2002-2014年中国恶性肿瘤死亡城乡差异分析

目的 了解我国2002-2014年城乡恶性肿瘤死亡率变化趋势及二者之间的差异,为科学防控恶性肿瘤提供依据。 方法 数据来源于国家卫生和计划生育委员会出版的《中国卫生统计年鉴》(2002-2014年)居民病伤死亡原因数据,使用Excel 2007,SPSS 23.0及美国国立癌症研究院研制的JoinPoint 4.2趋势分析软件,采用世界卫生组织(WHO 2000-2025)世界标准人口构成对死亡率数据进行标化。 结果 城市居民恶性肿瘤中,尤以肺癌死亡率居高,2014年城市肺癌标化死亡率为38.21/10万,农村居民2002-2009年肺癌死亡率逐步上升,尤其在2003年呈现大幅度的增加,标化死亡率为41.67/10万,随后逐渐平稳; 2002-2014年城乡居民肝癌死亡率均呈现下降趋势;农村胃癌、食道癌死亡率明显高于城市;城市结直肠癌、膀胱癌、乳腺癌死亡率高于农村;宫颈癌死亡率城乡长期变化趋势一致,近年均有增高的势头。 结论 2002-2014年中国城乡居民恶性肿瘤死亡率的分布存在明显的差别。城乡肺癌死亡率均居榜首;农村地区肝癌、胃癌、食道癌死亡相对突出,城市地区结直肠癌、膀胱癌死亡率相对突出;城市乳腺癌死亡率仍居高不下,近年来城乡宫颈癌死亡率逐步升高。预防仍是肿瘤工作的重点,城乡应结合流行特点,有的放矢地制定预防策略。

Urban-rural differences in mortalities of malignant tumors in China, 2002-2014

Objective To investigate the changing trend of mortalities of malignant tumors in rural and urban areas of China and their differences from 2002 to 2014, and to provide evidence for their scientific prevention and control. Methods Data were retrieved from death cause data of illness and injury in China Health Statistics Yearbook (2002-2014) published by National Health and Family Planning Commission. The data were analyzed by Excel 2007, SPSS 23.0 and JoinPoint 4.2 and standardized based on world standard population (WHO 2000-2025). Results For the malignant tumors in urban residents, lung cancer had the highest mortality, with the standardized mortality of 38.21/100,000 in 2014. The mortality of lung cancer in rural residents increased progressively in 2002-2009, showed a significant increase and reached a standardized mortality of 41.67/100,000 in 2003, and then gradually tended to be stable. The mortalities of liver cancer in urban and rural residents in 2002-2014 presented a downward tendency. The mortalities of stomach cancer and esophagus cancer were both higher in rural residents than in urban ones, while the mortalities of colorectal cancer, urinary bladder cancer and breast cancer were all lower in rural residents than in urban ones. The long-term changing trends of cervical cancer mortality were similar in rural and urban areas, and both showed an increasing tendency. Conclusions The mortalities of malignant tumors in rural and urban residents in China in 2002-2014 were significantly different. Lung cancer had the highest mortalities both in rural and urban areas. The mortalities of liver cancer, stomach cancer and esophagus cancer were higher in rural residents, while the mortalities of colorectal cancer and urinary bladder cancer were higher in urban residents. The mortality of breast cancer in urban residents remained at a high level, and the mortality of cervical cancer increased progressively. Prevention is still the emphasis of work concerning tumors, and targeted prevention strategies should be developed according to the epidemiological characteristics of tumors in rural and urban areas.