1992-2017年中国男性前列腺癌的死亡率趋势:APC模型分析

目的探讨1992—2017年中国男性前列腺癌死亡率的流行变化趋势。方法利用美国华盛顿大学健康测量与评价研究中心的死因数据,采用年龄-时期-队列(APC)模型和Intrinsic Estimator(IE)算法估计中国男性前列腺癌死亡风险的年龄效应、时期效应和队列效应。结果1992—2017年,中国男性前列腺癌死亡率整体呈上升趋势,粗死亡率(1/100000)从3.39上升到7.17。APC模型结果显示,中国男性在40岁以后,前列腺癌死亡风险的年龄效应随年龄增加而增大;时期效应总体呈上升趋势;队列效应说明自1908年以后出生的男性所经历的前列腺癌死亡风险呈下降趋势。结论中国男性前列腺癌死亡风险的时期效应占主导地位。生活方式以及性观念的改变、人口老龄化、吸烟、环境污染等因素可能是造成时期效应增加的主要原因,在前列腺癌防治工作中应重视这些方面的改善,同时加强PSA筛查的认知率与健康教育的综合预防,有助于从整体上降低男性前列腺癌的死亡率。

Trends in prostate cancer mortality in Chinese men from 1992 to 2017:an APC model analysis

Objective To explore the prevalence trend of male prostate cancer mortality in China from 1992 to 2017.Methods The age-period-cohort(APC)model and the Intrinsic Estimator(IE)algorithm were used to estimate the age effect,period effect and cohort effect of prostate cancer mortality risk in Chinese men.Results The overall mortality rate of prostate cancer in Chinese men was on the rise from 1992 to 2017,with the crude mortality rate per 100,000 male rising from 3.39‰to 7.17‰.The results of the APC model analysis showed that the age effect of prostate cancer mortality increased with age in Chinese men after the age of 40.The period effect was generally on the rise.The cohort effect indicated that men born in China after 1980 experienced a declining risk of prostate cancer death.Conclusions The period effect of prostate cancer mortality risk was dominant in Chinese men.Changes in lifestyle and sexual attitudes,population aging,smoking,environmental pollution and other factors may be the main reasons for the increase in the period effect.The attention should be paid to improve these aspects in the prevention and treatment of prostate cancer,and at the same time the awareness rate of PSA screening should be strengthened.Comprehensive prevention with health education can help reduce overall prostate cancer mortality in men.