Sun Chao, Liu Yan, Huang Yiman, Li Bang, Rang Weiqing
Hunan Key Laboratory of Typical Environmental Pollution and Health Hazards, School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.
School of Public Health, Wuhan University, Wuhan, Hubei, People's Republic of China.
Int J Gen Med. 2021 Dec 20;14:9965-9976. doi: 10.2147/IJGM.S344448. eCollection 2021.
This study aimed to analyze incidence and mortality trends and risk factors of colorectal cancer (CRC) in China during 2005-2015.
Patient cases were extracted from the Chinese Cancer Registry Annual Report. Joinpoint regression and Poisson regression were applied to analyze incidence and mortality trends and risk factors of CRC. Age-period-cohort model was used to evaluate the age, period and cohort effects on CRC.
The standardized incidence and mortality rate of CRC in China showed a decreasing trend during 2005-2015. The incidence in men (APC=-1.22%, P<0.05) decreased from 2005 to 2015 and decreased in women (APC =-3.55%, P<0.05) from 2005 to 2013, then increased during 2013-2015 (APC =18.77%, P<0.05). The incidence and mortality in urban areas were higher than those in rural (The incidence in urban: APC =-0.97%, P<0.05; rural: APC =1.94%, P<0.05; the mortality in urban: APC =-0.67%, P<0.05; rural: APC =0.29%). For age-specific rates, the incidence begins to increase significantly at 40-45 age group and reached a peak at 75; the mortality increased significantly at 45-50. The age effect increased with age in general. The 1920 birth cohort had the highest risk of colorectal cancer incidence and death. Poisson regression showed region, gender and age were independent risk factors of CRC.
The age-adjusted standardized incidence rate (ASIR) and age-adjusted standardized mortality rate (ASMR) of CRC in China during 2005-2015 were decreasing. A great concern on men, rural areas and people aged over 75 should be aroused to prevent colorectal cancer.
本研究旨在分析2005 - 2015年期间中国结直肠癌(CRC)的发病率、死亡率趋势及危险因素。
从《中国癌症登记年报》中提取患者病例。采用Joinpoint回归和泊松回归分析CRC的发病率、死亡率趋势及危险因素。运用年龄 - 时期 - 队列模型评估年龄、时期和队列对CRC的影响。
2005 - 2015年期间,中国CRC的标准化发病率和死亡率呈下降趋势。男性发病率从2005年至2015年下降(APC = - 1.22%,P < 0.05),女性发病率从2005年至2013年下降(APC = - 3.55%,P < 0.05),然后在2013 - 2015年期间上升(APC = 18.77%,P < 0.05)。城市地区的发病率和死亡率高于农村地区(城市发病率:APC = - 0.97%,P < 0.05;农村发病率:APC = 1.94%,P < 0.05;城市死亡率:APC = - 0.67%,P < 0.05;农村死亡率:APC = 0.29%)。按年龄别发病率来看,发病率在40 - 45岁年龄组开始显著上升,并在75岁时达到峰值;死亡率在45 - 50岁时显著上升。总体而言,年龄效应随年龄增长而增加。出生于1920年的队列患结直肠癌的发病率和死亡率风险最高。泊松回归显示地区、性别和年龄是CRC的独立危险因素。
2005 - 2015年期间中国CRC的年龄调整标准化发病率(ASIR)和年龄调整标准化死亡率(ASMR)呈下降趋势。应高度关注男性、农村地区及75岁以上人群以预防结直肠癌。