广东省居民恶性肿瘤死亡趋势分析

目的了解广东省居民恶性肿瘤死亡水平及变化趋势。方法对广东省1970-1972、1990-1992以及2004-005年3次死因调查的恶性肿瘤死亡个案数据进行描述性流行病学分析，主要统计指标有死亡率、标化死亡率、死因构成及顺位。结果广东省1970-1972、1990—1992以及2004—2005年3次死因调查恶性肿瘤粗死亡率分别为52．23／10万、111．49／10万和135．93／10万，中标率分别为53．27／10万、95．70／10万和94．50／10万。3次调查恶性肿瘤在全省全死因顺位分别排第3位、第2位、第1位。3次调查恶性肿瘤前5位死因分别是1970-1972年为肝癌、食管癌、鼻咽癌、胃癌和肺癌，1990-1992年为肝癌、食管癌、肺癌、胃癌和鼻咽癌，2004-2005年为肝癌、肺癌、胃癌、食管癌和结直肠癌。在3次调查中，肝癌一直居第1位（3次调查粗死亡率分别是11．03／10万、23．22／10万和37．02／10万，中标率分别是11．17／10万、20．57／10万和26．95／10万）；肺癌、胃癌、结直肠癌位次逐渐前移，鼻咽癌位次逐渐后移。肝癌、肺癌、结直肠癌及女性乳腺癌死亡率呈逐渐上升趋势，宫颈癌呈下降趋势，鼻咽癌粗死亡率呈上升趋势，但标化率则呈下降趋势。死亡率差别分解法结果显示第2次调查恶性肿瘤死亡率较第1次升高有79．25％是由其他危险因素引起，20．75％是由人口老化引起的，第3次调查与第2次调查相比则98．61％是由人口老化引起的。结论广东省居民恶性肿瘤死亡率从绝对性上升趋势转变为相对上升趋势，需根据不同癌种变化趋势以及死亡模式变化采取针对性措施。

Mortality trend of cancer among residents in Guangdong Province

Objective To understand the mortality trend of cancer in Guangdong province. Methods To analyze the three retrospective review data （from 1970 to 1972,from 1990 to 1992, and from 2004 to 2005 ） of Guangdong Province with SPSSI0. 0 and Excel. Results In the 1970-1972,1990-1992 and 2004-2005 surveys, the cancer crude death rates were 52.23/100 000, 111.49/100 000, and 135.93/100 000, respectively. The standardized mortalities were 53.27/100 000,95.70/100 000, and 94. 50/100 000, respectively. The cancer ranked the 3rd, 2od, and 1 st in all cause of death in the whole province followed in the three periods, respectively. The top five causes of death about malignant neoplasms were liver cancer, esophagus cancer, nasopharygeal cancer, gastric cancer, and lung cancer in 1970-1972, liver cancer, esophagus cancer, lung cancer, gastric cancer, and nasopharyngeal cancer in 1990-1992, and liver cancer, lung cancer, gastric cancer, esophagus cancer, and eolorectal cancer in 2004-2005, respectively. Liver cancer was the first death cause of all cancers constantly in the three time surveys （the crude death rate were 11.03/100 000, 23.22/100 000, and 37.02/100 000, respectively; the standardized mortalities were 11.17/100 000, 20. 57/100 000, and 26. 95/100 000, respectively）. Death cause ranking of lung cancer, gastric cancer, and colorectal cancer were advancing gradually, while the nasopharyngeal carcinoma was moving backward. The mortalities of liver cancer, lung cancer and colorectal cancer were increased in the past thirty years, the cervical cancer was decreased. The crude death rate of nasopharyngeal cancer was increased, but the standardized mortality was decreased. The difference decomposition of death rates showed that other risk factor accounted for 79.25% of the reasons of the in- crease of the mortality in 1990-1992 compared to 1970-1972, population aging accounting for 20. 75%. Population aging accounted for 98.61% for the increase in 2004-2005 compared to 1990-1992. Conclusion The cancer mortality trends have turned to relative increase from absolute increase in Guangdong residents. The corresponding measures should be taken according to the death trend and death model of different cancers.