2019年甘肃省肿瘤登记地区肝癌流行特征及2010—2019年变化趋势分析

Epidemiological characteristics of liver cancer in tumour register area of Gansu Province in 2019 and the change trends from 2010 to 2019

目的分析2019年甘肃省肝癌的流行情况及2010—2019年甘肃省肝癌发病、死亡变化趋势,为制定肝癌防治策略提供依据。方法收集整理甘肃省肿瘤登记处2010—2019年肿瘤登记资料,计算肝癌粗发病率、粗死亡率、中国人口标化率(中标率)、世界人口标化率(世标率)和累积发病(死亡)率(0~74岁),并分析其流行特征。利用Joinpoint 5.0统计软件计算2010—2019年甘肃省肝癌发病率、死亡率的年度变化百分比(APC)和平均年度变化百分比(AAPC)。结果2019年甘肃省肿瘤登记地区肝癌新发病例共计2294例,占全部恶性肿瘤发病的9.13%,位居癌症发病谱第5位,发病率、世标发病率、中标发病率、累积发病率(0~74岁)分别为24.74/10万、17.55/10万、16.09/10万、1.90%。男性肝癌的中标发病率(21.90/10万)高于女性(10.27/10万),农村地区(17.34/10万)高于城市地区(15.44/10万)。2019年甘肃省肿瘤登记地区肝癌死亡病例共计1819例,占全部恶性肿瘤死亡的14.50%,位居恶性肿瘤死亡谱第3位。粗死亡率、世标死亡率、中标死亡率、累积死亡率(0~74岁)分别为19.62/10万、13.95/10万、12.64/10万、1.46%,男性肝癌死亡中标率(17.11/10万)高于女性(8.19/10万),农村地区(13.28/10万)高于城市地区(12.30/10万)。2010—2015年甘肃省肿瘤登记地区肝癌发病率呈上升趋势(APC=8.06%,P<0.05),2015—2019年发病率呈明显的下降趋势(APC=-9.27%,P<0.05),2010—2019年总体发病率变化趋势差异无统计学意义(AAPC=-0.06%,P>0.05)。2010—2019年甘肃省肿瘤登记地区肝癌死亡率变化趋势无统计学意义(AAPC=3.07%,P>0.05)。结论肝癌仍然是甘肃省疾病负担较重的癌症之一,防控不容忽视,应针对地域特点及流行特征,因地制宜制定精准的防控措施来遏制肝癌的发生。

Objective To analyze the prevalence of liver cancer in Gansu Province in 2019 and the change trend of the incidence and death in Gansu Province from 2010 to 2019,and provide the basis for formulating the prevention and treatment strategies for liver cancer.Methods The tumor registration data in Gansu Province from 2010 to 2019 were collected and sorted.The crude incidence of liver cancer,the crude mortality rate,the age-standardized rate of Chinese population(ASRC),the age-standardized rate of world population(ASRW)and cumulative incidence and death rate(0-74 years old)were calculated,and the prevalence characteristics were analyzed.Joinpoint regression model software was used to analyze the annual percentage change(APC)and average annual percentage change(AAPC)of liver cancer in Gansu Province from 2010-2019.Results In 2019,there were 2294 new cases of liver cancer in the cancer registration areas of Gansu Province.It accounted for 9.13%of the total incidence of malignant tumors.Liver cancer ranked the fifth in the cancer spectrum.The crude incidence was 24.74/105,the age-standardized incidence rate by Chinese population in 2000(ASIRC)was 17.55/105,age-standardized incidence rate by world standard(Segi's)population(ASIRW)was 16.09/105,respectively.The cumulative incidence rate(0-74 years old)was 1.90%.The ASIRC(21.90/105)in males was higher than that(10.27/105)in females;the ASIRC(17.34/105)in rural area was higher than that(15.44/105)in urban area.There were 1819 death cases of liver cancer in the cancer registration areas of Gansu Province in 2019.It accounted for 14.50%of the total death cases of malignant tumors.Liver cancer ranked the third in the cancer death spectrum.The crude mortaly,the age-standardized mortality rate by world standard(segi's)population(ASMRW),the age-standardized mortality rate by Chinese population in 2000(ASMRC)and the cumulative mortality rate(0-74 years old)were 19.62/105,13.95/105,12.64/105 and 1.46%,respectively.The ASMRC(17.11/105)in males was higher than that(8.19/105)in females;the ASMRC(13.28/105)in rural area was higher than that(12.30/105)in urban area.The incidence of liver cancer in tumor registration areas of Gansu Province showed upward trend from 2010 to 2015(APC=8.06%,P<0.05),but the incidence of liver cancer in tumor registration areas of Gansu Province showed downward trend from 2015 to 2019(APC=-9.27%,P<0.05),there was no significant diference in total incidence change trend of liver cancer from 2010 to 2019(AAPC=-0.06%,P>0.05).There was no significant diference in total mortality change trend of tumor registration areas in Gansu Province(AAPC=3.07,P>0.05).Conclusion Liver cancer is still one of the cancers with a heavy disease burden in Gansu Province,the prevention and control of live cancer still can't be ignored.It should formulate the precise prevention and control measures to curb the occurrence of liver cancer based on the regional characteristics and epidemic characteristics.