河南省居民1988—2012年女性乳腺癌死亡率趋势分析及预测

Time Trend and Prediction of Mortality of Female Breast Cancer Patients in He'nan Province, 1988-2012

目的探讨河南省居民1988—2012年女性乳腺癌死亡率变化趋势,对河南省未来(2013—2020年)的乳腺癌死亡率进行预测。方法从河南省癌症及生命统计中心数据库中抽取河南省1988—2012年死于乳腺癌的全部记录及相应时期的人口数据,计算各时期死亡率、中国标准人口调整死亡率及世界标准人口调整死亡率,用Joinpoint模型估计死亡率的时间变化趋势。运用贝叶斯年龄-时期-队列模型对河南省2013—2020年的乳腺癌死亡率进行预测。结果河南省女性乳腺癌标化死亡率从1988—1992年的2.68/10万上升至2008—2012年的5.04/10万。30岁以上年龄组死亡率随年龄增加而快速增加。Joinpoint模型趋势参数显示,城市地区乳腺癌死亡率2000年前呈上升趋势,近年来轻微下降,农村地区呈持续上升趋势。预测结果显示,2013—2020年,城市地区乳腺癌粗死亡率变化不大,而农村粗死亡率从7.84/10万上升到9.14/10万。结论河南省居民女性乳腺癌死亡率在1988—2012年呈上升趋势,未来(2013—2020年)农村地区乳腺癌疾病负担将明显增加。

Objective To investigate the trend of mortality of female breast cancer patients from 1988 to 2012, and to predict the mortality of breast cancer patients from 2013 to 2020 in He’nan Province. Methods The records of female breast cancer patients death and the population data from 1988 to 2012 in He’nan Province were drawn from He’nan Provincial Center for Tumor and Health Statistics Database.The period-specific mortality rates and the age-adjusted mortality rates directly standardized to Chinese population and the world populations were calculated. The time trend of mortality was estimated by Joinpoint model. The mortality of breast cancer patients from 2013 to 2020 in He’nan Province was predicted using Bayesian age-periodcohort model. Results The age-standardized mortality of female breast cancer patients in He’nan Province was rising from 2.68/100,000 during 1988-1992 to 5.04/100,000 during 2008-2012. The age-specific mortality over 30 was increased greatly with age. The trend parameters estimated by Joinpoint model demonstrated that the breast cancer mortality in urban area was increased before 2000 and dropped slightly in recent years, but the rate was increased constantly in rural area. Predictive model showed that the mortality rate in urban area would change little during 2013-2020, however, it would be increased from 7.84/100,000 to 9.14/100,000 in rural area. Conclusion There is an obvious upward trend of mortality of female breast cancer patents from 1988 to 2012. And the burden of breast cancer in rural area would be increased greatly from 2013 to 2020.