Wang Baohua, Wang Qiutong, Wang Ning, Qi Jinlei, Wu Jing
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
China CDC Wkly. 2022 Apr 15;4(15):317-321. doi: 10.46234/ccdcw2022.076.
Cancer is a major health problem in China. Integrated interventions have been implemented in key areas of Anhui, Henan, Jiangsu, and Shandong provinces with historically higher than average cancer mortality. Assessing the cancer mortality trend and its impact on life expectancy (LE) could help evaluate the effectiveness of interventions in these regions.
Based on the National Cause-of-Death Surveillance, we analyzed the standardized mortality rate (SMR) of cancer, cause eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs), and rate of life lost in key areas of 4 provinces from 2008 to 2018. Joinpoint program was used to compute the average annual percentage change (AAPC) of cancer mortality. Arriaga's decomposition method was used to estimate the contribution of cancer to LE in each age group.
From 2008 to 2018, cancer SMR decreased in the study region (AAPC=-3.09%, <0.001), which increased LE. The positive effect was the greatest in the 75-79 age group (0.120 years, 2.90%), and the negative effect was the greatest in the 50-54 age group (-0.094 years, -2.20%). Compared to 2008, cancer CELE increased by 3.95 years, PGLEs increased by 0.32 years, and rate of life lost increased by 0.21% in 2018.
Cancer SMR decreased in key areas of 4 provinces from 2008 to 2018. This change had a positive effect on the increase of LE. However, the rate of life lost due to cancer increased. Integrated interventions should continue to further reduce the cancer burden.
癌症是中国的一个主要健康问题。在安徽、河南、江苏和山东等癌症死亡率历史上高于平均水平的重点地区实施了综合干预措施。评估癌症死亡率趋势及其对预期寿命（LE）的影响有助于评估这些地区干预措施的有效性。
基于全国死因监测，我们分析了2008年至2018年4省重点地区癌症的标准化死亡率（SMR）、消除病因预期寿命（CELE）、预期寿命潜在增加量（PGLEs）以及寿命损失率。采用Joinpoint程序计算癌症死亡率的平均年度百分比变化（AAPC）。使用阿里亚加分解法估计癌症对各年龄组预期寿命的贡献。
2008年至2018年，研究地区癌症SMR下降（AAPC=-3.09%，<0.001），这增加了预期寿命。积极影响在75-79岁年龄组最大（0.120岁，2.90%），消极影响在50-54岁年龄组最大（-0.094岁，-2.20%）。与2008年相比，2018年癌症CELE增加了3.95岁，PGLEs增加了0.32岁，寿命损失率增加了0.21%。
2008年至2018年，4省重点地区癌症SMR下降。这一变化对预期寿命的增加有积极影响。然而，因癌症导致的寿命损失率有所上升。综合干预措施应继续进一步减轻癌症负担。
