2004—2018年中国肺癌死亡趋势分析及预测

Death trends of lung cancer in China from 2004 to 2018

目的分析2004—2018年中国肺癌死亡率水平及变化趋势,为采取有效控制和预防肺癌提供流行病学依据。方法从《中国死因监测数据集(2004—2018)》选取肺癌死亡数据,分别计算不同年份肺癌死亡率、标化死亡率,采用Joinpoint软件计算标化死亡率年度变化百分比(annual percent change, APC)和平均年度变化百分比(average annual percent change, AAPC)。构建时间序列分析模型,筛选最佳模型并预测中国未来10年的肺癌死亡率。结果肺癌粗死亡率2006年下降到28.27/10万,其他持续上升至2018年的46.51/10万。肺癌粗死亡率男性高于女性,农村高于城市,东部地区高于中部和西部地区。城市肺癌标化死亡率呈现下降趋势,农村呈现上升趋势(AAPC;=-0.79%,AAPC;=1.05%,P<0.05)。东部地区肺癌标化死亡率在2004—2018年整体呈下降趋势(AAPC=-2.22%,P<0.05),而西部地区则呈上升趋势(AAPC=1.90%,P<0.05)。预测自2019年后我国肺癌的粗死亡率将会持续上升,标化死亡率围绕36.50/10万上下波动。结论肺癌死亡率存在城乡、地区差异,需积极寻找相关危险因素并针对不同地区特定人群加强防控措施。

Objective To understand the mortality and trends of lung cancer in China from 2004 to 2018, and to provide epidemiological basis for lung cancer intervention. Methods Lung cancer death data were retrieved from the cause of death monitoring data set in the national disease surveillance system. The annual death rate and standardized death rate of lung cancer were calculated respectively. Meanwhile, the annual percent change(APC) and the average annual percent change(AAPC) of standardized death rate were determined using Joinpoint software. Eviews 10 software was used to construct time series analysis models, and the best model was selected to predict the mortality rate in the coming decade in China. Results The crude death rate of lung cancer was temporarily down to 28.27/100 000 in 2006 then was all the way up to 46.51/100 000 in 2018. The crude mortality rates of lung cancer increased with age, and were higher in men than in women, in rural areas than in urban areas and in the eastern region than in the central and western regions. The AAPC of standardized mortality rate of lung cancer showed down-ward trend in urban areas(AAPC=-0.79%, P<0.05) while it showed up-ward trend in rural areas(AAPC=1.05, P<0.05). The overall mortality rate of lung cancer in eastern China showed a down-ward trend from 2004 to 2018(AAPC=-2.22%, P<0.05), while it showed an increasing trend in western China(AAPC=1.90%, P<0.05). In the coming 10 years, the crude mortality rate of lung cancer in China will continue to rise, and the standardized mortality rate will fluctuate around 36.50/100 000. Conclusions There are differences in mortality rate of lung cancer between urban and rural areas and between eastern and western regions in China,so it is necessary to actively explore the related risk factors and strengthen prevention and control measures for specific populations in different regions.