1999—2019年天津市居民恶性肿瘤死亡谱变化对期望寿命的影响

Impact of changes in malignant tumor death spectrum on life expectancy in Tianjin residents from 1999-2019

目的探讨1999—2019年天津市居民恶性肿瘤死亡谱变化对不同年龄、性别及城乡居民期望寿命的影响。方法收集1999年1月1日至2019年12月31日天津市户籍人口数据和死亡数据,应用简略寿命表,采用Arriaga分解法,计算不同年龄、性别及地区恶性肿瘤死亡谱变化对期望寿命的影响。结果1999—2019年天津市男性和女性居民的期望寿命分别增加了4.96和5.69岁。其中恶性肿瘤死亡率下降对1999—2007年男性和女性居民期望寿命增量的贡献分别为0.12岁(3.30%)和0.03岁(0.77%),对2007—2019年男性和女性居民期望寿命增量的贡献分别为0.05岁(3.13%)和0.12岁(6.08%)。60~69岁组居民恶性肿瘤死亡率下降对期望寿命增加贡献最大,肺癌、胃癌、食管癌、肝癌死亡率的下降对期望寿命增加贡献较大,肺癌在男性和农村地区居民中产生了负向作用,而在女性和城市地区居民中产生的是正向作用。≥85岁组居民肺癌、结直肠癌、胰腺癌死亡率的大幅增高对期望寿命产生了很大的负向作用。乳腺癌、卵巢癌在女性中的贡献率为负值。结论1999—2019年天津市居民期望寿命增长主要归因于老年人以及恶性肿瘤中胃癌、食管癌和肝癌死亡率的下降,而肺癌、结直肠癌、胆囊癌、胰腺癌和乳腺癌死亡率的升高是阻碍天津市居民期望寿命增加最主要的疾病。

Objective To analyze the effects of changes in the spectrum of deaths from malignant tumors on the life expectancies of residents of different ages,sexes,and regions(urban or rural)in Tianjin from 1999 to 2019.Methods The Abridged Life Table method and the Arriaga's decomposition method were used to calculate the effects of changes in spectrum of deaths from malignant tumors on the life expectancies of Tianjin residents of different ages,sexes,and regions.Results During 1999-2019,the life expectancies increased by 4.96 years and 5.69 years for males and females,respectively,in Tianjin.The decreases in the mortalities from malignant neoplasms contributed 0.12 year(3.30%)and 0.03 year(0.77%)for males and females,respectively,to the increase during 1999-2007,and 0.05 year(3.13%)and 0.12 year(6.08%)for males and females,respectively,during 2007-2019.The decreases in the mortality rates of malignant tumors contributed the most to the increase among residents in the 60-69 years group,and the decreases in mortality rates of lung,gastric,esophageal,and liver cancers had relatively larger contribution.Lung cancer had a negative effect on the life expectancies of men and rural residents,but a positive effect on those of women and urban residents.The significant increases in the mortality rates of lung,colorectal,and pancreatic cancers in the≥85 years group had a large negative effect on the overall life expectancy.Breast and ovarian cancers contributed negatively to the life expectancy of female residents.Conclusion The overall increase in the life expectancy in Tianjin from 1999 to 2019 was mainly attributed to the elderly and the decreases in the mortality rates of gastric,esophageal,and liver cancers,among other malignancies,while the increases in the mortality rates of lung,colorectal,gallbladder,pancreatic,and breast cancers were the most significant factors hindering the increase of the life expectancy in Tianjin.