2012—2022年大连市居民胃癌死亡趋势分析

Analysis on death trend of gastric cancer among residents in Dalian City from 2012 to 2022

目的分析2012—2022年大连市居民胃癌死亡分布及趋势,为大连市胃癌综合防控提供政策参考和评价指标。方法收集2012—2022年大连市居民胃癌死因监测数据,采用标化死亡率、粗死亡率、占肿瘤死因构成比、年度变化百分比(annual percent change,APC)等指标对胃癌死亡趋势进行统计学分析。结果2012—2022年大连市居民标化死亡率(2010中标率,简称“中标率”)为14.58/10万(11.55/10万~17.47/10万),随年份增长呈下降趋势,差异有统计学意义(APC=-3.729,t=29.549,P<0.05);胃癌粗死亡率为25.51/10万(23.65/10万~27.22/10万),随年份增长下降,差异无统计学意义(APC=-0.795,t=2.192,P>0.05);胃癌占肿瘤死因的构成比为11.01%(9.60%~12.42%),随年份增长下降,差异有统计学意义(APC=-2.274,t=9.458,P<0.05);2012—2022年女性居民胃癌粗死亡率和中标率分别为14.96/10万(14.32/10万~15.90/10万)和8.28/10万(6.79/10万~9.72//10万);男性胃癌粗死亡率和中标率分别为36.21/10万(33.73/10万~38.53/10万)和21.38/10万(16.78/10万~25.68/10万);女性死亡率低于男性(粗死亡率χ^(2)=2902.526,中标率χ^(2)=347.128,均P<0.05)。女性和男性中标率随年份增长下降,差异有统计学意义(女性APC=-3.149,t=6.589,P<0.05;男性APC=-3.921,t=8.329,P<0.05)、女性与男性的粗死亡率随年度增长而下降,差异无统计学意义(均P>0.05);大连市居民胃癌死亡率随年龄增长逐渐升高,差异有统计学意义(χ^(2)=44952.256,P<0.05),其中≥85岁组死亡率最高,<20岁居民无胃癌死亡病例。≥60岁人口比例随年份增长而上升,差异有统计学意义(APC=8.872,t=150.938,P<0.05)。结论大连市居民胃癌死亡率整体呈下降趋势。女性死亡率低于男性,死亡率随年龄增长而逐渐升高,占肿瘤构成比呈下降趋势,标化死亡率呈下降趋势,大连市老龄人口比例升高掩盖了粗死亡率下降的程度;同时,老龄人口比例的增加,将会增加胃癌的死亡绝对数,提示应提高胃癌早筛、早诊和早治的水平及范围,加强综合干预,以期进一步降低大连市胃癌死亡率。

Objective To analyze the death distribution and trend of gastric cancer among residents in Dalian City from 2012 to 2022,provide policy reference and evaluation indicators for the comprehensive prevention and control of gastric cancer in Dalian City.Methods The monitoring data on causes of death from gastric cancer among residents in Dalian City from 2012 to 2022 were collected,and the statistical analysis was conducted on the mortality trend of gastric cancer using indicators such as standardized mortality rate,crude mortality rate,proportion of tumor causes of death,and annual percentage change(APC).Results The standardized mortality rate(standardized mortality rate of China in 2010,hereafter referred to asstandardized mortality rate)of residents in Dalian City from 2012 to 2022 was 14.58/100000(11.55/100000-17.47/100000),showing a downward trend with increasing years,and the difference was statistically significant(APC=-3.729,t=29.549,P<0.05).The crude mortality rate of gastric cancer was 25.51/100000(23.65/100000-27.219/100000),showing a downward trend with increasing years,and the difference was not statistically significant(APC=-0.795,t=2.192,P>0.05).The proportion of gastric cancer as a cause of tumor death was 11.01%(9.60%-12.42%),showing a downward trend with increasing years,and the difference was statistically significant(APC=-2.274,t=9.458,P<0.05).The crude mortality rate andstandardized mortality rate of gastric cancer in female residents from 2012 to 2022 was 14.96/100000(14.32/100000-15.90/100000)and 8.28/100000(6.79/100000-9.72/100000)respectively,while those in male residents was 36.21/100000(33.73/100000-38.53/100000)and 21.38/100000(16.78/100000-25.68/100000)respectively,and the mortality rates of females were lower than those of males(crude mortality rate χ^(2)=-2902.526,standardized mortality rate χ^(2)=347.128,both P<0.05).The standardized mortality rate of males and females decreased with the increase of year,and the differences were statistically significant(female APC=-3.149,t=6.589,P<0.05;male APC=-3.921,t=8.329,P<0.05),while the crude mortality rate of males and females decreased with the increase of year,but the differences were not statistically significant(both P>0.05).The mortality rate of residents in Dalian City increased with age,and the difference was statistically significant(χ^(2)=44952.256,P<0.05),the mortality rate in≥85 age group was the highest,and there was no death of gastric cancer in<20 age group.The proportion of people≥60 years old increased with the increase of years,and the difference was statistically significant(APC=8.872,t=150.938,P<0.05).Conclusions The overall mortality rate of gastric cancer among residents in Dalian City shows a decreasing trend.The mortality rate of females is lower than that of males.The mortality rategradually increases with age,and the proportion of tumor composition shows a decreasing trend.The standardized mortality rate shows a decreasing trend.The increase in the proportion of elderly population masks the extent of the decrease in crude mortality rate in the city.Meanwhile,the increase in the proportion of elderly population will increase the absolute number of deaths from gastric cancer,indicating the need to improve the level and scope of early screening,diagnosis and treatment of gastric cancer,and strengthen comprehensive intervention,so as to further reduce mortality of gastric cancer in Dalian City.