Zheng W L, Zhang H, Wang D Z, Zhang S, Pang S, Li C K, Jiang G H
Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Jan 10;40(1):64-69. doi: 10.3760/cma.j.issn.0254-6450.2019.01.013.
To analyze the mortality and years of life lost (YLL) trends of cervical cancer in Tianjin, and provide references for the research and prevention programs of cervical cancer. Mortality rate, standard mortality rate, cumulative rate (0-74 years-old) and truncated rate (35-64 years-old) of cervical cancer from 1999 to 2015 were calculated. The annual percentage change of the mortality rate and YLL rate were analyzed by using Joinpoint regression analysis, and the trend in different age-groups were analyzed. From 1999 to 2015, 1 741 cases died of cervical cancer in Tianjin, the average crude mortality rate was 2.15/100 000. The average age-standardized rate of (ASR) China and ASR world were 1.47/100 000 and 1.50/100 000 respectively. The average YLL was 3 347.97 person-years. Deaths occurred in those aged 0-34 years, 35-64 years and 65 years and over accounted for 3.10, 57.84 and 39.06 of the total, respectively. The mortality rate of cervical cancer in urban area was higher than that in rural area, with a ratio of 1.37∶1 between urban area and rural area. The age-specific mortality rate of cervical cancer during 1999-2015 increased with age. Two peaks of mortality rate were observed in those aged 50 years and aged 75 years, during 2014-2015. From 1999 to 2011, the mortality rate of cervical cancer was stable (APC=-0.2, =0.80), but there was a rapid increase from 2011 to 2015 (APC=21.6, <0.01). But group aged 20-49 years, it showed an upward trend from 1999 to 2015 (APC=6.9, <0.01). For group aged 50-69 years, it showed a downward trend from 1999 to 2007 (APC=-9.2, <0.01), and an upward trend from 2007 to 2015 (APC=14.5, <0.01). For group aged 70 years and over, it showed a downward trend from 1999 to 2009 (APC=-10.2, <0.01), but the difference in the mortality were not significant from 2009 to 2015 (APC=7.8, =0.10). Since 2008, the YLL rate of cervical cancer in group aged 50-70 years had exceeded that in group aged >70 years and the gap gradually widened. There had been a rapid increase trend of cervical cancer mortality since 2011 in Tianjin. Women aged 50-70 years were the main group of life loss.
分析天津市宫颈癌的死亡率和寿命损失年(YLL)趋势,为宫颈癌的研究和预防方案提供参考。计算了1999年至2015年宫颈癌的死亡率、标准死亡率、累积率(0至74岁)和截缩率(35至64岁)。采用Joinpoint回归分析方法分析死亡率和YLL率的年度变化百分比,并分析不同年龄组的趋势。1999年至2015年,天津市有1741例死于宫颈癌,平均粗死亡率为2.15/10万。中国的平均年龄标准化率(ASR)和世界ASR分别为1.47/10万和1.50/10万。平均YLL为3347.97人年。0至34岁、35至64岁和65岁及以上人群的死亡分别占总死亡人数的3.10%、57.84%和39.06%。城区宫颈癌死亡率高于农村地区,城区与农村地区之比为1.37∶1。1999年至2015年宫颈癌的年龄别死亡率随年龄增长而上升。在2014年至2015年期间,50岁和75岁人群出现了两个死亡率高峰。1999年至2011年,宫颈癌死亡率稳定(年度变化百分比[APC]=-0.2,P=0.80),但2011年至2015年迅速上升(APC=21.6,P<0.01)。但在20至49岁年龄组,1999年至2015年呈上升趋势(APC=6.9,P<0.01)。对于50至69岁年龄组,1999年至2007年呈下降趋势(APC=-9.2,P<0.01),2007年至2015年呈上升趋势(APC=14.5,P<0.01)。对于70岁及以上年龄组,1999年至2009年呈下降趋势(APC=-10.2,P<0.01),但2009年至2015年死亡率差异无统计学意义(APC=7.8,P=0.10)。自2008年以来,50至70岁年龄组宫颈癌的YLL率超过70岁以上年龄组,且差距逐渐扩大。自2011年以来,天津市宫颈癌死亡率呈快速上升趋势。50至70岁女性是寿命损失的主要群体。