Yang X Y, Wang N, Wei C C, He F D, Qi J L, Wang B H
Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2023 Oct 10;44(10):1583-1590. doi: 10.3760/cma.j.cn112338-20230224-00107.
To analyze the trend of liver cancer mortality in rural key areas of Jiangsu Province, Anhui Province, Shandong Province, and Henan Province (4 provinces) from 2009 to 2019 and to explore the influence of behavioral risk factors on liver cancer mortality and its lagging effect, and provide a reference for the prevention and treatment of liver cancer in China. Based on the 2009-2019 National Cause of Death Surveillance Database of the Chinese Center for Disease Control and Prevention, and the survey data of tumor and risk factor behavior of residents in key areas of 4 provinces, Joinpoint 4.2 software was used to calculate the average annual percentage change (AAPC) for assessing the temporal trend of standardized mortality of liver cancer; Chi-square test and trend Chi-square test were used to analyze the regional distribution difference and temporal change trend of behavioral habit factors. Stata 16 was used to establish a panel model to analyze the correlation and lagging effect of behavioral risk factors with liver cancer. The standardized mortality rate of liver cancer in Jinhu County, Sheyang County, Lingbi County, Shou County, Mengcheng County, Wenshang County, Juye County, Luoshan County, Shenqiu County, and Xiping County showed a downward trend (AAPC<0, <0.05) from 2009 to 2019. The consumption frequency of pickles/salted fish, red meat, and aquatic products showed a downward trend. The consumption frequency of healthy foods such as fresh vegetables, fresh fruits, and dairy products in all counties and districts showed an upward trend, and the consumption frequency of fried foods, kimchi, smoked foods, moldy foods, coffee, and soy products remained at a low level (<0.05); but the consumption frequency of soy products and dairy products was still <20.00%. Fried food, pickles/salted fish, current smoking rate, alcohol consumption rate, and unvaccinated hepatitis B vaccine rate were positively correlated with liver cancer death, and there was a lag effect, and the lag period was 4, 1, 6, 5, 4 years respectively. From 2009 to 2019, the mortality rate of liver cancer in rural key areas of 4 provinces shows a downward trend. There is a correlation and lagging effect between behavioral risk factors such as fried food, smoking, and alcohol consumption and liver cancer death.
分析2009年至2019年江苏省、安徽省、山东省和河南省（4省）农村重点地区肝癌死亡率的变化趋势，探讨行为危险因素对肝癌死亡率的影响及其滞后效应，为我国肝癌防治提供参考依据。基于中国疾病预防控制中心2009 - 2019年全国死因监测数据库以及4省重点地区居民肿瘤与危险因素行为调查数据，采用Joinpoint 4.2软件计算年均百分比变化（AAPC）以评估肝癌标准化死亡率的时间趋势；运用卡方检验和趋势卡方检验分析行为习惯因素的地区分布差异和时间变化趋势。使用Stata 16软件建立面板模型分析行为危险因素与肝癌的相关性及滞后效应。金湖县、射阳县、灵璧县、寿县、蒙城县、汶上县、巨野县、罗山县、沈丘县和西平县2009年至2019年肝癌标准化死亡率呈下降趋势（AAPC＜0，P＜0.05）。腌菜/咸鱼、红肉和水产品的消费频率呈下降趋势。各区县新鲜蔬菜、新鲜水果和乳制品等健康食品的消费频率呈上升趋势，油炸食品、泡菜、烟熏食品、霉变食品、咖啡和豆制品的消费频率维持在较低水平（P＜0.05）；但豆制品和乳制品的消费频率仍＜20.00%。油炸食品、腌菜/咸鱼、当前吸烟率、饮酒率和未接种乙肝疫苗率与肝癌死亡呈正相关，且存在滞后效应，滞后时间分别为4年、1年、6年、5年、4年。2009年至2019年，4省农村重点地区肝癌死亡率呈下降趋势。油炸食品、吸烟、饮酒等行为危险因素与肝癌死亡之间存在相关性及滞后效应。
