Bao H L, Liu Y N, Wang L J, Fang L W, Cong S, Zhou M G, Wang L H
Division of Cancer Control and Prevention, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing 100050, China.
Division of Vital Statistics and Death Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Jan 10;38(1):58-64. doi: 10.3760/cma.j.issn.0254-6450.2017.01.011.
To analyze the mortality of cervical cancer and its temporal trend in women in China between 2006 and 2012. The cause-of-death data about cervical cancer, which was abstracted from National Disease Surveillance Points and adjusted by special survey for underreporting, was used to analyze the age and area specific crude mortality rates of cervical cancer in China during 2006-2012. The age-standardized mortality rate was calculated by using world standardized population (Segi's). The Joinpoint regression model was used to obtain annual percentage change and 95 for assessing the time trend of mortality rate of cervical cancer from 2006 to 2012. In 2012, the crude mortality rate of cervical cancer was 3.15 per 100 000 in women in China. The mortality rate in rural area (3.45/100 000) was higher than that in urban area (2.76/100 000), while the central area had the highest mortality rate of cervical cancer (3.77/100 000) compared with western area (3.23/100 000) and eastern area (2.54/100 000). The Segi's age-standardized mortality rate in eastern area increased by 2.9 (95: 0.8-5.0) annually, an increase of 6.0 was observed in age group 30-59 years (95: 1.6-10.5). However, the Segi's age-standardized mortality rate in central area declined by 4.6 (95: -5.9 - -3.3), where the declines of 3.2 and 5.7 were observed in age groups 30-59 years and ≥60 years (95: - 5.0-- 1.4 and 95: - 9.3 --2.0) and respectively. There was no significant change in cervical cancer mortality in western area. The similar trends were observed in the age-standardized mortality rate calculated according to the population of China. The decline of overall mortality rate of cervical cancer tended to stop in China and significant differences still exist among different areas. Our results suggest that the central/western areas and rural areas are still key areas for cervical cancer prevention and control and close attention should be paid to the increase of cervical cancer mortality in women aged 35-59 years in eastern area. It is essential to establish a systematic cervical cancer prevention network with larger population coverage to reduce the deaths caused by cervical cancer.
分析2006年至2012年中国女性宫颈癌死亡率及其时间趋势。从国家疾病监测点提取并经漏报专项调查调整的宫颈癌死因数据，用于分析2006 - 2012年中国宫颈癌的年龄别和地区别粗死亡率。采用世界标准人口（Segi氏人口）计算年龄标准化死亡率。使用Joinpoint回归模型获得年度百分比变化及95%可信区间，以评估2006年至2012年宫颈癌死亡率的时间趋势。2012年，中国女性宫颈癌粗死亡率为十万分之3.15。农村地区死亡率（十万分之3.45）高于城市地区（十万分之2.76），中部地区宫颈癌死亡率最高（十万分之3.77），高于西部地区（十万分之3.23）和东部地区（十万分之2.54）。东部地区Segi氏年龄标准化死亡率每年上升2.9（95%可信区间：0.8 - 5.0），30 - 59岁年龄组上升6.0（95%可信区间：1.6 - 10.5）。然而，中部地区Segi氏年龄标准化死亡率下降4.6（95%可信区间： - 5.9 - - 3.3），30 - 59岁和≥60岁年龄组分别下降3.2和5.7（95%可信区间： - 5.0 - - 1.4和95%可信区间： - 9.3 - - 2.0）。西部地区宫颈癌死亡率无显著变化。根据中国人口计算的年龄标准化死亡率也观察到类似趋势。中国宫颈癌总体死亡率下降趋势趋于停滞，不同地区仍存在显著差异。我们的结果表明，中西部地区和农村地区仍是宫颈癌防控的重点区域，应密切关注东部地区35 - 59岁女性宫颈癌死亡率的上升。建立覆盖人群更广的系统性宫颈癌预防网络以减少宫颈癌所致死亡至关重要。
