2018年甘肃省武威市白血病流行特征及2010-2018年变化趋势

Epidemiological characteristics of leukemia in Wuwei City,Gansu Province in 2018 and trends from 2010 to 2018

目的分析2018年甘肃省武威市白血病发病与死亡特征及2010-2018年白血病发病与死亡变化趋势。方法选取2010-2018年武威市肿瘤登记项目点上报的符合数据质量标准要求的白血病发病、死亡和人口数据进行汇总分析。按性别和年龄组分层计算粗发病/死亡率、标化发病/死亡率、累计发病/死亡率,采用Joinpoint 5.0线性回归模型分析2010-2018年武威市白血病中标发病/死亡率的年度变化百分比(APC),分析白血病发病和死亡趋势。中国人口标化率(简称中标率)及世界人口标化率(简称世标率)分别采用2000年全国普查标准人口年龄构成和Segi世界标准人口年龄构成计算。结果2018年武威市白血病发病率为4.70/10万,中标发病率为3.81/10万,死亡率为1.74/10万,中标死亡率为1.52/10万;男性白血病中标发病率和中标死亡率均高于女性(4.85/10万vs 2.73/10万;1.75/10万vs 1.30/10万);白血病发病人群主要集中在50~84岁年龄段,75~79岁年龄段出现达到高峰,死亡人群主要集中在15~19、40~59和65~79岁年龄段。在不同分型白血病中,髓样白血病中标发病率高于淋巴样白血病(2.69/10万vs 0.58/10万),中标死亡率低于淋巴样白血病(0.21/10万vs 0.37/10万)。2010-2015年武威市白血病中标发病率呈上升趋势(APC为19.91%,95%CI:1.61%~41.47%),差异有统计学意义(t=3.05,P=0.038),2015-2018年APC为-8.45%,差异无统计学意义,t=-0.72,P=0.513;2010-2018年武威市白血病中标死亡率呈上升趋势(APC为9.04%,95%CI:2.01%~16.58%),差异有统计学意义,t=3.06,P=0.018。结论2018年武威市白血病发病和死亡处于相对较低水平,但2010-2018年武威市白血病发病和死亡水平呈上升趋势,防控形势依旧严峻。相关部门应重视白血病的防治工作,对重点人群加强白血病一级预防健康宣教工作,有针对性的采取干预措施,增强居民健康意识。

Objective To analyze the characteristics of leukemia incidence and death in Wuwei City,Gansu Province in 2018 and trends of leukemia incidence and death from 2010 to 2018.Methods The incidence,death and population data of leu-kemia reported by tumor registration project sites in Wuwei City from 2010 to 2018,which met the data quality standards were collected and analyzed.The crude incidence/mortality rates,standardized incidence/mortality rates,cumulative inci-dence/mortality rates were calculated by gender and age group.The annual percentage change(APC)of the age-standard-ized incidence/mortality rates of leukemia in Wuwei City from 2010 to 2018 was analyzed by Joinpoint 5.0 linear regres-sion model,and the incidence and mortality trends of leukemia were analyzed.The Chinese population standardized rate(CPSR)and the world standardized rate(WPSR)were calculated using the age distribution of the 2000 national census and Segi world standard population age composition respectively.Results In 2018,the incidence rate of leukemia in Wu-wei City was 4.70/100000,the standardized incidence rate was 3.81/100000,the mortality rate was 1.74/100000,and the standardized mortality rate was 1.52/100000.The standardized incidence and mortality rates of leukemia in males were both higher than those in females(4.85/100000 vs 2.73/100000;1.75/100000 vs 1.30/100000);The incidence of leukemia mainly concentrated in the age group of 50 to 84 years old,peaking in the age group of 75 to 79 years old,and the death population mainly concentrated in the age group of 15 to 19 years old,40 to 59 years old and 65 to 79 years old.Among different types of leukemias,myeloid leukemia had a higher standardized incidence rate than lymphoid leukemia(2.69/100000 vs 0.58/100000)and a lower mortality than lymphoid leukemia(0.21/100000 vs 0.37/100000).From 2010 to 2015,the standardized incidence of leukemia in Wuwei City showed an increasing trend(APC of 19.91%,95%CI:1.61%-41.47%),which was statistically significant(t=3.05,P=0.038),while from 2015 to 2018,the APC was-8.45%,with no statistical significance(t=-0.72,P=0.513).From 2010 to 2018,the standardized mortality rate of leukemia in Wuwei City showed an increasing trend(APC of 9.04%,95%CI:2.01%-16.58%),and the differ-ence was statistically significant(t=3.06,P=0.018).Conclusions In 2018,the incidence and mortality of leukemia in Wuwei City were at relatively low levels,but from 2010 to 2018,the incidence and death of leukemia in Wuwei City showed an increasing trend,and the prevention and control situation was still severe.Relevant departments should pay at-tention to the prevention and treatment of leukemia,strengthen the primary prevention of leukemia health education for key groups,take targeted intervention measures,and enhance the health awareness of residents.