高密市2004-2012年恶性肿瘤死亡变化趋势分析

目的了解高密市2004-2012年恶性肿瘤死亡变化趋势,为恶性肿瘤防治提供依据。方法对高密市＂全国第3次死因回顾抽样调查＂和常规死因监测报告数据,使用粗死亡率、标化死亡率、潜在减寿年数（potential years of life lost,PYLL）、潜在工作减寿年数（work potential years of life lost,WPYLL）和年度变化百分比（annual percentage change,APC）等描述恶性肿瘤死亡分布特征和变化趋势。结果高密市2004-2012年恶性肿瘤粗死亡率为165.50/10万,在全死因中居第2位,呈＂W＂形变化趋势,男性死亡率高于女性,χ^2=1 120.546,P〈0.01;〈30岁恶性肿瘤死亡极低,死亡主要集中在55-74岁年龄组,占所有恶性肿瘤死亡的64.38%;恶性肿瘤的PYLL和WPYLL在全死因分别高居第1位和第2位,PYLL率和WPYLL率分别为18.22‰和8.69‰;标化死亡率（APC为-3.59%）、调整PYLL率和调整WPYLL率呈下降趋势;恶性肿瘤死因前5位的是肺癌、胃癌、肝癌、食管癌和结直肠癌,其中胃癌（APC为-3.44%）粗死亡率呈下降趋势,肝癌、胃癌和肺癌标化死亡率呈下降趋势,APC分别为-4.78%、-6.38%和-4.21%。结论恶性肿瘤仍是影响高密市居民健康和经济发展的主要因素,虽然标化死亡率等指标呈下降趋势,但由于人口老龄化加剧,粗死亡率、PYLL和WPYLL等绝对值未表现出下降趋势,仍需提高警惕,加强监测。     

四川省肿瘤医院16年恶性肿瘤住院患者死因构成及变化趋势

目的:回顾性分析四川省肿瘤医院16年来恶性肿瘤住院患者主要死因构成及年代变化趋势。方法:回顾性收集四川省肿瘤医院2004年01月至2019年12月收治的恶性肿瘤住院患者及死亡病例,分析恶性肿瘤住院患者的主要死亡原因,性别、年龄分布,死因构成的年代变化以及死亡患者占同期住院患者比例的年代变化。结果:2004年-2019年16年间我院收治恶性肿瘤住院患者总数280 042例,恶性肿瘤死亡5 213例,恶性肿瘤住院患者和恶性肿瘤死亡患者数量呈逐年上升趋势。前10位死因顺位依次为:肺癌(34.5%)、肝癌(9.8%)、食管癌(8.2%)、结直肠癌(7.4%)、胃癌(5.5%)、淋巴瘤(3.9%)、乳腺癌(3.8%)、胰腺癌(3.6%)、前列腺癌(2.5%)和胆囊癌(2.0%),合计占总死亡数的81.2%。男性病死率明显高于女性(2.1% vs 1.6%,P＜0.001)。<40岁、40~49岁、50~59岁和≥60岁4个年龄组恶性肿瘤住院患者的病死率分别为0.8%、1.4%、1.8%、2.8%,随着年龄的增长,恶性肿瘤的病死率呈明显上升趋势(P＜0.001)。肺癌始终是第一大死因,3个年代的构成比逐年上升。食管癌和胃癌的死亡构成比明显下降,而肝癌和结直肠癌的死亡构成比明显上升。恶性肿瘤死亡患者占同期住院患者比例为1.86%。其中2004年恶性肿瘤死亡患者占同期住院患者比例为12.6%,2019年下降至1.4%,随时间呈明显下降趋势(P＜0.001)。结论:恶性肿瘤住院患者逐年增加,死亡患者占同期住院患者的比例逐年下降,肺癌仍是恶性肿瘤第一大死因,食管癌和胃癌的死亡构成比随时间呈下降趋势。     

