金昌队列人群随访十年主要慢性病死亡率与早死概率变化趋势

目的  分析金昌队列人群2011-2020年四种主要慢性病的死亡率、早死概率及变化趋势，锁定影响人群健康的核心病种，为人群慢性病防治提供基础数据。方法  以金昌队列为平台，纳入基线全部人群48 001人，连续10年追踪随访其结局，应用简略寿命表法与joinpoint回归法计算死因构成比、粗死亡率、标化死亡率、早死概率及年度变化百分比(annual percent change, APC)等指标。结果  2011-2020年金昌队列人群4类主要慢性病平均死亡构成比为80.26%，4类主要慢性病粗死亡率呈上升趋势(APC=6.48%)，心脑血管疾病粗死亡率呈上升趋势(APC=10.02%)，其他三类疾病粗死亡率与标化死亡率均无变化趋势。除女性心脑血管疾病早死概率呈上升趋势外(APC=12.92%)，其他主要慢性病早死概率均无变化趋势。男性主要慢性病死亡率及早死概率高于女性。主要慢性病不同病种平均死亡率前3位为肺癌、脑卒中、冠心病。结论  4类主要慢性病是导致金昌队列人群死亡的主要疾病，肺癌、脑卒中为核心病种。男性为慢性病防治的重点人群，同时还应重点关注女性心脑血管疾病的防治，降低慢性病早死概率。

Mortality and premature mortality in trends of variance in major chronic diseases in Jinchang Cohort during ten-year follow-up

  Objective  To identify the core diseases which affect population health, and to provide basic data for public prevention and treatment of chronic diseases through analyzing mortality rate, probability of premature mortality, and trends in chronic diseases from 2011 to 2020.  Methods  A total of 48 001 participants from the baseline in the Jinchang cohort were included in this study. Follow-up lasted for ten years to gain the outcome. Leading indicators for chronic diseases like proportionate mortality rate, crude mortality rate, age-standardized mortality rate, probability of premature death, and annual percent change (APC) were calculated using the abbreviated life table method and joinpoint regression model.  Results  The average proportionate mortality rate of major chronic diseases in the Jinchang cohort was 80.26%. The crude mortality rate of the four major chronic diseases showed an upward trend (APC=6.48%) during the observation period. The crude mortality rate of cardiovascular and cerebrovascular diseases was also on the rise (APC=10.02%). Except for women with cardiovascular and cerebrovascular diseases whose probability of premature mortality increased (APC=12.92%), probability of premature mortality in other major chronic diseases remained unchanged. The mortality rate and probability of premature mortality of major chronic diseases in men was higher than that in women. The top three average mortality rates of different major chronic diseases were lung cancer, stroke, and coronary heart disease.  Conclusions  The four major chronic diseases were the main causes of death in the Jinchang cohort, with lung cancer and stroke as the core diseases. Public prevention and treatment of chronic diseases need to focus more on males. Additionally, females are at a higher risk of cardiovascular and cerebrovascular diseases, which requires early prevention to reduce premature mortality from chronic diseases.