Department of Respiratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of General Practice, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
JMIR Public Health Surveill. 2022 Apr 20;8(4):e33633. doi: 10.2196/33633.
Lung cancer is a leading cause of death worldwide, and its incidence shows an upward trend. A study of the long-term changes in the premature death rate in lung cancer in a developed region of China has great exploratory significance to further clarify the effectiveness of intervention measures.
This study examined long-term changes in premature lung cancer death rates in order to understand the changes in mortality and to design future prevention plans in Pudong New Area (PNA), Shanghai, China.
Cancer death data were collected from the Mortality Registration System of PNA. We analyzed the crude mortality rate (CMR), age-standardized mortality rate by Segi's world standard population (ASMRW), and years of life lost (YLL) of patients with lung cancer from 1973 to 2019. Temporal trends in the CMR, ASMRW, and YLL rate were calculated by joinpoint regression expressed as an average annual percentage change (AAPC) with the corresponding 95% CI.
All registered permanent residents in PNA (80,543,137 person-years) from 1973 to 2019 were enrolled in this study. There were 42,229 deaths from lung cancer. The CMR and ASMRW were 52.43/10 and 27.79/10 person-years, respectively. The YLL due to premature death from lung cancer was 481779.14 years, and the YLL rate was 598.16/10 person-years. The CMR and YLL rate showed significantly increasing trends in men, women, and the total population (P<.001). The CMR of the total population increased by 2.86% (95% CI 2.66-3.07, P<.001) per year during the study period. The YLL rate increased with an AAPC of 2.21% (95% CI 1.92-2.51, P<.001) per year. The contribution rates of increased CMR values caused by demographic factors were more evident than those caused by nondemographic factors.
Lung cancer deaths showed an increasing trend in PNA from 1973 to 2019. Demographic factors, such as the aging population, contributed more to an increased CMR. Our research can help us understand the changes in lung cancer mortality and can be used for similar cities in designing future prevention plans.
肺癌是全球主要的死亡原因之一，其发病率呈上升趋势。研究中国发达地区肺癌早逝率的长期变化，对于进一步明确干预措施的效果具有重要的探索意义。
本研究旨在探讨肺癌早逝率的长期变化，以了解死亡率的变化，并为中国上海市浦东新区（PNA）制定未来的预防计划。
从 PNA 死因登记系统中收集癌症死亡数据。我们分析了 1973 年至 2019 年期间肺癌患者的粗死亡率（CMR）、按 Segi 世界标准人口校正的死亡率（ASMRW）和寿命损失年（YLL）。CMR、ASMRW 和 YLL 率的时间趋势通过连接点回归计算，以平均年变化百分比（AAPC）表示，95%置信区间（CI）。
本研究纳入了 1973 年至 2019 年期间 PNA 的所有常住居民（80543137 人年），共登记肺癌死亡 42229 例。CMR 和 ASMRW 分别为 52.43/10 和 27.79/10 人年。因肺癌早逝导致的 YLL 为 481779.14 年，YLL 率为 598.16/10 人年。男性、女性和总人口的 CMR 和 YLL 率均呈显著上升趋势（P<.001）。研究期间，总人口的 CMR 以每年 2.86%（95%CI 2.66-3.07，P<.001）的速度增长。YLL 率以每年 2.21%（95%CI 1.92-2.51，P<.001）的速度增长。人口因素导致的 CMR 值增加贡献率大于非人口因素。
1973 年至 2019 年，PNA 的肺癌死亡呈上升趋势。人口因素，如人口老龄化，对 CMR 的增加贡献更大。本研究有助于了解肺癌死亡率的变化，并可用于设计类似城市的未来预防计划。