2008—2012年哈尔滨市道里区恶性肿瘤发病与死亡分析

目的 描述和分析哈尔滨市道里区2008—2012年恶性肿瘤发病趋势及死亡情况。方法 收集哈尔滨市道里区肿瘤登记处上报的2008—2012年肿瘤登记数据,计算主要恶性肿瘤粗发病率和死亡率、中标率、世标率、累积率和截缩率等指标,分析5年时间恶性肿瘤发病率和死亡率的变化趋势。结果 2008—2012年哈尔滨市道里区恶性肿瘤发病例数10 893例,其中男性5 879例,女性5 014例。发病率呈现先上升后趋于平稳的趋势,男性恶性肿瘤发病率、中标率、世标率、累计率和截缩率均高于女性。发病率在0~25岁时处于较低水平,25~80岁快速上升,并在80岁时达到高峰,随后开始下降。2008—2012年哈尔滨市道里区恶性肿瘤死亡例数6 801例,其中男性4 069例,女性2 732例。五年的死亡率未见明显变化,男性恶性肿瘤死亡率、中标率、世标率、累计率和截缩率均高于女性。死亡率在0~30岁时处于较低水平,30~75岁快速上升,并在80岁时达到高峰,随后开始下降。2008—2012年道里区恶性肿瘤发病率最高为肺癌,其次为肝癌、结直肠癌、胃癌和乳腺癌,恶性肿瘤死亡率最高为肺癌,其次为肝癌、结直肠癌、胃癌和胰腺癌。结论 2008—2012年哈尔滨市道里区恶性肿瘤发病率先上升后趋于平稳,死亡率未见明显变化。肺癌、消化系统恶性肿瘤、女性乳腺癌是哈尔滨市道里区恶性肿瘤发病与死亡的主要癌种。     

2008-2016年天津市河西区恶性肿瘤发病与死亡趋势分析

目的:分析天津市河西区恶性肿瘤发病与死亡的流行趋势,为肿瘤防治提供科学依据。方法:分析2008-2016年河西区户籍居民的肿瘤随访登记数据,计算发病率、死亡率、中国人口标化率、世界人口标化率、0~74岁累积率,并分析其时间趋势。结果:2008-2016年河西区恶性肿瘤粗发病率为370.17/10万,中标发病率为190.07/10万,世标发病率为184.09/10万,累积发病率（0~74岁）为21.13%。恶性肿瘤粗死亡率为211.80/10万,中标死亡率为92.50/10万,世标死亡率为90.98/10万,累积死亡率（0~74岁）为10.32%。恶性肿瘤发病顺位第 1 位的是肺癌,发病率为 91.30/10 万,其次为乳腺癌、结直肠癌、肝癌和胃癌,前 10 位恶性肿瘤占全部恶性肿瘤发病的 76.65%;恶性肿瘤死亡率第 1 位的是肺癌,死亡率为 75.85/10 万,其次为肝癌、结直肠癌、胃癌和胰腺癌,前 10 位恶性肿瘤占全部恶性肿瘤死亡的 81.34%。2008-2016年期间河西区恶性肿瘤发病率呈平稳上升趋势,而恶性肿瘤标化死亡率呈下降趋势。结论:2008-2016年天津市河西区恶性肿瘤的发病率呈上升趋势,肿瘤负担依然严峻。     

中国恶性肿瘤死亡谱及分类构成特征研究

中国恶性肿瘤死亡谱及分类构成特征研究李连弟张思维鲁凤珠牧人孙秀娣皇甫小梅孙杰周有尚夏毅戴旭东饶克勤陈育德孙爱明薛志福恶性肿瘤是影响人民生命健康的一类重要疾病,但具体到每一种肿瘤,均有其各自特征,对人民的危害情况差异很大。因此,研究恶性肿瘤的死亡谱、分...     

