四川省肿瘤医院16年恶性肿瘤住院患者死因构成及变化趋势

Causes of death in hospitalized patients with malignant tumors in Sichuan Cancer Hospital during 16 years

目的:回顾性分析四川省肿瘤医院16年来恶性肿瘤住院患者主要死因构成及年代变化趋势。方法:回顾性收集四川省肿瘤医院2004年01月至2019年12月收治的恶性肿瘤住院患者及死亡病例,分析恶性肿瘤住院患者的主要死亡原因,性别、年龄分布,死因构成的年代变化以及死亡患者占同期住院患者比例的年代变化。结果:2004年-2019年16年间我院收治恶性肿瘤住院患者总数280042例,恶性肿瘤死亡5213例,恶性肿瘤住院患者和恶性肿瘤死亡患者数量呈逐年上升趋势。前10位死因顺位依次为:肺癌(34.5%)、肝癌(9.8%)、食管癌(8.2%)、结直肠癌(7.4%)、胃癌(5.5%)、淋巴瘤(3.9%)、乳腺癌(3.8%)、胰腺癌(3.6%)、前列腺癌(2.5%)和胆囊癌(2.0%),合计占总死亡数的81.2%。男性病死率明显高于女性(2.1%vs 1.6%,P<0.001)。<40岁、40~49岁、50~59岁和≥60岁4个年龄组恶性肿瘤住院患者的病死率分别为0.8%、1.4%、1.8%、2.8%,随着年龄的增长,恶性肿瘤的病死率呈明显上升趋势(P<0.001)。肺癌始终是第一大死因,3个年代的构成比逐年上升。食管癌和胃癌的死亡构成比明显下降,而肝癌和结直肠癌的死亡构成比明显上升。恶性肿瘤死亡患者占同期住院患者比例为1.86%。其中2004年恶性肿瘤死亡患者占同期住院患者比例为12.6%,2019年下降至1.4%,随时间呈明显下降趋势(P<0.001)。结论:恶性肿瘤住院患者逐年增加,死亡患者占同期住院患者的比例逐年下降,肺癌仍是恶性肿瘤第一大死因,食管癌和胃癌的死亡构成比随时间呈下降趋势。

Objective:To analyze the main causes of death and the trend of change in hospitalized patients with malignant tumors in recent 16 years.Methods:Hospitalized patients and death cases with malignant tumors from January 2004 to December 2019 in Sichuan Cancer Hospital were collected.The main causes of death in patients with malignant tumor,the gender,age distribution,the age changes of the cause of death and the age changes in the proportion of the patients who died in the same period were analyzed.Results:In the 16 years of 2004-2019 years,280042 cases of malignant tumor were admitted to hospital,5213 cases of malignant tumor died,and the number of malignant tumor patients and malignant tumor deaths was increasing year by year.The first 10 causes of death were lung cancer(34.5%),liver cancer(9.8%),esophageal cancer(8.2%),colorectal cancer(7.4%),gastric cancer(5.5%),lymphoma(3.9%),breast cancer(3.8%),pancreatic cancer(3.6%),prostate cancer(2.5%)and gallbladder cancer(2%),which accounted for 81.2%of the total number of deaths.Male mortality was significantly higher than that of females(2.1%vs 1.6%,P<0.001).The mortality rate of hospitalized patients aged<40,40~49,50~59 and 60 years old and 4 age groups were 0.8%,1.4%,1.8%and 2.8%respectively.With the increase of age,the mortality of malignant tumor showed an obvious upward trend(P<0.001).Lung cancer had always been the leading cause of death,and the constituent ratio of the 3 years had increased year by year.The constituent ratio of death in esophageal and gastric cancer decreased significantly,while the constituent ratio of liver cancer and colorectal cancer increased significantly.The proportion of cancer patients died in the same period was 1.86%.Among them,the proportion of patients who died of malignant tumor in 2004 accounted for 12.6%in the same period,and decreased to 1.4%in 2019,which showed a significant decline with time(P<0.001).Conclusion:The number of hospitalized patients with malignant tumor is increasing year by year,the proportion of death patients in the same period is declining year by year.Lung cancer is still the first major cause of death.The ratio of death to cancer of the esophagus and gastric cancer is decreasing with time.