摘要
目的了解我国2005-2016年老年人恶性肿瘤流行特征,为我国老年人恶性肿瘤防控政策的制定提供参考依据。方法从2008-2019年《中国肿瘤登记年报》中选取我国≥60岁老年人恶性肿瘤的相关数据,运用Joinpoint回归模型计算年度变化百分比(APC)来反映时间趋势,构建年龄-时期-队列模型探讨影响恶性肿瘤发病和死亡风险的年龄、时期与出生队列效应。结果2005-2016年,我国老年人恶性肿瘤的发病率和死亡率均呈明显下降趋势,APC发病=-0.73%,P=0.009;APC死亡=-1.23%,P<0.001。我国老年人恶性肿瘤发病率和死亡率均男性高于女性,农村男/女发病率的比值呈明显下降趋势,t=-6.89,P<0.001;城市男/女死亡率的比值逐年扩大,t=2.74,P=0.020。农村地区发病率呈下降趋势(APC=-1.48%,P<0.001),其中男性下降更明显,APC=-2.10%,P<0.001;农村(APC男=-3.10%,P<0.001;APC女=-2.80%,P<0.001)男、女死亡率下降均较城市(APC男=-0.68%,P=0.026;APC女=-1.03%,P=0.006)明显。年龄-时期-队列模型分析结果显示,无论男女、城乡,恶性肿瘤发病和死亡风险均随年龄的增加而增加;随着时间的推移,除农村发病和死亡风险不断下降外,其余均表现为先升后降;较晚出生的队列死亡风险低于较早出生的队列。肺癌、胃癌、肝癌、食管癌、结直肠癌和乳腺癌是造成我国老年人疾病负担的主要恶性肿瘤,其中肺癌位于男性和女性伤残调整寿命年构成首位。随着年龄的增长,肝癌所致疾病负担顺位有所下降,而结直肠癌所致疾病负担顺位有所上升。结论2005-2016年中国老年人恶性肿瘤发病、死亡总体呈下降趋势,但仍处于较高水平,且性别差异明显。男性、城市地区、低年龄段老年人应作为恶性肿瘤防治的重点人群,同时重点防控肺癌、胃肠道恶性肿瘤等威胁我国老年人健康的主要恶性肿瘤。
Objective To understand the epidemiological characteristics of malignant tumors in the elderly in China from 2005to 2016,and to provide reference basis for formulating prevention and control policies for malignant tumors in the elderly.Methods To select relevant data on malignant tumors in elderly people aged≥60years in China from the Annual Report of Cancer Registration of China from 2008to 2019,use Joinpoint regression model to calculate annual percentage of change(APC)to reflect the time trend,and construct an age period cohort model to explore the age,period,and birth cohort effects that affect the incidence and mortality risk of malignant tumors.Results From 2005to 2016,the incidence rate and mortality of malignant tumors in the elderly in China showed a significant downward trend,with the APCincidence=-0.73%,P=0.009;APCdeath=-1.23%,P<0.001.The incidence rate and mortality of malignant tumors in the elderly in China were higher in men than that in women,and the ratio of male to female incidence rate in rural areas showed a significant downward trend,t=-6.89,P<0.001.The ratio of male to female mortality in urban areas had increased year by year,t=2.74,P=0.020.The incidence rate in rural areas showed a downward trend(APC=-1.48%,P<0.001),especially in men,APC=-2.10%,P<0.001.In rural areas(APCmale=-3.10%,P<0.001;APCfemale=-2.80%,P<0.001),both male and female mortality rates decreased significantly compared to urban areas(APCmale=-0.68%,P=0.026;APCfemale=-1.03%,P=0.006).The results of age period cohort model analysis showed that the risk of cancer onset and death increased with age,regardless of gender,urban or rural areas.With the passage of time,the risk of morbidity and mortality in rural areas continued to decline,while the rest showed an increase first and then a decrease.The risk of death in the late birth cohort was lower than that in the early birth cohort.Lung cancer,gastric cancer,liver cancer,esophageal cancer,colorectal cancer and breast cancer were the main malignant tumors that cause the disease burden of the elderly in China.Among them,lung cancer ranked first in male and female disability adjusted life years.With the growth of age,the order of disease burden caused by liver cancer decreases,while the order of disease burden caused by colorectal cancer increases.Conclusions From 2005to 2016,the incidence and mortality of malignant tumors in the elderly in China show an overall downward trend,but they are still at a high level,with significant gender differences.Men,urban areas,and the elderly at low age should be the key population for the prevention and control of malignant tumors,while focusing on the prevention and control of lung cancer,gastrointestinal cancer,and other major malignant tumors that threaten the health of the elderly in China.
作者
何小双
徐丽娜
刘冬
辛雯艳
崔梅
赵宇
屈媛媛
HE Xiaoshuang;XU Lina;LIU Dong;XIN Wenyan;CUI Mei;ZHAO Yu;QU Yuanyuan(First Affiliated Hospital of Shihezi University,Shihezi 832000,China;Department of Pathology,Xinjiang Autonomous Region People's Hospital,Urumqi 830000,Chin)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第11期631-638,共8页
Chinese Journal of Cancer Prevention and Treatment
作者简介
第一作者:何小双,女,新疆石河子人,硕士,主治医师,主要从事呼吸系统疾病的临床研究工作。E-mail:1136218426@qq.com;通信作者:屈媛媛,女,新疆石河子人,硕士,主治医师,主要从事呼吸系统疾病的临床研究工作。E-mail:15299432401@163.com。
