Shi T T, Liu Z Q, Fan H, Zhang P Y, Yu S Z, Zhang T J
Department of Epidemiology/Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
Institute of Preventive Medicine, Fudan University, Shanghai 200032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Mar 10;43(3):330-335. doi: 10.3760/cma.j.cn112338-20210924-00749.
To understand the incidence trend of liver cancer in China from 2005 to 2016, and explore the correlation between the incidence trend of liver cancer and the incidence trend of hepatitis B. The incidence data of liver cancer in China from 2005 to 2016 were collected from the Annual Report of Cancer Registry in China. The incidence data of hepatitis B were collected from China Public Health Science Data Center. World standardized incidence rate (WSR) was calculated according to the World Segi's population. Joinpoint regression model was used to analyze the trend of WSR of liver cancer [measured by average annual percentage change (AAPC)]. The age-period-cohort model was fitted to analyze the age, period and cohort effects in people aged 20- years and above. Pearson correlation coefficient was used to explore the correlation between the incidence of liver cancer and the incidence of hepatitis B. The crude incidence of liver cancer in China showed a trend of first increase before 2009 and then relatively stable. The world standardized morbidity rate of liver cancer in China decreased from 19.11 per 100 000 in 2005 to 17.74 per 100 000 in 2016 (AAPC=-0.5%, 95%: -1.3%-0.3%, =0.240). The incidence of liver cancer in male decreased significantly (AAPC=-1.0%, 95%: -1.5%--0.5%, =0.001). The incidence of liver cancer in women increased from 2005 to 2010 [annual percentage change (APC)=1.7%, 95%: -0.1%-3.4%, =0.059] but showed a significant decrease trend from 2010 to 2016 (APC=-1.6%, 95%: -2.3%--1.0%, =0.001). From 2005 to 2016, the incidence of liver cancer showed a decreasing trend in urban areas (AAPC=-0.3%, 95%: -0.8%-0.3%, =0.316) and rural areas (AAPC=-3.9%, 95%: -4.4%--3.3%, <0.001). Risk for liver cancer increased with age, while the period effect showed a trend of first increase then decrease and cohort effect showed a decrease trend. The morbidity rates of both hepatitis B and liver cancer showed decrease trends from 2009 to 2016, and there was a significant correlation (=0.71, 95%: 0.01-0.94, =0.048). From 2005 to 2016, the morbidity rate of liver cancer in China showed a decrease trend, and there were significant gender and urban-rural area specific differences. Age effect had a great impact on the risk for liver cancer. With the progress of population aging in China, liver cancer is still a public health problem, to which close attention needs to be paid.
为了解2005年至2016年中国肝癌的发病趋势，并探讨肝癌发病趋势与乙型肝炎发病趋势之间的相关性。收集了中国2005年至2016年的肝癌发病数据，来自《中国癌症登记年报》。乙型肝炎的发病数据来自中国公共卫生科学数据中心。根据世界Segi人口计算世界标准化发病率（WSR）。采用Joinpoint回归模型分析肝癌WSR的趋势[以年均变化百分比（AAPC）衡量]。拟合年龄-时期-队列模型，分析20岁及以上人群的年龄、时期和队列效应。采用Pearson相关系数探讨肝癌发病率与乙型肝炎发病率之间的相关性。中国肝癌的粗发病率在2009年前呈先上升后相对稳定的趋势。中国肝癌的世界标准化发病率从2005年的每10万例19.11例降至2016年的每10万例17.74例（AAPC = -0.5%，95%：-1.3% - 0.3%，P = 0.240）。男性肝癌发病率显著下降（AAPC = -1.0%，95%：-1.5% - -0.5%，P = 0.001）。女性肝癌发病率在2005年至2010年呈上升趋势[年变化百分比（APC）= 1.7%，95%：-0.1% - 3.4%，P = 0.059]，但在2010年至2016年呈显著下降趋势（APC = -1.6%，95%：-2.3% - -1.0%，P = 0.001）。2005年至2016年，城市地区（AAPC = -0.3%，95%：-0.8% - 0.3%，P = 0.316）和农村地区（AAPC = -3.9%，95%：-4.4% - -3.3%，P < 0.001）的肝癌发病率均呈下降趋势。肝癌风险随年龄增加而升高，时期效应呈先上升后下降趋势，队列效应呈下降趋势。2009年至2016年，乙型肝炎和肝癌的发病率均呈下降趋势，且两者存在显著相关性（r = 0.71，95%：0.01 - 0.94，P = 0.048）。2005年至2016年，中国肝癌发病率呈下降趋势，且存在显著的性别和城乡差异。年龄效应对肝癌风险影响较大。随着中国人口老龄化进程的推进，肝癌仍是一个需要密切关注的公共卫生问题。
