Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Department of Cause of Death and Cancer Surveillance, Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
Cancer Med. 2021 Apr;10(8):2865-2876. doi: 10.1002/cam4.3744. Epub 2021 Mar 16.
Cancer is an important focus of public health worldwide. This study aims to provide a comprehensive overview of temporal trends in incidence and mortality of leading cancer in Guangzhou, China from 2004 to 2015.
Data were collected from the population-based registry in Guangzhou. Age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were calculated and Joinpoint regression was used for evaluating the average annual percent changes (AAPC) among the entire study period and the estimated annual percent changes (EAPC) in time segments. The effects of age, period, and birth cohort were assessed by the age-period-cohort model.
The age-standardized incidence and mortality by the world standard population decreased significantly among males with AAPC of -1.7% (95% CI: -3.0%, 0.2%) and -2.7% (95% CI: -4.3%, -1.1%) for all malignancies during 2004-2015, while among females, the age-standardized incidence had a non-significant reduction with AAPC of -1.3% (95% CI: -2.8%, 0.2%) and the age-standardized mortality demonstrated a remarkable decline (AAPC -2.0%, 95% CI: -3.6%, -0.3%). For males, the most commonly diagnosed cancers were trachea, bronchus, and lung (TBL), liver, colorectal, nasopharyngeal, stomach, and prostate cancer. For females, breast, TBL, colorectal, liver stomach, and thyroid cancer ranked the top. Unfavorable trends were observed in ASIR of colorectal, thyroid, and prostate cancer. APC models yielded different ages, periods, and birth cohort effect patterns by cancer sites.
Cancer burden remained a public health challenge in Guangzhou as the aging population and lifestyles changes, despite declines in incidence and mortality rates in some cancers. Surveillance of cancer trends contributed to valuable insights into cancer prevention and control.
癌症是全球公共卫生的一个重要关注点。本研究旨在提供中国广州 2004 年至 2015 年主要癌症发病率和死亡率的时间趋势综合概述。
数据来自广州基于人群的登记处。计算了年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR），并使用 Joinpoint 回归评估了整个研究期间的平均年变化百分比（AAPC）和时间段内的估计年变化百分比（EAPC）。年龄-时期-队列模型评估了年龄、时期和出生队列的影响。
男性所有恶性肿瘤的世界标准人口年龄标准化发病率和死亡率均显著下降，2004 年至 2015 年期间，AAPC 分别为 -1.7%（95%CI：-3.0%，0.2%）和 -2.7%（95%CI：-4.3%，-1.1%），而女性的年龄标准化发病率呈非显著下降，AAPC 为-1.3%（95%CI：-2.8%，0.2%），年龄标准化死亡率则显著下降（AAPC -2.0%，95%CI：-3.6%，-0.3%）。对于男性，最常见的诊断癌症是气管、支气管和肺癌（TBL）、肝癌、结直肠癌、鼻咽癌、胃癌和前列腺癌。对于女性，乳腺癌、TBL、结直肠癌、肝癌、胃癌和甲状腺癌排名最高。结直肠癌、甲状腺癌和前列腺癌的 ASIR 呈不利趋势。APC 模型根据癌症部位产生了不同的年龄、时期和出生队列效应模式。
尽管某些癌症的发病率和死亡率有所下降，但由于人口老龄化和生活方式的改变，癌症负担仍是广州公共卫生面临的挑战。对癌症趋势的监测有助于深入了解癌症的预防和控制。
