2004-2019年中国恶性肿瘤死亡趋势及预测分析

Trend analysis and prediction of cancer mortality in China from 2004 to 2019

目的 了解2004-2019年我国恶性肿瘤死亡趋势并进行预测分析,为制定我国恶性肿瘤防治策略提供理论基础。方法 利用2004-2019年全球疾病负担研究数据,采用Joinpoint回归模型计算恶性肿瘤标化死亡率的全时间段内平均年度变化百分比(AAPC)及95%CI,应用GM(1,1)对我国2020-2025年恶性肿瘤死亡粗率进行预测。结果 与2004年相比,2019年我国恶性肿瘤死亡例数增至271.19万例,死亡粗率升至190.66/10万,年龄标化死亡率降至140.66/10万。我国总人群、男性和女性恶性肿瘤标化死亡率AAPC分别为-1.32%、-1.13%和-1.68%,均呈下降趋势,P<0.001。2004-2016年我国总人群恶性肿瘤标化死亡率以每年1.60%的速度下降,2016-2019年变化保持平稳;女性的下降速度快于男性,AAPC=0.56%,Z=2.245,P=0.025。GM(1,1)模型预测2020-2025年我国恶性肿瘤死亡粗率略有上升,预估2025年死亡粗率达200.56/10万。结论 我国恶性肿瘤死亡负担仍较重,男性高于女性。预测我国恶性肿瘤死亡粗率将逐年上升,应采取有效预防措施,尤其重视男性恶性肿瘤的防治。

Objective To understand the tendency of cancer mortality and predict death trend in the future,therefore,providing theoretical basis for cancer prevention and control in China.Methods Based on Global Burden of Disease Study database from 2004 to 2019,the average annual percent change(AAPC) and its 95% control interval of age-standardized mortality rates for the entire time period were calculated via Joinpoint Regression Models.GM(1,1) model was used for predicting crude mortality rates in the future in China.Results Comparing with 2004,the number of people die of cancer increased to 271.19 ten thousand.The crude mortality rate increased to 190.66/10~5 while age-standardized mortality rate decreased to 140.66/10~5.The age-standardized mortality rates in total population and both genders showed a downward trend with average annual decrease of-1.32%,-1.13% and-1.68%,respectively(P<0.001).From 2004 to 2016,the age-standardized mortality rate was at an annual decrease of 1.60% then retained stable between 2016 and 2019.The age-standardized mortality rate of females fell faster than that of males(AAPC=0.56%,Z=2.245,P=0.025).From 2020 to 2025,GM(1,1) model predicted that the crude mortality rate of cancer would show an upward trend and increase to 200.56/10~5 in 2025.Conclusions The disease burden was higher in males than that in females.The crude mortality rate of cancer would be on the rise.Health departments should actively formulate effective prevention and treatment measures,especially targeting for males.