASR-World were 2.48%(95%CI:1.89%-3.08%),0.89%(95%CI:0.18%-1.61%)and 0.74%(95%CI:0.00%-1.48%),respectively.Conclusion:The mortality of leukemia has presented a rising trend in Qidong City from 1972 to 2016,with higher mortality in male than in female.Males and the elderly are the main concerns for the prevention and control of leukemia deaths.