中国20世纪70年代与90年代子宫颈癌死亡率及其变化趋势

目的 描述我国20世纪70年代与90年代子宫颈癌死亡率的分布情况,为新世纪我国对子宫颈癌的预防与控制策略提供科学依据。方法 资料来源于中国70年代及90年代两次全国死因调查结果。计算经年龄地区调整后的子宫颈癌死亡粗率及调整率。基于年龄调整率比较两个年代的子宫颈癌的变化及趋势。结果 在20年中,子宫颈癌的死亡率由70年代的10.7／10万下降至90年代的3．89／10万,下降了63．64％,构成比由15．19％下降为4．86％,在恶性肿瘤中所占的位次自70年代的第3位降至90年代的第6位。但是,下降趋势不均匀,仍然有一些高危地区(大多分布在我国中西部农村地区)子宫颈癌的死亡率下降不明显或保持不变,有些地区,如甘肃武都及山西阳城甚至达到世界最高水平。尽管城乡两地均呈现出显著的下降趋势(P=0．001),但城乡之间仍存在较大的差异。90年代的资料显示在城市年轻的妇女中子宫颈癌有较陡的上升趋势。结论我国子宫颈癌在20年中呈现明显的下降趋势,但它仍然是困扰我国广大妇女,尤其是农村妇女的主要健康问题。新世纪我国预防与控制子宫颈癌的重点应放在中西部农村地区及城市中的年轻妇女。

Changes of mortality rate for cervical cancer during 1970's and 1990's periods in China

To describe the distribution changes of the mortality rate for cervical cancer in China between the1970' s and1990' s and provide the scientific evidence for the prevention and control strategies for cervical cancer campaign in China between next century.Methods Data from two National Surveys for the Causes of Death in1970' s and1990' s in China.The crude and adjusted mortality rates for the cervical cancer and the distributions based on age and area were calculated and described.The comparison of the differences of changes between two mortality rates periods and together with its trends were shown based on the age-standardized.Results During two decades,the mortality rate for cervical cancer was10.7per100000in1970's which declined to3.89per100000in1990' s,and from the3r d ranking among all female malignant tumors to the6th in1990' s (decreased about 63.64%).But the declination was not evenly.There have still been some high-risk areas,most located in rural countries in the mid-west of China,with rates remain unchanged and even at the highest level in the world,such as Wudu in Gansu and Yangcheng in Shanxi.A big difference was showed between rural country and city,but in both of them,the mortality rates in1990' s were significantly much lower than in1970' s(P=0.001)at each five-year age group.And in the city,there was a much sharper increased trend in young women in1990' s.Conclusions The mortality rate for cervical cancer campaign in China has been substantially declined during past twenty years,but it' s still a major health problem for women,especially in rural China.The focus of the prevention and control for the cervical cancer in the next century should put on rural areas,especially in mid-west of China and young women in the city.