2008-2018年中国4省重点地区肝癌死亡趋势及去死因期望寿命分析

目的分析2008-2018年中国4省重点地区人群肝癌死亡率变化趋势, 探讨肝癌死亡对期望寿命变化的影响程度, 为评估该地区综合防控效果、促进卫生资源合理配置提供数据支撑。方法基于2008-2018年中国CDC全国死因监测数据库中4省重点地区死因数据, 分析该地区肝癌死亡率、去死因期望寿命(CELE)、去死因期望寿命增长年(PGLEs), 采用Joinpoint 4.9.0.0软件计算平均年度变化百分比(AAPC), 采用Arriaga分解法估计各年龄组肝癌死亡率变化对期望寿命变化的贡献情况。结果 2008-2018年4省重点地区肝癌标化死亡率整体呈下降趋势(AAPC=-4.37%, P<0.001)。肝癌死亡率变化对期望寿命增长起积极作用, 贡献值0.240岁, 贡献度5.62%;其中, 积极作用最大的是45～49岁年龄组(0.041岁, 0.96%), 消极作用最大的是50～54岁年龄组(-0.015岁, -0.35%)。与2008年相比, 2018年4省重点地区人群期望寿命增长4.27岁(AAPC=0.59%, P<0.001), 肝癌CELE增长4.20岁(AAPC=...

Analysis on liver cancer mortality and cause eliminated life expectancy in key areas of 4 provinces, China, 2008-2018

Objective To explore the changes of liver cancer mortality and the effect of liver cancer on life expectancy in key areas of four provinces in China from 2008 to 2018 and provide the basis for the evaluation of comprehensive prevention and control of cancer and promotion of the rational allocation of health resources. Methods Based on the national cause-of-death surveillance in key areas of the 4 provinces from 2008 to 2018, we analyzed the mortality of liver cancer, cause eliminated life expectancy (CELE) and potential gains in life expectancy (PGLEs). Software Joinpoint 4.9.0.0 was used to calculate the average annual percentage change (AAPC). Arriaga''s decomposition method was used to estimate the contribution of the changes of liver cancer mortality in each age group to life expectancy. Results The standardized mortality of liver cancer in key areas of the 4 provinces showed a downward trend from 2008 to 2018 (AAPC=-4.37%, P<0.001). The changes of liver cancer mortality had a positive effect on the increase of life expectancy, with a contribution value of 0.240 years and a contribution degree of 5.62%. The positive effect was greatest in age group 45-49 years (0.041 years, 0.96%), and the negative effect was greatest in age group 50-54 years (-0.015 years, -0.35%). Compared with 2008, the life expectancy increased by 4.27 years (AAPC=0.59%, P<0.001), the liver cancer CELE increased by 4.20 years (AAPC=0.58%, P<0.001), the PGLEs decreased by 0.07 years (AAPC=-0.62%,P<0.001), and life loss rate decreased by 0.13% (AAPC=-1.18%, P=0.001). The liver cancer PGLEs increased in Yongqiao district, Anhui province (0.09 years), and decreased in other districts (counties), with the largest decline was in Fugou county, Henan province (-0.21 years). Conclusions From 2008 to 2018, the standardized mortality rate of liver cancer in key areas of the 4 provinces decreased gradually, contributing to the growth of life expectancy. The life loss caused by liver cancer decreased gradually, but the PGLEs varied with districts (counties).