2007—2019年南京市胃癌死亡率及早死寿命损失年变化趋势分析

Analysis on the long-term trend of mortality and years of life lost of stomach in Nanjing,2007—2019

目的分析2007-2019年南京市胃癌死亡率及早死寿命损失年(Years of life lost,YLL)变化趋势。方法利用南京市居民全死因监测系统,收集2007年1月1日-2019年12月31日南京市户籍居民胃癌死亡病例。计算胃癌的死亡率、标化死亡率、YLL和YLL率;采用Joinpoint回归分析胃癌死亡率和YLL率的变化趋势,计算平均年度变化百分比(Average annual percentage change,AAPC)。结果2007-2019年南京市胃癌死亡共32187例,其中男性死亡22296例,女性死亡9891例,男性死亡率高于女性(52.64/10万vs.23.61/10万),差异有统计学意义(u=2.281,P<0.05);城市地区居民因胃癌死亡10591例,农村地区居民死亡21596例,城区地区居民胃癌死亡率低于农村地区居民(26.02/10万vs.49.56/10万),差异有统计学意义(u=55.257,P<0.05)。南京市胃癌年龄别死亡率随着年龄的增加而上升,在40岁之前较低,40岁后开始上升,男性至80岁达最高之后下降,女性至85岁达到最高峰。2007-2019年南京市胃癌死亡率、标化死亡率均呈下降趋势(死亡率AAPC为-2.65%,标化死亡率AAPC为-7.69%,P<0.05)。2007-2019年南京市因胃癌导致的YLL合计为681511人年,YLL率为8.09‰,2007-2019年南京市YLL率呈下降趋势(AAPC为-3.86%,P<0.05),YLL率均随年龄的增加而上升(AAPC为52.43%,P<0.05),且男性增长速度快于女性(男性AAPC为54.90%,女性AAPC为49.70%,P<0.05)。结论南京市胃癌死亡有明显的性别、年龄和城乡分布差异,可根据高危人群特征逐步推进南京市胃癌早诊早治工作,提高胃癌患者生活质量,减轻个人和社会的癌症负担。

Objective To analyze the long-term trend of mortality and years of life lost(YLL)of stomach cancer in Nanjing from 2007 to 2019.Methods From January 1,2007 to December 31,2019,the date of stomach cancer deaths was collected from the Nanjing Surveillance System for all causes of death.The crude and age-standardized mortality rate of stomach cancer was calculated according to Chinese standard population in 2000.The Joinpoint regression was used to calculate the average annual percentage change(AAPC)to indicate the trend of mortality and YLL rates of stomach cancer.Results From 2007 to 2019,there were 32187 deaths of stomach cancer in Nanjing,22296 in male and 9891 in female,the crude rates of male were higher than female(52.64/105 vs.23.61/105,u=2.281,P<0.05),10591 in urban areas and 21596 in rural areas,the crude rates of urban areas were lower than rural areas(26.02/105 vs.49.56/105,u=55.257,P<0.05).The mortality rates of stomach cancer increased from the age of 40 years and peaked in age group of 80-years in males,peaked in age group of 85-years in females.From 2007 to 2019,the crude mortality and age-standardized mortality were decreased with year(AAPC,crude mortality:-2.65%,age-standardized mortality:-7.69%,P<0.05).The total YLL numbers were 681,511 person-years and the rates were 8.09 person-years per thousand.From 2007 to 2019 was,YLL rates were decreased with year(AAPC was-3.86%,P<0.05),and increased with age(the AAPC was 52.43%,P<0.05),and the rates of males increased faster than those of females(AAPC,males:54.90%,females:49.70%,P<0.05).Conclusion The mortality of stomach cancer varied with sex,age and areas(urban area and rural area).The present analysis provides the character of stomach cancer in Nanjing,which can help optimize the screening and prevention strategies of stomach cancer to improve life quality and reduce the disease burden.