目的利用上海市杨浦区1974-2015年肝胆系统恶性肿瘤的死亡数据,分析肝癌和胆道癌症死亡趋势变化及影响因素。方法 应用Joinpoint回归模型分析上海市杨浦区肝癌和胆道癌症死亡趋势,应用年龄-时期-队列(APC)模型评估年龄和队列因素对肝癌和胆道癌症死亡率的影响。结果 1974-2015年杨浦区共报告肝癌死亡9866例,男女比例为2.7∶1,粗死亡率为23.09/10万,标化死亡率为18.87/10万;胆道癌症死亡2173例,男女比例为1∶1.7,粗死亡率为5.04/10万,标化死亡率为3.82/10万。Joinpoint回归分析显示1974-2015年肝癌标化死亡率呈下降趋势,而胆道癌症标化死亡率呈上升趋势。在APC模型中,随着年龄的增长,肝癌和胆道癌症的死亡风险整体呈上升趋势。总人群中1930年之前出生者肝癌和胆道癌症死亡风险呈上升趋势;1930-1949年出生的男性肝癌、男女性胆道癌症死亡风险呈下降趋势,1949年之后出生者呈上升趋势;而1930年之后出生的女性肝癌死亡风险呈下降趋势。结论 1974-2015年杨浦区肝癌死亡率呈下降趋势,男性肝癌死亡数高于女性;胆道癌症死亡率呈上升趋势,女性死亡人数高于男性;由老龄化因素造成的肝癌和胆道癌症死亡率上升;暴露因素对肝癌和胆道癌症的影响较一致,可能与当时社会经济因素有关。
Objective To analyze the mortality and influencing factors of hepatobiliary cancer patients using the death data of hepatobiliary malignant tumors of Yangpu District, Shanghai, from 1974 to 2015. Methods Joinpoint regression was used to analyze the mortality trend of hepatobiliary cancer. Age-period-cohort (APC) model was employed to evaluate the effects of age and cohort factors on the mortality rate of hepatobiliary cancer. Results From 1974 to 2015, a total of 9 866 liver cancer deaths were reported in Yangpu District, with a male to female ratio of 2.7∶1;and the crude mortality rate and standardized mortality rate were 23.09/100 000 and 18.87/100 000, respectively. A total of 2 173 biliary tract cancer deaths were reported, with a male to female ratio of 1∶1.7;and the crude mortality rate and standardized mortality rate were 5.04/100 000 and 3.82/100 000, respectively. Joinpoint regression analysis showed that the standardized mortality rate of liver cancer decreased from 1974 to 2015, while that of biliary tract cancer increased. In APC model, the overall mortality risk of liver cancer and biliary tract cancer increased with the increase of age. The mortality rates of liver cancer and biliary tract cancer were increased in the population born before 1930. The mortality rates of the male liver cancer and the male and female biliary tract cancer were decreased in the population born between 1930 and 1949. The mortality rate of liver cancer was increased in the females born after 1949. Conclusion From 1974 to 2015, the mortality rate of liver cancer has a decreasing trend in Yangpu District, Shanghai, and the mortality rate of male is higher than that of female. The mortality rate of biliary tract cancer shows an increasing trend, and the mortality rate of female is higher than that of male. The mortality rates of liver cancer and biliary tract cancer associated with aging factors have increased. Exposure factors have a consistent effect on liver cancer and biliary tract cancer, which may be related to soci
Academic Journal of Second Military Medical University
biliary tract neoplasms
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