全国第三次死因回顾抽样调查资料分析 Ⅱ:湖北省居民恶性肿瘤死亡现状及变化趋势

 目的　通过死因回顾抽样调查了解湖北省居民恶性肿瘤死亡现状。方法　通过本次死因回顾 抽样调查结果与全国第一次死因回顾抽样调查结果比较,分析湖北省恶性肿瘤死亡的变化趋势。结果 　湖北省城乡居民恶性肿瘤标化死亡率为129. 0/ 10 万。男性恶性肿瘤死亡率高于女性,男∶女为1. 81∶ 1 。肝癌、肺癌、胃癌、食管癌、结肠直肠和肛门癌列湖北省居民恶性肿瘤死亡的前5 位。结论　自上世 纪70 年代,湖北省恶性肿瘤死亡率呈持续上升趋势,肺癌、肝癌、肠癌、乳腺癌和胃癌上升幅度较大,其 中肺癌年均上升22. 4 %;而宫颈癌则有显著下降,年均下降幅度达23. 6 %。     

烟台市农村居民1990～1992年恶性肿瘤死因分析

经对烟台市农村居民１９９０～１９９２年死因调查发现，恶性肿瘤死亡率为１３４．２５／１０万人口（以下简写１０万），位居各类死因的第三位，是男性各类死因的第一位，女性各类死因的第三位。死亡率和全国各大城市市区相仿，比全国和山东高２７．２２％和１３．８８％。男女死亡比值为１．５８，略高于全国农村１．５７的水平。和７０年代相比较，调整死亡率除宫颈癌、乳腺癌和食管癌分别下降７７．１７％、３１．８５％和２４．０１外，其它恶性肿瘤均呈上升趋势。总调整死亡率上升了２０．３６％、其中尤以白血病、肝癌和肺癌为突出，分别上升了２００．７６％、１０４．８％和１８２．２６％，按前２０年癌亡增长比率计算到２０００年癌亡率将达到１６６．０７／１０万，成为烟台市农村居民各类死因的首位。在主要恶性肿瘤死因中前５位死因是胃癌、肝癌、肺癌、大肠癌和食管癌，占因癌死亡的８０．３１％。消化系统的恶性肿瘤占恶性肿瘤死亡的８７．２５％。提示：在今后恶性肿瘤的防治工作中应把消化系统恶性肿瘤做为防治的重点。     

中山市30年恶性肿瘤死因分析

目的 探讨中山市居民30年恶性肿瘤死亡规律，为中山市肿瘤防治工作开发提供科学依据。方法 统计分析中山市居民30年恶性肿瘤死亡率、死亡趋势、构成比、期望寿命等指标。结果 30年期间中山市男性恶性肿瘤总死亡率有明显上升趋势，而女性略有下降；中山市居民死因谱30年期间发生了明显变化，但心脏病、呼吸系统疾病、脑血管疾病与恶性肿瘤一直是中山市居民四大主要死因；部分病种如肺癌、男性膀胱癌、男性食管癌、女性肝癌等死亡率有明显上升趋势。结论 中山市恶性肿瘤总死亡率处于国内外较低水平；男性恶性肿瘤是中山市肿瘤防治工作的重点，肺癌、肝癌是重点防治病种。     

2016-2020年沙依巴克区居民恶性肿瘤死因监测分析

目的 分析2016-2020年沙依巴克区居民恶性肿瘤死亡水平及减寿情况,为制定恶性肿瘤防控策略提供依据。方法 按照国际疾病分类标准(ICD-10)进行编码,应用SPSS 24.0、Excel 2010计算粗死亡率、标化死亡率、年度变化百分比(APC)、潜在减寿年数(PYLL)、平均减寿年数(AYLL)和潜在减寿率(PYLLR)等指标;并应用Joinpoint 4.9.0.1线性回归模型分析沙依巴克区居民恶性肿瘤死亡特征及变化趋势。结果 2016-2020年沙依巴克区居民恶性肿瘤年均粗死亡率为73.20/10万,年均总标化死亡率为72.73/10万。恶性肿瘤死亡率最高的前7位依次为肺癌、肝癌、结直肠癌、胃癌、胰腺癌、食道癌和乳腺癌,占恶性肿瘤总死亡人数的54.33%。主要恶性肿瘤粗死亡率随年龄增加不断上升。按年龄分布,0～55岁年龄段死亡率随年龄增加逐渐上升(APC=12.71%,P<0.001),56～70岁上升趋势有所减缓(APC=6.58%,P=0.102),71～85岁粗死亡率上升趋势显著(APC=12.98%,P<0.001)。减寿分析显示,沙依巴克区居民恶性肿瘤P...     

