中国 2005-2017 年白血病的流行病学特征：对数线性回归和年龄-时期-队列分析。

Epidemiological characteristics of leukemia in China, 2005-2017: a log-linear regression and age-period-cohort analysis.

机构信息

Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China.

Shihezi Center for Disease Control and Prevention, Shihezi, Xinjiang, China.

出版信息

BMC Public Health. 2023 Aug 28;23(1):1647. doi: 10.1186/s12889-023-16226-1.

DOI:10.1186/s12889-023-16226-1

PMID:37641011

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10464264/

Abstract

BACKGROUND

Leukemia is a threat to human health, and there are relatively few studies on the incidence, mortality and disease burden analysis of leukemia in China. This study aimed to analyze the incidence and mortality rates of leukemia in China from 2005 to 2017 and estimate their age-period-cohort effects, it is an important prerequisite for effective prevention and control of leukemia.

METHODS

Leukemia incidence and mortality data from 2005 to 2017 were collected from the Chinese Cancer Registry Annual Report. Joinpoint regression model was used to estimate the average annual percentage change (AAPC) and annual percentage change (APC) response time trend. Age-period-cohort model was constructed to analyze the effects of age, period and cohort.

RESULTS

The age-standardized incidence rate of leukemia was 4.54/100,000 from 2005 to 2017, showed an increasing trend with AAPC of 1.9% (95% CI: 1.3%, 2.5%). The age-standardized mortality rate was 2.91/100,000, showed an increasing trend from 2005 to 2012 with APC of 2.1% (95%CI: 0.4%, 3.9%) and then a decreasing trend from 2012 to 2017 with APC of -2.5% (95%CI: -5.3%, 0.3%). The age-standardized incidence (mortality) rates of leukemia were not only higher in males than that in females, but also increased more rapidly. The incidence of leukemia in rural areas was lower than in urban areas, but the AAPC was 2.2 times higher than urban areas. Children aged 0-4 years were at higher risk of leukemia. The risk of leukemia incidence and mortality increased with age. The period effect of leukemia mortality risk showed a decreasing trend, while the cohort effect showed an increasing and then decreasing trend with the turning point of 1955-1959.

CONCLUSIONS

The age-standardized incidence rate of leukemia in China showed an increasing trend from 2005 to 2017, while the age-standardized mortality rate increased first and then decreased in 2012 as a turning point. Differences existed by gender and region. The risk of leukemia incidence and mortality increased accordingly with age. The risk of mortality due to leukemia gradually decreased from 2005 to 2017. Leukemia remains a public health problem that requires continuous attention.

摘要

背景

白血病是威胁人类健康的一大因素，目前针对中国白血病的发病率、死亡率和疾病负担分析的研究相对较少。本研究旨在分析 2005 年至 2017 年中国白血病的发病率和死亡率，并估计其年龄-时期-队列效应，这是有效预防和控制白血病的重要前提。

方法

收集 2005 年至 2017 年中国癌症登记年报中的白血病发病率和死亡率数据。使用 Joinpoint 回归模型估计平均年度百分比变化（AAPC）和年度百分比变化（APC）的反应时间趋势。构建年龄-时期-队列模型以分析年龄、时期和队列的影响。

结果

2005 年至 2017 年，白血病的年龄标准化发病率为 4.54/100000，呈上升趋势，AAPC 为 1.9%（95%CI：1.3%，2.5%）。年龄标准化死亡率为 2.91/100000，2005 年至 2012 年呈上升趋势，APC 为 2.1%（95%CI：0.4%，3.9%），2012 年至 2017 年呈下降趋势，APC 为-2.5%（95%CI：-5.3%，0.3%）。白血病的年龄标准化发病率（死亡率）不仅在男性中高于女性，而且上升速度更快。农村地区白血病的发病率低于城市地区，但 AAPC 却是城市地区的 2.2 倍。0-4 岁儿童患白血病的风险较高。白血病发病率和死亡率随年龄增长而增加。白血病死亡率的时期效应呈下降趋势，而队列效应则呈先增后降的趋势，转折点为 1955-1959 年。