2005—2015年全国肝癌发病趋势分析

Incidence tendency of hepatocellular carcinoma in China,2005-2015

目的通过分析《中国肿瘤登记年报》中肝癌发病的变化趋势,为有效开展肝癌防治工作提供科学参考依据。方法整理2005—2015年肝癌发病数据,运用Joinpoint软件进行回归模型分析我国肝癌发病率变化趋势,利用R软件进行负二项回归模型分析肝癌在人群水平上发病的危险因素。结果2005—2015年我国肝癌标化发病率基本表现为农村高于城市,男性高于女性。肝癌标化发病率总体呈下降趋势(AAPC=-0.818,P<0.05);城乡男性肝癌年龄别发病率大多在30~岁年龄组呈快速上升趋势,农村和城市女性年龄别发病率分别在45~和50~岁年龄组,随时间增长呈快速上升趋势。城市人群的发病风险是农村人群的1.198倍(95%CI:1.041~1.379,P<0.05),男性是女性的3.715倍(95%CI:3.228~4.275,P<0.001),每增加5岁,肝癌的发病风险平均增大8.0%(OR=1.080,95%CI:1.077~1.083,P<0.001)。结论2005—2015年我国肝癌发病情况总体呈下降趋势,但存在城乡、性别及年龄差异,需要制定更加有效完善的预防措施,从而达到预防肝癌的最优效果。

Objective To analyze the changing trend of liver cancer incidence in the Annual Report on Cancer Registration in China so as to provides a scientific reference basis for effective development of liver cancer prevention and treatment.Methods The data about the incidence of liver cancer from 2005 to 2015 were sorted.A Joinpoint regression model was used to analyze the changing trend in the incidence rate of liver cancer in China,and the software R was used to perform negative binomial regression model analysis on the risk factors of liver cancer at the population level.Results The standardized incidence rate of liver cancer in China from 2005 to 2015 was basically higher in rural areas than in urban areas as well as higher in males than in females.The standardized incidence rate of liver cancer showed an overall downward trend(AAPC=-0.818,P<0.05).The age-specific incidence rate of liver cancer in urban and rural males aged 30 years showed a rapid increasing trend,and the age-specific incidence rates in rural and urban females aged 45-and 50-years both showed a rapid upward trend over time.The risk of the disease in urban population was 1.198 times that of rural population(95%CI:1.041-1.379,P<0.05),and the risk in males were 3.715 times that of females(95%CI:3.228-4.275,P<0.001).The risk of liver cancer increased by an average of 8.0%for every additional 5 years of age(OR=1.080,95%CI:1.077-1.083,P<0.001).Conclusion From 2005 to 2015,the incidence of liver cancer in China showed an overall downward trend,but there were differences in urban and rural areas,genders and ages.More effective and complete preventive measures need to be formulated to achieve the optimal effect of liver cancer prevention.