Increasing thyroid cancer incidence in Canada, 1970-1996: time trends and age-period-cohort effects.

We examined time trends in thyroid cancer incidence in Canada by age, time period and birth cohort between 1970 and 1996. Age-specific incidence rates by time period and birth cohort were calculated and age-period-cohort modelling used to estimate effects underlying the observed trends. Overall age-adjusted incidence rates of thyroid cancer doubled, from 3.3 and 1.1 per 100 000 in 1970-72 to 6.8 and 2.2 per 100 000 in 1994-96, among females and males respectively. Almost all the increase between 1970-72 and 1994-96 was due to papillary carcinoma of the thyroid. Age, birth cohort and period effects significantly improved the fit of the model for females, while age and birth cohort effects were significant determinants of the incidence among males. There were significant differences in the patterns/curvature for age, period and birth cohort effects between women and men. Our results suggest that the increases in thyroid cancer incidence in Canada may be associated with more intensive diagnostic activities and change in radiation exposure in childhood and adolescence. Temporal changes in reproductive factors among young women may explain some of the gender differences observed.     

Recent trends in breast,cervical, and colorectal cancer screening test utilization in Canada,using self-reported data from 2008 and 2012

In Canada, self-reported data from the Canadian Community Health Survey 2008 and 2012 provide an opportunity to examine overall utilization of breast, cervical, and colorectal cancer screening tests for both programmatic and opportunistic screening.Among women 50–74 years of age, utilization of screening mammography was stable (62.0% in 2008 and 63.0% in 2012). Pap test utilization for women 25–69 years of age remained high and stable across Canada in 2008 and 2012 (78.9% in 2012). The percentage of individuals 50–74 years of age who reporting having at least 1 fecal test within the preceding 2 years increased in 2012 (to 23.0% from 16.9% in 2008), but remains low.Stable rates of screening mammography utilization (about 30%) were reported in 2008 and 2012 among women 40–49 years of age, a group for which population-based screening is not recommended. Although declining over time, cervical cancer screening rates were high for women less than 25 years of age (for whom screening is not recommended). Interestingly, an increased percentage of women 70–74 years of age reported having a Pap test.In 2012, a smaller percentage of women 50–69 years of age reported having no screening test (5.9% vs. 8.5% in 2008), and more women reported having the three types of cancer screening tests (19.0% vs. 13.2%).Efforts to encourage use of screening within the recommended average-risk age groups are needed, and education for stakeholders about the possible harms of screening outside those age groups has to continue.     

基于死因监测青岛市居民2008-2012年原发性肝癌死亡分析

目的 发展中国家的肝癌发病率呈现下降趋势,但中国的肝癌疾病负担仍然严重,本研究旨在通过分析青岛市2008-2012年居民肝癌死亡情况及其流行特征,为进一步制定肝癌防控措施提供科学依据.方法 运用Excel和SPSS 21.0统计软件对青岛市2008-2012年死因监测系统的肝癌死亡病例数据进行整理和分析,计算其粗死亡率、标化死亡率、年度变化百分比(annual percent change,APC),描述其3者间分布特征.结果 2008-2012年青岛市居民死于肝癌13 004例,其中男9 554例,女3 450例;肝癌粗死亡率为33.99/10万,标化死亡率为27.98/10万;男性肝癌死亡率为49.89/10万,高于女性的18.06/10万,是女性肝癌死亡率的2.8倍.经标化后,男性死亡率(41.19/10万)是女性(14.42/10万)的2.9倍.肝癌标化死亡率从2008年的35.66/10万下降到2012年的20.21/10万,下降了43.33%,通过时间趋势分析,差异有统计学意义,P<0.05;5年来肝癌在恶性肿瘤死因顺位中一直居于第2位,仅次于肺癌.各时期随年龄的增长肝癌死亡率随之增加,死亡率有城乡差异,农村标化死亡率为30.98/10万,高于城市的18.69/10万,城乡死亡率比为1:1.66.结论 5年来肝癌总死亡率呈下降趋势,差异有统计学意义,死亡率男性高于女性,农村高于城市,肝癌死因顺位居第2位,其仍是青岛市城乡居民恶性肿瘤死亡的主要原因,男性、农村及高龄人群是当前肿瘤防治工作的重点.     

