基于年龄-时期-队列模型的中国膀胱癌发病死亡趋势分析

目的 分析1990一2019年中国膀胱癌发病死亡情况及长期变化趋势。方法 利用全球疾病负担（Global Burden of Disease，GBD）数据库，分析1990一2019年中国膀胱癌发病和死亡情况，应用 Joinpoint 软件分析发病率和死亡率的时间变化趋势，计算年度变化百分比和平均年度变化百分比。构建年龄-时期-队列模型，分析年龄、时期和出生队列对膀胱癌发病及死亡趋势变化的影响。结果 2019年膀胱癌发病率、标化发病率分别为7.03/10万和5.16/10万，2019年膀胱癌死亡率、标化死亡率分别为2.82/10万和2.24/10万。1990一2019年中国膀胱癌标化发病率有升高趋势，平均年度变化百分比为1.5%，标化死亡率有降低趋势，平均年度变化百分比为-0.5%。 年龄-时期-队列模型结果显示，发病与死亡的净漂移值分别为1.96%和-1.21%。 发病与死亡风险随年龄的增加而增高，发病的风险随时期的增加而升高，死亡的风险随时期的增加而降低。队列效应亦表现不同，出生越晚的人群发病风险高，死亡风险低。结论 1990一2019 年中国膀胱癌标化发病率呈上升趋势，发病和死亡风险随年龄升高而升高，并且近年代出生人群发病风险升高，提示近年代出生的老年人群应作为膀胱癌防治工作的重点人群。

Incidence and mortality trends of bladder cancer in China based on age-period-cohort model

Objective To analyze the incidence and long-term trend of bladder cancer in China in 1990-2019 years. Methods The Global Burden of Disease (GBD) database was used to analyze the incidence and mortality of bladder cancer in China over the past 1990-2019 years. The time trend of incidence rate and mortality rate were analyzed by Joinpoint software, and the percentage of annual change and the percentage of annual average change were calculated. An age period cohort model was constructed to analyze the impact of age, period and birth cohort on the incidence and mortality trends of bladder cancer. Results The incidence rate and standardized incidence rate of bladder cancer in 2019 were 7.03/10⁵ and 5.16/10⁵, and the mortality rate and standardized mortality rate of bladder cancer were 2.82/10⁵ and 2.24/10⁵. In China, standard incidence rate of bladder cancer increased in 1990-2019 years, the average annual percentage change was 1.5%, standardized mortality rate decreased, and the average annual percentage change was -0.5%. The results of age period cohort model showed that the net drift values of morbidity and mortality were 1.96% and -1.21% respectively. The risk of morbidity and mortality increased with the increase of age, the risk of morbidity increased with the increase of period, and the risk of death decreased with the increase of period. The cohort effect was also different. The later the birth, the higher the risk of morbidity and the lower the risk of death. Conclusion The incidence of standardized incidence of bladder cancer in China increases from 1990 to 2019. The risk of morbidity and mortality increase with age. The incidence rate of birth risk has increased in recent years, suggesting that the elderly population born in the near future should be the focus of prevention and treatment of bladder cancer.