[江苏省海门市1993年至2006年肝细胞癌死亡率时间趋势分析]

[Analysis of time trend of hepatocellular carcinoma mortality in Haimen city of Jiangsu province from 1993 to 2006].

作者信息

Wang Jiao-feng, Lin Wen-yao, Jiang Feng, Meng Wei, Shen Fu-min

机构信息

Key Laboratory of Public Health Security, Ministry of Education, Department of Epidemiology, school of Public Health, Fudan University. Shanghai 200032, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2010 Jul;31(7):727-32.

PMID:21162831

Abstract

OBJECTIVE

To predict the trend of hepatocellular carcinoma (HCC) mortality and investigate the features of its mortality including age, period, and birth cohort in males living in Haimen city of Jiangsu province, China.

METHODS

Grey model (GM) was modeled using standardized mortality rate (SMR) of HCC from 1993 to 2006, and was applied to predicting SMR until 2012. Based on the mortality density (MD) for a four-year period, the goodness-of-fit of models and comparisons between models were evaluated so as to obtain the best one among these models including the effects of intercept, age-period-cohort (APC), age-period (AP), age-cohort (AC), period-cohort(PC), and APC. Both APC full model and the best model were used to estimate effects of age, period, and cohort on HCC mortality. In addition, MD form 2005 to 2012 was predicted by the best model.

RESULTS

Predictions based on GM (1,1) showed that SMR was 48.578 pre 100 000 population (relative error=-1.267%) in 2007 year, which declined between 2008 and 2012. The lowest value was 45.578 pre 100 000 people (in the 2012 year). The results of fitted models and comparisons between models showed that AP model was the best one (ΔG(2) = 9.065, AIC = 202.544). The curvatures of the effects of the three factors from APC model suggested that significances existed in changes of curvatures of 36.5 - 40.5 years old-(-0.368) and 64.5 - 68.5 years old-(-0.489) as well as in the change of 1956 - 1959 birth cohort (C(2)(1949.5, 1967.5) = -0.492). The estimation of relative risks for AP model showed that the age effects were upward to 64.5 - 68.5 years old-, then downward; and that the period effects were found to be declined between 1993 and 2004. Predictions based on AP model suggested the decrease of HCC mortality.

CONCLUSION

The slightly decreasing trend of HCC mortality for males might be explained by age, period and a minor birth cohort effects in Haimen of China.

摘要

目的

预测中国江苏省海门市男性肝细胞癌（HCC）死亡率趋势，并研究其死亡率在年龄、时期和出生队列方面的特征。

方法

利用1993年至2006年HCC的标准化死亡率（SMR）建立灰色模型（GM），并应用该模型预测至2012年的SMR。基于四年期的死亡率密度（MD），评估模型的拟合优度以及模型间的比较，以从包括截距、年龄-时期-队列（APC）、年龄-时期（AP）、年龄-队列（AC）、时期-队列（PC）和APC效应的这些模型中获得最佳模型。APC全模型和最佳模型均用于估计年龄、时期和队列对HCC死亡率的影响。此外，用最佳模型预测2005年至2012年的MD。

结果

基于GM（1,1）的预测显示，2007年SMR为每10万人48.578（相对误差=-1.267%），在2008年至2012年期间呈下降趋势。最低值为每10万人45.578（2012年）。拟合模型结果和模型间比较表明，AP模型是最佳模型（ΔG(2)=9.065，AIC=202.544）。APC模型中三个因素效应的曲率表明，36.5 - 至40.5岁（-0.368）和64.5 - 至68.5岁（-0.489）的曲率变化以及1956 - 1959年出生队列的变化（C(2)(1949.5, 1967.5)= -0.492）存在显著性。AP模型的相对风险估计表明，年龄效应在64.5 - 至68.5岁时上升，然后下降；时期效应在1993年至2004年期间呈下降趋势。基于AP模型的预测表明HCC死亡率下降。