基于年龄-时期-队列效应模型分析2012—2022年山东省甲状腺癌流行趋势

Analysis of the incidence and mortality of thyroid cancer in Shandong Province from 2012 to 2022 based on the age-period-cohort model

目的分析2012—2022年山东省甲状腺癌发病死亡趋势,并估计其发病的年龄-时期-队列效应。方法基于2012—2022年山东省肿瘤登记地区甲状腺癌数据,利用Joinpoint回归分析甲状腺癌发病、死亡的变化趋势,计算平均年度变化百分比(AAPC)。拟合年龄-时期-队列模型分析20岁以上人群甲状腺癌发病风险的年龄、时期及队列效应。结果2012—2022年山东省甲状腺癌发病率呈上升趋势,AAPC值为21.68%(95%CI:19.14%~24.27%,P<0.001),且女性发病率高于男性,城市发病率高于农村;甲状腺癌死亡率变化趋势相对稳定,AAPC值为-3.04%(95%CI:-8.81%~3.09%,P=0.323)。甲状腺癌发病的年龄效应在60岁之前随年龄增长而增加,60岁之后随年龄增长而降低,发病高峰集中在55~59岁年龄组;时期效应随时间推移而增加;队列效应则表现为1957年之前出生的队列随时间推移呈下降趋势,1957年之后出生的队列呈上升趋势。结论2012—2022年山东省甲状腺癌发病率呈上升趋势,年龄是重要影响因素;甲状腺癌死亡率较为稳定。

Objective To analyze the trend of incidence and mortality of thyroid cancer and estimate its age-period-cohort effect in Shandong Province from 2012 to 2022.Methods The Joinpoint regression was used to analyze the trend of incidence and mortality of thyroid cancer and calculate the average annual percentage change(AAPC)based on the data on thyroid cancer from 2012 to 2022.The age-period-cohort model was used to analyze the age-effect,time-effect and cohort-effect of thyroid cancer risk in the population aged over 20 years.Results From 2012 to 2022,the incidence of thyroid cancer in Shandong province showed a significant upward trend,with an AAPC of 21.68%(95%CI:19.14%-24.27%,P<0.001).The incidence of females was higher than that of males,and the incidence of urban areas was higher than that of rural areas.The trend of thyroid cancer mortality was relatively stable with an AAPC of-3.04%(95%CI:-8.81%-3.09%,P=0.323).The age effect of incidence increased with age before 60 years old and decreased with age after 60 years old.The incidence peaked in the age group of 55-59.The period effect increased with time.The cohort effect showed that the cohort born before 1957 had a downward trend over time,while the cohort born after 1957 had an upward trend.Conclusion The incidence of thyroid cancer in Shandong shows a rising trend from 2012 to 2022.Age is an important factor affecting the risk of thyroid cancer.The mortality of thyroid cancer remains stable.