2017年我国四省农村不同经济水平地区结直肠癌流行特征及2008—2017年变化趋势分析

Epidemiological Characteristics of Colorectal Cancer in Rural Areas with Different Economic Levels in 4 Provinces of China in 2017 and Its Trend from 2008 to 2017

[目的]分析我国4个省农村重点地区2017年结直肠癌发病、死亡情况及2008—2017年流行趋势。[方法]利用我国4个省份的农村12个县(区)结直肠癌发病及死亡数据、户籍人口数据,结合中国县域统计年鉴社会经济水平数据,计算2017年4个省农村地区不同经济水平结直肠癌发病率、死亡率及其中国人口标化率(简称中标率),并与全国及全国农村平均水平进行比较。中标率采用2000年全国普查标准人口年龄构成计算。采用Joinpoint4.9.0.0软件计算平均年度变化百分比(average annual percentage change,AAPC),分析2008—2017年结直肠癌发病、死亡率的时间变化趋势。[结果]2017年4个省农村重点地区结直肠癌中标发病率为14.38/10万、中标死亡率为5.51/10万,均略低于全国平均水平和全国农村平均水平。其中男性中标发病率和死亡率(16.92/10万、6.72/10万)均高于女性(11.95/10万、4.38/10万),高GDP地区中标发病率和死亡率(15.85/10万、6.61/10万)均高于低GDP地区(14.07/10万、5.23/10万)。发病率、死亡率均随着年龄的增长而上升。2008—2017年结直肠癌中标发病率(AAPC=5.34%)与中标死亡率(AAPC=1.44%)均呈现显著上升趋势(P均<0.05)。[结论]4个省农村重点地区结直肠癌中标发病率、死亡率处于持续上升趋势,应进一步加强农村地区结直肠癌的预防和综合干预工作,降低发病和死亡。

[Purpose]To analyze the incidence and mortality of colorectal cancer in key rural areas of 4 provinces in China in 2017 and the trends from 2008 to 2017.[Methods]The incidence and mortality data of colorectal cancer and household registration population data of 12 counties in rural areas of 4 provinces(Jiangsu,Shandong,Henan and Anhui)were collected from cancer registries,and the socio-economic data were obtained from China County Statistical Yearbook.The crude incidence,mortality and age-standardized rates by Chinese standard population in 2000(ASIRC,ASMRC)of colorectal cancer in 2017 were calculated,and compared with the national and national rural average levels.Joinpoint 4.9.0.0 software was used to calculate the average annual percentage change(AAPC)for time trends of ASIRC and ASMRC of colorectal cancer.[Results]In 2017,the ASIRC(14.38/105)and ASMRC(5.51/105)of colorectal cancer in rural areas of study sites were slightly lower than the national average and the national rural average levels.The ASIRC and ASMRC of men(16.92/105,6.72/105)were higher than those of women(11.95/105,4.38/105).The ASIRC and ASMRC in high GDP areas(15.85/105,6.61/105)were higher than those in low GDP areas(14.07/105,5.23/105).The incidence and mortality increased with age.From 2008 to 2017,the ASIRC(AAPC=5.34%)and ASMRC(AAPC=1.44%)of colorectal cancer were on the rise(both P<0.05).[Conclusion]The ASIRC and ASMRC in rural areas of study sites are on the rise from 2008 to 2017.Research on colorectal cancer prevention and comprehensive intervention in rural areas should be further strengthened to reduce incidence and mortality.