山东省2012-2022年胃癌发病死亡趋势分析及2023-2030年预测

Trends of stomach cancer incidence and mortality in Shandong province from 2012 to 2012 and predictions from 2023 to 2030

目的分析2012—2022年山东省胃癌发病率和死亡率变化趋势并预测2023—2030年发展趋势。方法2012—2022年山东省胃癌发病和死亡资料来源于山东省肿瘤登记处,计算不同年度、性别、城乡的胃癌发病率、年龄别发病率、死亡率和年龄别死亡率,采用2000年中国标准人口年龄构成进行标化。使用Joinpoint软件计算发病率和死亡率的平均年度变化百分比(AAPC),贝叶斯年龄-时期-队列模型预测2023—2030年胃癌发病和死亡趋势。结果2012—2022年,山东省胃癌标化发病率和标化死亡率均呈下降趋势,标化发病率从2012年的27.47/10万降至2022年的16.06/10万(AAPC=-5.10%,P<0.001),标化死亡率从17.69/10万降至11.09/10万(AAPC=-5.52%,P<0.001)。不同性别和城乡地区人群的标化发病率和标化死亡率均呈下降趋势,男性发病和死亡水平始终高于女性,城乡差异逐渐缩小,2022年城乡胃癌标化发病率(城市16.09/10万,农村16.03/10万)和标化死亡率(城市11.10/10万,农村11.08/10万)水平已接近一致。年龄-时期-队列模型预测结果显示,2023—2030年山东省胃癌标化发病率将进一步下降(AAPC=-0.51%,P=0.001),但变化趋于平缓,其中,男性(AAPC=-1.46%,P=0.010)和农村地区(AAPC=-1.21%,P<0.001)发病率预计仍有少量下降空间,女性和城市地区发病率趋势无统计学意义。死亡率趋势与发病率一致。结论山东省胃癌发病率和死亡率呈下降趋势,预计到2030年将进一步下降,但趋势趋于平缓,应面向胃癌高危人群和高危因素尽早降低疾病负担。

Objective We aimed to analyse the trend of incidence and mortality of stomach cancer in Shandong province from 2012 to 2022 and predict the development trend from 2023 to 2030.Methods Data on incidence and mortality of stomach cancer in Shandong province from 2012 to 2022 were obtained from Shandong Cancer Registry.The incidence,age-specific incidence,mortality and age-specific mortality in different years,sexes and urban and rural areas were calculated,the rates were standardized based on the age composition of the Chinese standard population in 2000.The average annual percent change(AAPC)of incidence and mortality was calculated using Joinpoint software.The Bayesian age-period-cohort model was used to predict the trend of stomach cancer incidence and mortality from 2023 to 2030.Results From 2012 to 2022,the stomach cancer age-standardized incidence rate(ASIR)and age-standardized mortality rate(ASMR)showed a decreasing trend.The ASIR decreased from 27.47/100000 in 2012 to 16.06/100000 in 2022(AAPC=-5.10%,P<0.001),and the ASMR decreased from 17.69/100000 to 11.09/100000(AAPC=-5.52%,P<0.001).The ASIR and ASMR of male,female,urban and rural population also showed downward trends.The incidence and mortality rates of men were always higher than those of women,and the difference between urban and rural areas is gradually narrowing.In 2022,the ASIR(16.09/100000 in urban and 16.03/100000 in rural)and the ASMR(11.10/100000 in urban and 11.08/100000 in rural)of stomach cancer between urban and rural areas were nearly identical.The Bayesian age-period-cohort model predicted that the ASIR of stomach cancer in Shandong would further decrease from 2023 to 2030(AAPC=-0.51%,P=0.001),but the change tended to be smooth.The incidences in male(AAPC=-1.46%,P=0.010)and rural areas(AAPC=-1.21%,P<0.001)were still expected to have a little room for decline.The trend of incidences in female and urban areas were not statistically significant.The trend of mortality was consistent with the incidence.Conclusions The stomach cancer incidence and mortality in Shandong shows a decreasing trend and it is expected to decrease further by 2030.However,the trend tends to be smooth,and the disease burden should be reduced as early as possible for high-risk population and high-risk factors of stomach cancer.