摘要
背景宫颈癌是女性常见的妇科肿瘤之一,占所有女性癌症的12%左右。该病与肝癌一样,约有85%的患者来自欠发达地区。目的探讨1993—2017年我国宫颈癌发病率和死亡率的长期趋势。方法本研究中所有的发病及死亡数据来源于美国华盛顿大学健康测量与评价中心(IHME)疾病负担网站。本研究首先运用Joinpoint回归分析模型,对中国1993—2017年宫颈癌发病率和死亡率趋势进行分段描述,进一步利用年龄-时期-队列模型和内生因子法估计成年女性宫颈癌发病及死亡风险的年龄效应、时期效应和队列效应。结果总的来说,1993—1998年中国宫颈癌发病率和死亡率呈下降趋势,2008—2015年呈上升趋势。Joinpoint回归模型结果显示:1993—2017年,女性宫颈癌的标化发病率从9.54/10万增加到10.88/10万〔AAPC(95%CI)=0.6(0.3,0.9),P<0.05〕,而标化死亡率则从4.88/10万下降到4.48/10万〔AAPC(95%CI)=-0.3(-0.5,-0.1),P<0.05〕。此外,在59岁之前,随着年龄的增长,宫颈癌发病率的年龄效应明显增加,并且发病率和死亡率的周期效应总体呈上升趋势。除某些时期外,出生队列的发病率和死亡率风险呈下降趋势,1916—1920年出生队列的发病率和死亡率风险均达到峰值,然后趋于平稳,在年轻一代中略有下降。结论总体而言,队列效应的降低可能导致癌症发病率和死亡率的降低,而年龄效应和周期效应的增加可能导致癌症发病率和死亡率的增加。
Background Cervical cancer is the seventh most common cancer globally,and the fourth most common cancer in women,accounting for about 12%of all cancers diagnosed among females.Cervical cancer and liver cancer are similar with respect to high prevalent region,with about 85%of the sufferers are from less developed regions.Objective To assess the long-term trends of cervical cancer incidence and mortality in China.Methods Data about cervical cancer incidence and mortality in Chinese adult females were extracted from the Institute for Health Metrics and Evaluation.Joinpoint regression was used for analyzing the trends of cervical cancer incidence and mortality during 1993—2017.The age-period-cohort model and intrinsic estimator method were adopted for analyzing the effects of age,period,and cohort on cervical cancer incidence and mortality.Results Overall,the trends of cervical cancer incidence and mortality totally experienced a significant decrease during 1993-1998,and showed an increasing trend during 2008-2015.Joinpoint regression analysis showed that from 1993 to 2017,the standardized incidence ratio of cervical cancer increased from 9.54/100000 to 10.88/100000〔AAPC(95%CI)=0.6(0.3,0.9),P<0.05〕,while its standardized mortality ratio decreased from 4.88/100000 to 4.48/100000〔AAPC(95%CI)=-0.3(-0.5,-0.1),P<0.05〕.Moreover,cervical cancer incidence increased significantly with age before the age of 59,and the period effect exhibited a general upward trend for both incidence and mortality.The incidence and mortality risks by birth cohort showed a declining trend except for some periods and the risks all peaked in the cohort born in 1916-1920,then leveled off and slightly decreased in younger generations.Conclusion Taken together,the decrease in the cohort effect might contribute to the decrease in cervical cancer incidence and mortality rates,while the increase of age and period effects might lead to the increase in its morbidity and mortality rates.
作者
王瑾瑶
张年萍
白志强
王震坤
WANG Jinyao;ZHANG Nianping;BAI Zhiqiang;WANG Zhenkun(Department of Preventive Medicine,Shanxi Datong University,Datong 037009,China;The Dean's Office,Shanxi Datong University,Datong 037009,China;School of Life Sciences,Shanxi Datong University,Datong 037009,China;Party Committee Organization Department,Tongji Medical College of Huazhong University of Science&Technology,Wuhan 430072,China)
出处
《中国全科医学》
CAS
北大核心
2022年第13期1564-1568,共5页
Chinese General Practice
基金
国家自然科学基金青年科学基金项目(81903396)--基于时空数据挖掘的国人伤害死亡风险分布特征及影响因素研究。
