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[2012年至2023年山东省女性乳腺癌发病率和死亡率的时空趋势及趋势预测]

[The spatio-temporal trend of female breast cancer incidence and mortality in Shandong Province from 2012 to 2023 and trend prediction].

作者信息

Jiang F, Fu Z T, Wang Q F, Chu J, Zhang B Y, Lu Z L, Guo X L, Xu A Q

机构信息

Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, China.

Institute of Preventive Medicine of Shandong University, Jinan 250014, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2025 Apr 10;46(4):646-654. doi: 10.3760/cma.j.cn112338-20240830-00539.

Abstract

We aimed to analyze the spatio-temporal trend of breast cancer incidence and mortality in Shandong Province from 2012 to 2023 and predict the development trend from 2024 to 2030. Data on the incidence and mortality of breast cancer in Shandong Province from 2012 to 2023 were obtained from the Shandong Cancer Registry. The incidence, age-specific incidence, mortality, and age-specific mortality in different years, as well as in urban and rural areas, were calculated, and the rates were standardized based on the age composition of the Chinese standard population in 2000. The average annual percent change (AAPC) rate was calculated using Joinpoint 4.8.0.1 software. The global and local spatial autocorrelation analysis were performed using GeoDa 1.12 software. The Bayesian age-period-cohort model was used to predict the trend of breast cancer incidence and mortality from 2024 to 2030. From 2012 to 2023, the breast cancer age-standardized incidence rate (ASIR) showed an increasing trend. The ASIR increased from 30.48/100 000 in 2012 to 39.94/100 000 in 2023 (AAPC=2.59%, <0.001). The ASIR of urban and rural females also showed an upward trend. Additionally, the ASIR in rural areas (AAPC=3.33%, <0.001) increased more than that in urban areas (AAPC=1.83%, =0.002). The incidence peak of breast cancer mainly concentrated in population aged 45-64 years, and with the increase of years, the incidence peak gradually moved forward. The age-standardized mortality rate (ASMR) showed a downward trend. The ASMR decreased from 6.89/100 000 in 2012 to 4.93/100 000 in 2023 (AAPC=-3.12%, <0.001). The ASMR of urban and rural females also showed a downward trend (urban: AAPC=-3.56%, =0.007; rural: AAPC=-2.72%, <0.001). The spatial analysis showed that from 2015 to 2023, the clustering areas of breast cancer incidence and mortality in Shandong had changed significantly. In 2015, the "High-high clusters" of ASIR mainly included Wendeng District in Weihai City, Dongying District, Kenli District, Lijin County, Guangrao County in Dongying City, Tianqiao District, Shizhong District in Jinan City; In 2023, the "High-high clusters" mainly included Jiaxiang County, Liangshan County, Jinxiang County, Wenshang County, Rencheng District in Jining City, Hedong District in Linyi City, Guangrao County in Dongying City. In 2015, the "High-high clusters" of ASMR only included Wenshang County in Jining City. In 2023, the "High-high clusters" mainly included Laizhou County in Yantai City, Junan County and Yishui County in Linyi City, Gaotang County in Liaocheng City, Dongping County and Ningyang County in Taian City. The Bayesian age-period-cohort model predicted that the ASIR trend of breast cancer in Shandong tended to be smooth (AAPC=0.33%, =0.001). However, the ASMR remained decreasing (AAPC=-4.68%, <0.001). The breast cancer incidence in Shandong showed an increasing trend, and it is expected to be smooth by 2030. However, the mortality showed a continuous downward trend. The incidence peak was mainly in the population aged 45-64 years, with obvious regional differences. Targeted prevention and control measures should be taken for high-risk groups and areas in Shandong Province.

摘要

我们旨在分析2012年至2023年山东省乳腺癌发病率和死亡率的时空趋势,并预测2024年至2030年的发展趋势。2012年至2023年山东省乳腺癌发病率和死亡率数据来自山东省癌症登记处。计算不同年份以及城乡地区的发病率、年龄别发病率、死亡率和年龄别死亡率,并根据2000年中国标准人口的年龄构成对率进行标准化。使用Joinpoint 4.8.0.1软件计算平均年度百分比变化(AAPC)率。使用GeoDa 1.12软件进行全局和局部空间自相关分析。采用贝叶斯年龄-时期-队列模型预测2024年至2030年乳腺癌发病率和死亡率趋势。2012年至2023年,乳腺癌年龄标准化发病率(ASIR)呈上升趋势。ASIR从2012年的30.48/10万上升至2023年的39.94/10万(AAPC=2.59%,<0.001)。城乡女性的ASIR也呈上升趋势。此外,农村地区的ASIR(AAPC=3.33%,<0.001)增长幅度大于城市地区(AAPC=1.83%,=0.002)。乳腺癌发病高峰主要集中在45-64岁人群,且随着年份增加,发病高峰逐渐前移。年龄标准化死亡率(ASMR)呈下降趋势。ASMR从2012年的6.89/10万降至2023年的4.93/10万(AAPC=-3.12%,<0.001)。城乡女性的ASMR也呈下降趋势(城市:AAPC=-3.56%,=0.007;农村:AAPC=-2.72%,<0.001)。空间分析表明,2015年至2023年,山东省乳腺癌发病率和死亡率的聚集区域发生了显著变化。2015年,ASIR的“高高聚集区”主要包括威海市文登区、东营市东营区、垦利区、利津县、广饶县、济南市天桥区、市中区;2023年,“高高聚集区”主要包括济宁市嘉祥县、梁山县、金乡县、汶上县、任城区、临沂市河东区、东营市广饶县。2015年,ASMR的“高高聚集区”仅包括济宁市汶上县。2023年,“高高聚集区”主要包括烟台市莱州市、临沂市莒南县和沂水县、聊城市高唐县、泰安市东平县和宁阳县。贝叶斯年龄-时期-队列模型预测,山东省乳腺癌的ASIR趋势趋于平稳(AAPC=0.33%,=0.001)。然而,ASMR仍在下降(AAPC=-4.68%,<0.001)。山东省乳腺癌发病率呈上升趋势,预计到2030年趋于平稳。然而,死亡率呈持续下降趋势。发病高峰主要在45-64岁人群,存在明显的地区差异。应对山东省的高危人群和地区采取针对性的防控措施。

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