中国居民1987—2015年鼻咽癌死亡趋势

目的：分析中国居民1987—2015年鼻咽癌死亡的时间变化趋势。方法：利用Joinpoint模型估算各人群(城市男性、城市女性、农村男性、农村女性)及各年龄组鼻咽癌死亡率的时间变化趋势，采用负二项回归模型分析鼻咽癌死亡在人群水平上的危险因素。结果：中国居民鼻咽癌年龄标化死亡率呈下降趋势，城市女性、农村女性、城市男性、农村男性中标死亡率平均年度变化百分比(AAPC)分别为–2.97%，–2.60%，–2.01%，–1.68%(P<0.05)；城市居民在85岁以上死亡率无明显下降趋势，男性AAPC为–1.54%，女性AAPC为–0.60%(P>0.05)；65岁以上农村男性截缩率无明显下降趋势(AAPC=–0.56%，P>0.05)，农村女性在85岁以上死亡率无明显下降趋势(AAPC=1.17%，P>0.05)；城市居民鼻咽癌的死亡风险是农村居民的1.11倍(P<0.01)，男性是女性的2.34倍(P<0.01)，每增加5岁死亡风险平均增大23%(OR=1.23，P<0.01)，1987—2015年每过1年死亡风险平均减少2%(OR=0.98，P<0.01)。结论：中国居民鼻咽癌死亡率变化呈下降趋势，并且存在明显的性别、年龄差异；中国居民在85岁以上鼻咽癌死亡率无明显下降趋势。

Mortality trend in nasopharynx cancer in Chinese resident from 1987 to 2015

Objective: To analyze epidemical features, distribution and time trend for nasopharynx cancerdeaths in China from 1987 to 2015.Methods: Negative binomial regression model was used to explore population-level risk factors fornasopharynx cancer deaths and a joinpoint regression model was used to estimate annual changesin nasopharynx cancer mortality in various populations.Results: A falling trend in age-standardized nasopharynx cancer mortality rates was observedamong Chinese residents with the average annual percent change (AAPC) at –2.97% among urbanfemale residents and –2.60% among rural female residents (P<0.05), –2.01% among urban maleresidents, and –1.68% among rural male residents (P<0.05), respectively. It decreased yearly forurban male aged over 85 years with AAPC at –1.54% and the age-specific mortality rates decreasedyearly for the urban female aged over 85 years with AAPC at –0.60%, the age-specific mortalityrates decreased yearly for rural male residents aged more than 65 years with AAPC at –0.56% andfor rural female residents aged more than 85 with AAPC at 1.17%, with no significant difference(P<0.05). The nasopharynx cancer deaths risks were higher in urban residents than those in ruralresidents (OR=1.11, P<0.01), and they were also higher in male residents than those in femaleresidents (OR=2.34, P<0.01). A 5-year increment in age was associated with a 23% increase innasopharynx cancer mortality (OR=1.23, P<0.01) and a one year increment in calendar year wasrelated to a 2% decrease in mortality (OR=0.98, P<0.01).Conclusion: There was a significant gender and age difference in a decreased trend of nasopharynxcancer mortality among Chinese residents in a long period; no increased trend was observed in theoverall populations over 85 years old.