2009—2018年广西肿瘤登记地区结直肠癌流行特征及疾病负担趋势分析

Τrends of Incidence,Mortality and Disease Burden of Colorectal Cancer in Guangxi Cancer Registration Areas from 2009 to 2018

[目的]分析2009—2018年广西肿瘤登记地区结直肠癌的流行特征和疾病负担及其时间变化趋势,为制定广西结直肠癌的防控策略提供依据。[方法]基于2009—2018年广西各肿瘤登记处结直肠癌的发病和死亡数据,计算粗发病率、粗死亡率及其标化率、伤残调整寿命年(disability-adjusted life years,DALYs)、过早死亡损失寿命年(years of life lost,YLLs)、伤残损失寿命年(years of lived with disability,YLDs)等指标,分析广西结直肠癌的流行特征及疾病负担;应用Joinpoint回归模型计算2009—2018年广西结直肠癌DALYs率、粗发病率、粗死亡率及其标化率的平均年度变化百分比(average annual percentage change,AAPC),分析结直肠癌流行特征和疾病负担的时间变化趋势。[结果]2009—2018年广西结直肠癌的粗发病率、粗死亡率和DALYs率整体均呈上升趋势,粗发病率由2009年的21.99/10万上升至2018年的23.27/10万(AAPC=2.73%,P=0.019);粗死亡率由2009年的10.05/10万上升至2018年的11.70/10万(AAPC=2.84%,P=0.010);DALYs率则以年均2.50%(P=0.025)的幅度增长。不同性别中,男性结直肠癌粗发病率和粗死亡率的年均增长幅度分别为3.63%和4.17%,女性粗发病率和粗死亡率的年均增长幅度分别为1.67%和1.17%,男性增长幅度大于女性。不同年龄组人群中,45~64岁人群上升幅度最大,发病率和死亡率分别以年均4.28%和3.28%的幅度增长。[结论]2009—2018年广西结直肠癌的发病率、死亡率及DALYs率均呈上升趋势,尤其在男性、中老年人群中显著上升。应加强结直肠癌预防和健康教育工作,对结肠癌危险因素进行有效干预,同时加强男性以及高龄人群等高危群体的筛查工作。

[Purpose]To analyze the trends of incidence,mortality and disease burden of colorectal cancer(CRC)in the cancer registration areas of Guangxi from 2009 to 2018.[Methods]The incidence and mortality data of CRC from 2009 to 2018 in cancer registration areas of Guangxi were collected.The crude incidence/mortality rates,age-standardized incidence/mortality rates(ASIR/ASMR),disability-adjusted life years(DALYs),years of life lost(YLLs),years of lived with disability(YLDs)and other indexes were calculated.The Joinpoint regression model was applied to calculate the average annual percentage change(AAPC)of DALYs rate,crude incidence rate,crude mortality rate,ASIR and ASMR of CRC from 2009 to 2018.[Results]From 2009 to 2018,the crude incidence,crude mortality and DALYs rate of CRC in Guangxi showed an overall upward trend.The crude incidence rate increased from 21.99/105 in 2009 to 23.27/105 in 2018,with an AAPC of 2.73%(P=0.019);crude mortality rate increased from 10.05/105 in 2009 to 11.70/105 in 2018,with an AAPC of 2.84%(P=0.010);DALYs rate increased by an AAPC of 2.50%(P=0.025).AAPC of crude incidence and crude mortality of CRC in men was 3.63%and 4.17%,while AAPC in women was 1.67%and 1.17%,respectively.People in age group of 45~64 years old had the highest increase,with an AAPC of 4.28%and 3.28%in incidence and mortality rates,respectively.[Conclusion]From 2009 to 2018,the incidence,mortality and DALYs rates of CRC in Guangxi showed an increasing trend,especially in men,middle-aged and elderly people.The prevention and health education of CRC should be strengthened,the risk factors of CRC should be effectively intervened,and the screening of high-risk groups such as men and elderly people should be strengthened.