2008-2021年南京市高淳区消化系统恶性肿瘤死亡趋势及其对期望寿命的影响

Mortality trend of malignant tumor of digestive system and its impact on life expectancy in Gaochun District,Nanjing from 2008 to 2021

目的分析南京市高淳区2008年1月1日至2021年12月31日年户籍居民消化系统恶性肿瘤死亡趋势及其对期望寿命的影响,为制定高淳区消化系统恶性肿瘤防控策略提供数据支撑。方法利用2008—2021年高淳区户籍人口和消化系统恶性肿瘤死亡资料。采用Joinpoint 4.9.1.0回归分析高淳区消化系统恶性肿瘤死亡率变化趋势,计算平均年度变化百分比(AAPC)。采用简略寿命表计算人均期望寿命及其变化,利用Arriaga分解法估计消化系统恶性肿瘤死亡率变化对期望寿命变化的贡献情况。结果2008—2021年高淳区居民消化系统恶性肿瘤年均粗死亡率为111.99/10万,中标率为58.24/10万,消化系统恶性肿瘤标化死亡率呈下降趋势(AAPC=-6.78%,P<0.05),男性高于女性(79.83/10万vs.35.65/10万),且下降速度快于女性(男性AAPC=-7.84%,女性AAPC=-5.59%,均P<0.05),胃癌、食管癌、胆囊癌标化死亡率分别以10.11%、9.94%、4.62%的速度下降(均P<0.05)。2008—2021年南京市高淳区户籍居民期望寿命增加了8.11岁,其中消化系统恶性肿瘤死亡率的降低使期望寿命增加1.37岁,胃癌、肝癌、食管癌、胆囊癌对期望寿命呈“正向贡献”,累计增加1.43岁,结直肠癌和胰腺癌对期望寿命呈“负向贡献”,累计减少0.07岁。结论2008—2021年高淳区消化系统恶性肿瘤死亡呈下降趋势,对南京市居民期望寿命增长起到积极作用,需重点关注胃癌、结直肠癌和胰腺癌死亡对期望寿命的影响。

Objective To analyze the mortality trend of digestive system cancer and its impact on life expectancy of registered residents in Gaochun District,Nanjing from 2008 to 2021,and to provide data support for formulating prevention and control strategy of digestive system cancer in Gaochun District.Methods The data of the registered population and mortality of digestive system cancer in Gaochun District from 2008 to 2021 were used.Joinpoint 4.9.1.0 regression was used to analyze the mortality trend of digestive system cancer in Gaochun District,and the average annual percentage change(AAPC)was calculated.The average life expectancy and its changes were calculated using the abbreviated life table,and the contribution of the mortality rate of digestive system cancer to the changes in life expectancy was estimated by Arriaga decomposition method.Results From 2008 to 2021,the average annual crude mortality rate of malignant tumors of digestive system in Gaochun District was 111.99/100000,and the rate was 58.24/100000.The standardized mortality rate of digestive system cancer in males was higher than that in females(79.83/100000 vs.35.65/100000),and the decrease rate is faster than that of female(male AAPC=-7.84%,female AAPC=-5.59%,both P<0.05).From 2008 to 2021,the standardized mortality of digestive system cancer showed a decreasing trend(AAPC=6.78%,P<0.05),while the standardized mortality of stomach cancer,esophageal cancer,and gallbladder cancer decreased at a rate of 10.11%,9.94%and 4.62%,respectively(all P<0.05).From 2008 to 2021,the life expectancy of registered residents in Gaochun District increased by 8.11 years.Among them,the reduction of mortality rate of digestive system cancer played a“positive role”in the increase of life expectancy,contributing 1.37 years;gastric cancer,liver cancer,esophageal cancer,and gallbladder cancer showed a“positive contribution”to the increase of life expectancy,adding 1.43 years.Colorectal cancer and pancreatic cancer had a“negative contribution”to life expectancy,with a cumulative loss of 0.07 years.Conclusions From 2008 to 2021,the mortality rate of digestive system cancer in Gaochun District showed a downward trend,which played a positive role in the increase of life expectancy of Nanjing residents.Attention should be paid to the impact of mortality rate of stomach cancer,colorectal cancer,and pancreatic cancer on life expectancy.