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[中国癌症发病率的趋势分析与预测]

[Trend analysis and prediction of cancer incidence in China].

作者信息

Chen Wan-qing, Zheng Rong-shou, Zeng Hong-mei, Zhang Si-wei, Li Ni, Zou Xiao-nong, He Jie

机构信息

National Office for Cancer Prevention and Control & National Central Cancer Registry, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Beijing 100021, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2012 Jul;46(7):581-6.

Abstract

OBJECTIVE

Based on the national cancer incidence database from 1998 to 2007, to analyze the cancer incidence trend and predict the cancer burden between 2008 and 2015.

METHODS

We picked up the cancer incidence data of 40 cancer registry sites from National Central Cancer Registry Database between 1998 and 2007. In total, 1 109 594 cancer cases were registered, covering 446 734 668 person-year. The separate incidence by district and gender were calculated, and the standardized incidence rate was calculated by world's population age structure. The incidence trend between the 10 years was analyzed by JoinPoint software, as well as the age-percentage-changes (APC). Age-Period-Cohort Bayesian Model was applied to fit the cancer incidence data stratified by age, district and gender. The cancer incidence between 2008 and 2015 was then predicted.

RESULTS

During the period of 1998 - 2007, in urban areas, the male cancer incidence rate was 277.61/100 000 (472 307/170 131 309), with the age standardized rate (ASR) at 202.05/100 000; while the female cancer incidence rate was 236.35/100 000 (389 586/164 830 893), with the ASR at 159.15/100 000; in rural areas, the male and female cancer incidence rates were separately 272.23/100 000 (153 478/56 377 236) and 170.09/100 000 (94 223/55 395 230), with the corresponding ASR at 244.34/100 000 and 137.90/100 000. Crude incidence rate in urban men increased from 247.00/100 000 (27 758/11 237 967) in 1998 to 305.76/100 000 (68 953/22 551 353) in 2007; while it increased from 207.37/100 000 (22 476/10 838 355) to 263.20/100 000 (58 055/22 057 787) among urban women. The crude incidence rate in rural men increased from 232.33/100 000 (10 045/4 323 628) to 303.65/100 000 (23 313/7 677 484) and it increased from 139.03/100 000 (5836/4 197 806) to 197.40/100 000 (14 850/7 522 690) among rural women. After age adjustment, the urban male APC value (95%CI) was 0.5% (-0.2% - 1.3%), showed no significantly statistical difference. However, the urban female APC value (95%CI), rural male APC value (95%CI) and rural female APC value (95%CI) were separately 1.7% (1.3% - 2.0%), 1.8% (0.9% - 2.6%) and 2.8% (1.8% - 3.7%), all showed an obvious uptrend. The outcome of Age-Period-Cohort Bayesian model predicted that by year 2015, the incidence cancer rate in urban areas will reach 309.13/100 000 (1.140 million new cases) among males and 303.79/100 000 (1.046 million new cases) among females; while in rural areas the rate will reach 288.66/100 000 (1.019 million new cases) among males and 222.59/100 000 (0.734 million new cases) among females.

CONCLUSION

The cancer incidence has increased annually; the uptrend in rural areas was more obvious than it in urban areas; the uptrend in females was more obvious than it in males. It is predicted that the annual incidence will continue to increase in the next years, and effective control programs should be carried out immediately.

摘要

目的

基于1998年至2007年国家癌症发病率数据库,分析癌症发病率趋势并预测2008年至2015年的癌症负担。

方法

我们从国家中央癌症登记数据库中提取了1998年至2007年40个癌症登记点的癌症发病率数据。共登记了1109594例癌症病例,覆盖446734668人年。计算了按地区和性别的发病率,并根据世界人口年龄结构计算了标准化发病率。使用JoinPoint软件分析了10年间的发病率趋势以及年龄百分比变化(APC)。应用年龄-时期-队列贝叶斯模型对按年龄、地区和性别分层的癌症发病率数据进行拟合。然后预测了2008年至2015年的癌症发病率。

结果

1998 - 2007年期间,城市地区男性癌症发病率为277.61/10万(472307/170131309),年龄标准化率(ASR)为202.05/10万;女性癌症发病率为236.35/10万(389586/164830893),ASR为159.15/10万;农村地区男性和女性癌症发病率分别为272.23/10万(153478/56377236)和170.09/10万(94223/55395230),相应的ASR分别为244.34/10万和137.90/10万。城市男性粗发病率从1998年的247.00/10万(27758/11237967)增至2007年的305.76/10万(68953/22551353);城市女性则从207.37/10万(22476/10838355)增至263.20/10万(58055/22057787)。农村男性粗发病率从232.33/10万(10045/4323628)增至303.65/10万(23313/7677484),农村女性从139.03/10万(5836/4197806)增至197.40/10万(14850/7522690)。年龄调整后,城市男性APC值(95%CI)为0.5%(-0.2% - 1.3%),无显著统计学差异。然而,城市女性APC值(95%CI)、农村男性APC值(95%CI)和农村女性APC值(95%CI)分别为1.7%(1.3% - 2.0%)、1.8%(0.9% - 2.6%)和2.8%(1.8% - 3.7%),均呈明显上升趋势。年龄-时期-队列贝叶斯模型预测结果显示,到2015年,城市地区男性癌症发病率将达到309.13/10万(114.0万新发病例),女性将达到303.79/10万(104.6万新发病例);农村地区男性发病率将达到288.66/10万(101.9万新发病例),女性将达到222.59/10万(73.4万新发病例)。

结论

癌症发病率逐年上升;农村地区上升趋势比城市地区更明显;女性上升趋势比男性更明显。预计未来几年发病率将持续上升,应立即实施有效的防控措施。

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