2001—2020年贵州省黔南州居民胰腺癌流行特征及变化趋势分析

目的 分析黔南州居民2001—2020年胰腺癌发病和死亡情况流行特征及其变化趋势,为胰腺癌的防治提供依据。 方法 利用黔南州肿瘤登记报告系统和居民全死因登记报告系统中2001—2020年居民胰腺癌发病和死亡登记资料,分别计算发病率和死亡率。采用2010年中国第6次人口普查标准人口构成计算胰腺癌中标发病率和中标死亡率,发病率和死亡率随年龄变化趋势采用趋势χ²检验。不同性别、城乡居民中标发病率和死亡率比较采用双样本Poisson率检验,采用年度变化百分比分析胰腺癌中标发病率和中标死亡率变化的时间趋势。结果 2001—2020年黔南州居民胰腺癌新发病例4 217例,发病率5.04/10万(男性6.23/10万,女性3.69/10万),男性发病率高于女性。中标发病率3.94/10万,20年间中标发病率APC=-4.3%(城镇APC=-6.9%,t=-2.112,P=0.100; 农村APC=-9.2%,t=-3.613,P=0.030),农村发病率降低变化趋势明显。城镇和农村发病率均在55岁后迅速上升,85岁以后达到高峰(99.11/10万),发病率随年龄增长呈上升趋势(χ²_趋势=1 607.499,P<0.001),城镇发病率(8.83/10万)高于农村(3.31/10万); 2001—2020年黔南州居民胰腺癌死亡3 962例,死亡率4.72/10万(男性5.90/10万,女性3.42/10万),男性死亡率高于女性。中标死亡率3.72/10万。20年间中标死亡率APC=-3.7%(城镇APC=-2.4%,t=-0.914,P=0.100; 农村APC=-7.7%,t=-1.313,P=0.300)。城镇和农村死亡率均在60岁后迅速上升,85岁以后达到高峰(94.59/10万),死亡率随年龄增长而增加呈上升趋势(χ²_趋势=1 658.436,P<0.001),城镇死亡率(8.07/10万)高于农村(3.21 /10万)。结论 2001—2020年黔南州胰腺癌发病和死亡虽然呈现平稳趋势,但农村发病率降低变化趋势明显,总体死亡率高于全国平均水平,城镇发病率和死亡率高于农村,老年人群和男性是防控的重点人群。

Trends of incidence and mortality of pancreatic cancer in Qiannan of Guizhou, 2001-2020

Objective To analyze the epidemiological characteristics and changing trends of incidence and mortality of pancreatic cancer of Qiannan from 2001 to 2020, so as to provide the evidence for enacting prevention and treatment measures of pancreatic cancer. Methods The pancreatic cancer data from the malignant tumor registration and registration system for all death causes of residents in Qiannan of Guizhou Province were collected. The incidence and mortality were calculated. Standardized incidence/mortality rates were calculated based on Chinese standard population(ASR China). The trend of incidence(mortality)with age was analyzed by trend χ² test. Comparison of incidence(mortality)rates between urban and rural residents of different sexes were analyzed by double-sample Poisson test. The annual percentage change(APC)was used to analyze the time trend of the incidence and mortality by Chinese standard population of pancreatic cancer. Results From 2001 to 2020, there were 4 217 new cases of pancreatic cancer in Qiannan of Guizhou Province. The incidence was 5.04/10⁵(6.23/10⁵ in male, 3.69 /10⁵ in female), and the incidence rate was higher in men than in women. The age-standardized incidence rate by Chinese standard population was 3.94/10⁵. The standardized rate of APC was -4.3%(APC=-6.9%, t=-2.112, P=0.100 in urban. APC=-9.2%, t=-3.613, P=0.030 in rural). The decreasing trend of incidence rate in rural areas was obvious. The incidence of pancreatic cancer in urban and rural increased rapidly after the age of 55 years old. The peak age ranged from over 85 years old(99.11/10⁵). The incidence rate increased with age growing(χ²_trend=1 607.499, P<0.001), and the incidence rate was higher in urban(8.83/10⁵)than in rural(3.31/10⁵). In the same period, there were 3 962 deaths. The mortality was 4.72/10⁵(5.90/10⁵ in male, 3.42 /10⁵ in female), which was higher in men than in women. The standardized rate of APC was -3.7%(APC=-2.4%, t=-0.914, P=0.100 in urban. APC=-7.7%, t=-1.313, P=0.300 in rural). The mortality of pancreatic cancer in urban and rural increased rapidly after the age of 60 years old. The peak age ranged from over 85 years old(94.59/10⁵). The mortality increased with age growing(χ²_trend=1 658.436, P<0.001), which was higher in urban(8.07/10⁵)than in rural(3.21/10⁵). Conclusion From 2001 to 2020, the incidence and mortality of pancreatic cancer in Qiannan of Guizhou Province show a stable trend, but the reducing tendency of rural incidence rate is obvious, and the overall mortality is higher than the national average. The rural incidence rate and mortality are higher in urban areas than those in rural areas. Among them, middle-aged and elderly men are the key population for the prevention and control of pancreatic cancer.