基于Joinpoint回归和年龄-时期-队列模型分析中国皮肤癌的长期发病趋势

  目的  分析中国皮肤癌的发病趋势并分别估计其年龄、时期、队列效应。  方法  从2019年全球疾病负担研究中估计中国皮肤癌发病率的变化趋势。采用Joinpoint回归分析模型分析年度变化百分比和平均年度变化百分比(average annual percentage change, AAPC)；利用年龄-时期-队列模型评估年龄、时期和出生队列效应对皮肤癌发病率的影响。  结果  1990―2019年中国皮肤癌男性和女性年龄标准化发病率均上升。Joinpoint回归分析模型分析显示皮肤恶性黑色素瘤男性AAPC为2.8%(95% CI: 2.6~3.0)，女性AAPC为3.0%(95% CI: 2.8~3.2)；基底细胞癌男性AAPC为4.2%(95% CI: 3.9~4.4)，女性AAPC为4.0%(95% CI: 3.7~4.3)；鳞状细胞癌男性AAPC为3.7%(95% CI: 3.5~3.9)，女性AAPC为2.9%(95% CI: 2.7~3.0)。此外，年龄-时期-队列模型表明无论男女，皮肤癌的发病风险均随年龄增长和年份推移而增加，且较晚出生的队列的发病风险均低于之前出生的队列。  结论  1990―2019年中国皮肤癌的发病率呈上升趋势，年龄越大、出生越早且生活在当代的人其发病风险更高。应重视皮肤癌的防治工作。

Analysis of secular trends in incidence of skin cancer in China based on Joinpoint regression and age-period-cohort model

  Objective  To analyze the incidence trends of skin cancer in China and to estimate age, period, and cohort effects.  Methods  We assessed incidence trends of skin cancer in China based on the Global Burden of Disease, Injuries, and Risk Factors Study 2019. Joinpoint regression analysis was used to calculate the annual percentage change and average annual percentage change (AAPC). Age-period-cohort model was used to explore the age effect, period effect, and cohort effect of skin cancer.  Results  Age-standardized incidence rate of skin cancer among males and females increased significantly in China from 1990 to 2019. Joinpoint regression indicated that AAPC of malignant skin melanoma in males was 2.8% (95% CI: 2.6-3.0) and in females was 3.0% (95% CI: 2.8-3.2); AAPC of basal cell carcinoma in males was 4.2% (95% CI: 3.9-4.4) and in females was 4.0% (95% CI: 3.7-4.3); AAPC of squamous cell carcinoma in males was 3.7% (95% CI: 3.5-3.9) and in females was 2.9% (95% CI: 2.7-3.0). For both males and females, the relative risk of skin cancer incidence increased with advancing age and time period, but decreased from earlier birth cohorts to more recent birth cohorts.  Conclusions  The incidence of skin cancer shows an increasing trend from 1990 to 2019. People who born earlier, being older, and living in modern times have a higher risk of skin cancer incidence. Control and treatment of skin cancer should be paid attention to.