河南省2016年肝癌的发病与死亡情况及2010-2016年趋势分析

Report of liver cancer incidence and mortality in 2016 and the time trends during 2010―2016 in Henan Province,China

目的:根据河南省肿瘤登记地区肿瘤登记数据估算河南省2016年肝癌发病与死亡情况。方法:按照《中国肿瘤登记手册》及国际癌症研究中心的登记质量标准评估2016年河南省肿瘤登记数据的完整性、有效性和可靠性。按照ICD10编码(C22)提取肝癌数据,并分别计算城乡、性别、年龄别登记人群肝癌发病率和死亡率,结合2016年全省人口数据估算全省肝癌发病及死亡情况。采用2000年中国标准人口年龄构成和Segi世界标准人口年龄构成分别计算中国人口标化率(简称中标率)、世界人口标化率(简称世标率)。采用Joinpoint回归模型估计肝癌中标发病率和中标死亡率年度变化百分比(annual percent change,APC)。结果:河南省2016年肝癌新发病例数为28635例,占河南省全部恶性肿瘤新发病例的9.58%,位居全部恶性肿瘤发病的第4位。肝癌粗发病率为26.43/10万,中标率为19.90/10万,世标发病率为19.79/10万;男性发病率高于女性,男性和女性中标发病率分别为28.07/10万和11.76/10万;农村地区发病率高于城市地区,中标发病率分别为20.50/10万和17.84/10万。河南省2016年肝癌死亡病例数为24052例,占河南省全部恶性肿瘤死亡的12.82%,位居全部恶性肿瘤死亡的第4位。肝癌粗死亡率为22.22/10万,中标死亡率为16.30/10万,世标死亡率为16.27/10万;男性死亡率高于女性,中标死亡率分别为22.99/10万和9.77/10万;城市地区和农村地区差别不大,肝癌中标死亡率分别为16.08/10万和16.41/10万。肝癌的年龄别发病率和死亡率在0~29岁年龄组和0~34岁年龄组较低,分别在30岁以后和35岁以后快速上升,均在85+岁年龄组达到峰值;肝癌新发病例数和估计死亡人数均在60~64岁年龄组达到峰值。2010年以来肝癌中标发病率平均每年下降2.1%。2013年以来肝癌中标死亡率平均每年下降7.4%。结论:河南省肝癌疾病负担较重,其城乡及男女性别差异明显,因此,应针对其流行特点及危险因素加大综合防控力度。

Objective:To estimate the incidence and mortality of liver cancer in Henan Province in 2016 according to the cancer registration data.Method:The data quality including completeness,validity,and reliability of local registries which submitted the cancer registration data of 2016 were assessed according to the criteria of Guideline on Cancer Registration in China and IARC/IACR.Liver cancer cases(ICD10:C22)were extracted from the database,and the incidence and mortality stratified by gender,age,and areas(urban/rural)were calculated,the provincial cancer incidence and mortality were estimated combined with provincial population data.China's 2000 census population and Segi's population were used to calculate the age-standardized rate.Joinpoint regression model was used to estimate the changing trend of age-standardized incidence and mortality along with the calendar year.Result:Approximately 28635 new liver cancer cases were diagnosed in Henan Province in 2016,accounting for 9.58%of all new cancer cases,and it ranked fourth among cancer of all sites.The crude liver cancer incidence was 26.43/100000 with an age-standardized incidence rate by China standard population(ASIRC)of 19.90/100000 and an age-standardized incidence rate by the world standard population(ASIRW)of 19.79/100000.The liver cancer incidence in males was higher than that in females,with the ASIRC of 28.07/100000 and 11.76/100000,respectively.It was higher in rural areas than that in urban areas,and they were 20.50/100000 and 17.84/100000,respectively.About 24052 liver cancer cases dead in Henan Province in 2016,accounting for 12.82%of all cancer deaths in Henan Province which ranked fourth among cancer of all sites.The crude mortality rate was 22.22/100000 with an age-standardized mortality rate by China standard population(ASMRC)of 16.30/100000 and an age-standardized mortality rate by world standard population(ASMRW)of 16.27/100000.The mortality in males was higher than that in females,with the ASMRC of 22.99/100000 and 9.77/100000,respectively.There was no significant difference between urban and rural areas,and the ASMRC was 16.08/100000 and 16.41/100000,respectively.The liver cancer age-specific incidence and mortality were low at the age groups of 0-29 and 0-34 years,and they started increasing rapidly after 30 and 35 years old,respectively,and reached the peak at the 85+age group.The estimated number of incident liver cancer cases and deaths reached the peak in the 60-64 years age group.The ASIRC and ASMRC were declining with annual percent change(APC)of 2.1%since 2010 and with APC of 7.4%since 2013.Conclusion:The disease burden of liver cancer in Henan Province remains large,and there are significant gender differences between urban and rural areas and between men and women.Therefore,comprehensive prevention and control efforts should be strengthened according to its epidemic characteristics and risk factors.