Trends in cervical cancer mortality in Korea 1993-2002: corrected mortality using national death certification data and national cancer incidence data

Cervical cancer is a major health problem for Korean women, accounting for 9.8% of new female cancer cases, even though incidence rates have been decreasing. The Korean cervical cancer mortality rate for 1993-2002 based on National Statistical Office data shows an increasing trend, but the actual rates are thought to have decreased by epidemiologists, clinicians and other cancer experts. To explain this gap and solve this problem, we corrected the number of cervical cancer deaths by comparing death certificate cases of unspecified uterine cancer data with the national cancer incidence databases of entire cancer registries in Korea. We used 2 different methods to make a correction. First, we considered "uterus, unspecified" deaths previously registered as "cervix, uterine" cases misclassified and added them to the cervical cancer deaths. Alternatively, we multiplied the total number of registered unspecified uterine cancer deaths by age-specific proportions of registered incident cervical cancer cases among all cancers and added the product to cervical cancer deaths. The overall corrected age-standardized cervical cancer mortality rates per 100,000 women decreased from 5.2 in 1993 to 3.9 in 2002 (estimated annual percentage change (EAPC): -4.05%, 95% CI: -4.88, -3.22). While cervical cancer mortality showed a decreasing tendency in women aged 30-69 years, it increased substantially in women aged > or =70 years (EAPC: 3.62%, 95% CI: 1.92-5.35). Results of this study will provide evidence-based foundation for the evaluation of the existing cervical cancer-screening programs.     

广州市2004-2013年原发性肝癌流行现况和趋势分析

目的 原发性肝癌是危害人群健康的常见恶性肿瘤,在我国发病位居所有恶性肿瘤第3位,其发病变化趋势全球不同.本研究通过分析广州市肿瘤登记处数据,了解原发性肝癌流行现况及其变化趋势.方法 根据广州市肿瘤登记处收集的2004-01-01-2013-12-31广州市原发性肝癌的病例资料,计算粗发病率、世界标化率(世标率)和年度变化百分比(annual percentage change,APC),标化率的计算采用Segi's世界标准人口.结果 2004-01-01-2013-12-31广州市居民肝癌新发病例22 135例,男17 875例,女4 260例,男女比为4.20∶1,粗发病率、世标率分别为28.34/10万和21.29/10万,粗发病率和世标率的APC分别为-0.91％(95％CI为-2.80％～1.00％)和-2.97％(95 ％CI为-4.60％～-1.30％);除≥75岁年龄组外其余各组均呈现下降趋势;男女患者肝癌发病均从40岁开始迅速增加,80～84岁达高峰.结论 广州市2004-2013年肝癌发病标化率呈下降趋势,但仍处于高发状态,应加强肝癌的防治研究.     

