摘要
背景与目的:随着我国人民生活水平的提高及饮食习惯的改变,结直肠癌死亡率有升高趋势,该研究旨在分析中国近30年结直肠癌死亡的时间变化趋势。方法:分层汇总中国大陆居民1987—2015年结肠、直肠和肛门癌死亡率数据,利用Joinpoint模型估算各人群及各年龄组死亡率的时间变化趋势,利用负二项回归模型分析其死亡在人群水平上的危险因素。结果:男性结肠、直肠和肛门癌死亡率呈上升趋势[城市死亡率平均年度变化百分比(average annual percent change,AAPC)=0.50%,农村AAPC=0.57%],女性死亡率小幅度下降[城市AAPC=-0.59%,农村AAPC=-0.45%];65岁以下男性和75岁以下女性居民死亡率基本呈下降趋势,65岁以上男性和75岁以上女性居民基本呈上升趋势。结直肠癌的死亡风险,城市居民是农村居民的1.46倍(95%CI:1.40~1.52),男性是女性的1.38倍(95%CI:1.32~1.42),每增加5岁,死亡风险平均增大51%(OR=1.50,95%CI:1.49~1.51),每过1年,死亡风险平均增加0.08%,但差异无统计学意义(OR=1.00,P=0.47)。结论:中国结直肠癌死亡率的变化趋势有地区、性别及年龄差异,男性居民呈上升趋势,女性居民呈小幅度下降趋势;高年龄组居民结直肠癌死亡率呈上升趋势。
Background and purpose： With the changes in people＇s lifestyles and dietary habits, there were upward trends in colorectal cancer mortality. We analyzed epidemiological features, distribution and time trend of colon, rectal and anal cancers in China for the last 30 years. Methods： Mortality data from 1987 to 2015 were aggregated for estimating annual changes in mortality rates. Negative binomial regression model was used to explore population-level risk factors of the cancer death. Results： Decreasing mortality rates among females in urban areas [average annual percent change（AAPC） =-0.59%] and in rural areas（AAPC=-0.45%） were observed, while increasing mortality rate was observed among males（0.50% in urban areas, 0.57% in rural areas）. The age-specific mortality rates roughly decreased among males under age 65 and females under age 75, but increased among males over age 65 and females over age 75. The cancer death risks were higher in urban populations than in rural populations（OR=1.46, 95%CI： 1.40-1.52） as well as in males than in females（OR=1.38, 95%CI： 1.32-1.42）. Mortality increased by 51% with a 5-year increment（OR=1.50, 95%CI： 1.49-1.51）, yet increased by 0.08% with a one-year increment but the difference was not statistically significant（OR=1.00, P=0.47）. Conclusion： The trends in colorectal cancer mortality differred by region, gender and age. Colon, rectal and anal cancers mortality decreased among females and young adults, while increased in males and the elderly.
作者
刘晓雪
宇传华
周薇
王永博
LIU Xiaoxue;YU Chuanhua;ZHOU Wei;WANG Yongbo(Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2018年第3期177-183,共7页
China Oncology
基金
国家自然科学基金(81773552
81273179)
关键词
结直肠癌
死亡率
趋势
危险因素
Colorectal cancer
Mortality
Trends
Risk factors
