Yang Ling, Huangpu Xiao-mei, Zhang Si-wei, Lu Feng-zhu, Sun Xiu-di, Sun Jie, Mu Ren, Li Lian-di, Qiao You-lin
Department of Epidemiology, Cancer Institute, CAMS and PUMC, Beijing 100021, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2003 Aug;25(4):386-90.
To describe the distribution changes of the mortality rate for cervical cancer in China between the 1970's and 1990's and provide the scientific evidence for the prevention and control strategies for cervical cancer campaign in China between next century.
Data from two National Surveys for the Causes of Death in 1970's and 1990's in China. The crude and adjusted mortality rates for the cervical cancer and the distributions based on age and area were calculated and described. The comparison of the differences of changes between two mortality rates periods and together with its trends were shown based on the age-standardized.
During two decades, the mortality rate for cervical cancer was 10.7 per 100,000 in 1970's which declined to 3.89 per 100,000 in 1990's, and from the 3rd ranking among all female malignant tumors to the 6th in 1990's (decreased about 63.64%). But the declination was not evenly. There have still been some high-risk areas, most located in rural countries in the mid-west of China, with rates remain unchanged and even at the highest level in the world, such as Wudu in Gansu and Yangcheng in Shanxi. A big difference was showed between rural country and city, but in both of them, the mortality rates in 1990's were significantly much lower than in 1970's (P = 0.001) at each five-year age group. And in the city, there was a much sharper increased trend in young women in 1990's.
The mortality rate for cervical cancer campaign in China has been substantially declined during past twenty years, but it's still a major health problem for women, especially in rural China. The focus of the prevention and control for the cervical cancer in the next century should put on rural areas, especially in mid-west of China and young women in the city.
描述20世纪70年代至90年代中国宫颈癌死亡率的分布变化情况,为下个世纪中国宫颈癌防治策略提供科学依据。
采用中国20世纪70年代和90年代两次全国死因调查的数据。计算并描述宫颈癌的粗死亡率和调整死亡率以及基于年龄和地区的分布情况。基于年龄标准化展示两个死亡率时期变化差异及其趋势的比较。
在二十年期间,20世纪70年代宫颈癌死亡率为十万分之10.7,到90年代降至十万分之3.89,从所有女性恶性肿瘤中的第3位降至90年代的第6位(下降约63.64%)。但下降并不均匀。仍存在一些高危地区,大多位于中国中西部农村,死亡率保持不变甚至处于世界最高水平,如甘肃武都和山西阳城。农村和城市之间存在很大差异,但在两个地区,90年代各五岁年龄组的死亡率均显著低于70年代(P = 0.001)。在城市,90年代年轻女性中有更明显的上升趋势。
在过去二十年中,中国宫颈癌防治工作中死亡率大幅下降,但它仍是女性尤其是中国农村女性的一个主要健康问题。下个世纪宫颈癌防治的重点应放在农村地区,特别是中国中西部地区以及城市中的年轻女性。