Misclassification of breast cancer as cause of death in a service screening area

Objective  The aim of this study was to assess the misclassification of cause of death for breast cancer cases, and to evaluate the differential misclassification between cases detected in an organized screening program and cases found in current clinical practice. Methods  All deaths occurring between 1999 and 2002 within breast cancer cases were linked to hospital discharge records. Death certificates and latest available hospital discharge notes were classified into various categories. We created a classification algorithm defining which combinations of categories (of death certificates and hospital discharge notes) suggested the probability of misclassification and the need for an in-depth diagnostic review. Questionable cases were reviewed by a team of experts in order to reach a consensus on cause of death. Based on our algorithmic classification and diagnostic review results, the agreement between original cause of death and that resulting from the assessment process was analyzed stratifying for every variable of interest. Results  According to death certificates, breast cancer was the cause of death in 66.9% of subjects, and after assessment this figure changed to 65.7%. The misclassification rate was 4.3% and did not differ significantly between screen-detected (4.7%) and non-screen-detected (4.3%) cases. Higher misclassification rates in favor of false positivity (cause of death wrongly attributed to breast cancer in death certificates) was observed for subjects with multiple cancers (6.5% vs. 1.9%), with no admission in the year before death (4.6% vs. 2.4%) and with an unknown cancer stage (4.9% vs 2.4% or 2.3%). Conclusions  The cause of death misclassification rate is modest, causing a slight overestimate of deaths attributed to breast cancer, and is not affected by modality of diagnosis. The study confirmed the validity of using cause-specific mortality for service screening evaluation. For the members of the working group, see Appendix     

2012年湖北省乳腺癌发病与死亡情况分析

目的 分析2012年湖北省肿瘤登记点数据,了解湖北省乳腺癌的发病与死亡情况。 方法 根据湖北省7个肿瘤登记点收集的乳腺癌登记资料,按照地区、性别、年龄及肿瘤登记点分层,统计分析2012年湖北省乳腺癌发病率、分布与死亡情况的流行病学特征。 结果 2012年湖北省7个肿瘤登记点共报告1 830例新发乳腺癌病例,其中女性1 809例（98.85%）,占女性恶性肿瘤新发病例的16.75%;乳腺癌死亡443例,其中女性433例（97.74%）,占女性恶性肿瘤死亡病例的8.31%;女性乳腺癌粗发病率为44.81/10万,其中城市地区发病率为62.53/10万,农村地区为27.46/10万;粗死亡率为10.73/10万,城市地区为14.57/10万,农村地区为6.96/10万。女性恶性肿瘤中乳腺癌发病率居第一位,死亡率居第5位。女性乳腺癌年龄别发病率呈60~64岁组和75~79岁组双峰分布;死亡率方面,0~59岁随着年龄增加而升高,59岁以后缓慢下降,74岁以后迅速上升。结论 湖北省肿瘤登记地区乳腺癌发病率与死亡率与同期全国数据之间存在差异,根据这些差异,为政府及相关部门制定乳腺癌防控策略及规划提供可靠的依据。     

Recent trends and future directions for lung cancer mortality in Europe

Lung cancer mortality patterns throughout Europe are very heterogeneous and largely reflect past smoking habits. In order to clarify the changing patterns of lung cancer in Europe we have plotted the overall lung cancer trends among men and women for 20 countries from 1950 up to 1998. Furthermore, using a Bayesian age-period-cohort approach, we have calculated 5 year projections of lung cancer rate up to 2003. Finally, we make some comments on probable future trends by analysing recent trends in adults aged <55 years. Lung cancer mortality rates up to age 75 years portray a general trend of decreasing lung cancer rates among men and increasing lung cancer rates among women. Exceptions to this decrease among men include Hungary where not only are current mortality rates much higher than previously observed in any other country (at 76.7 out of 100,000 in 1998) but they are projected to increase further in the short term. Rates among adults aged <55 years have recently peaked, indicating that overall rates are likely to peak in the next decade. Among women, rapid increases have been observed in Denmark, Netherlands, Hungary, Ireland and UK. Whereas Ireland and UK rates have started to decrease and are projected to continue falling, rates in the other three countries are projected to increase further. Trends in women aged <55 years indicate that rates in Danish women will peak in the next decade, whereas lung cancer rates among Dutch women are likely to continue increasing. Rates in Hungarian women are likely to increase and will surpass the current high rate observed in Denmark.