2005—2015年中国0~14岁儿童恶性肿瘤流行特征研究

背景恶性肿瘤已经成为我国儿童主要死亡原因之一，给社会及家庭带来极大经济负担。因此掌握儿童恶性肿瘤的流行规模和趋势具有重要意义。目的分析2005—2015年中国0~14岁儿童恶性肿瘤的流行病学特征，为我国儿童恶性肿瘤防控战略的制订和卫生资源的合理分配提供参考。方法收集2008—2018年"中国肿瘤登记年报"中0~14岁儿童恶性肿瘤的发病和死亡等数据，利用2010年全国人口构成计算标化发病率、死亡率，并通过Joinpoint模型计算年度变化百分比（annual change percentage，APC）来反映时间趋势。结果（1）2005—2015年中国0~14岁儿童恶性肿瘤的中位粗发病率为9.35/10万，中位粗死亡率为3.91/10万，其中0~4岁组中位粗发病率、死亡率均高于5~9岁组和10~14岁组（P<0.05）。（2）2005—2015年中国0~14岁男童中位粗发病率和死亡率均高于女童（发病率：10.21/10万vs 8.91/10万，P<0.05；死亡率：4.18/10万vs 3.47/10万，P<0.05）。（3）2005—2015年中国0~14岁城市儿童恶性肿瘤中位粗发病率和死亡率均高于农村儿童（发病率：10.87/10万vs 7.20/10万，P<0.05；死亡率：4.08/10万vs 3.54/10万，P<0.05）。（4）2005—2015年中国0~14岁儿童恶性肿瘤的中位粗死亡率呈上升趋势（APC=1.01%，P<0.05），其中0~4岁组中位粗死亡率随时间呈下降趋势（APC=-1.19%，P<0.05）；5~9岁组中位粗死亡率随时间呈上升趋势（APC=2.50%，P<0.05）；10~14岁组中位粗死亡率为随时间呈稳定状态（APC=0.64%，P>0.05）。（5）2005—2015年中国农村0~14岁儿童恶性肿瘤的发病率与死亡率均呈上升趋势（APC分别为7.73%和2.22%，P<0.05）。（6）2005—2015年中国0~14岁儿童恶性肿瘤发病与死亡前六位分别为白血病、脑癌、淋巴癌、骨癌、肾癌、肝癌。结论中国儿童恶性肿瘤发病和死亡在时间、人群、地区方面呈现出特定的分布特点，今后应将农村地区、5~9岁年龄组以及脑癌、白血病癌种的儿童作为重点防控对象。该文的微信推文请扫描下方二维码查看！

Characteristics of Cancer Epidemiology among 0-14 years old Chinese Children,2005-2015

Background Cancer has become a leading cause of death for Chinese children,imposing a great economic burden on society and families.Therefore,it is extremely important to understand the epidemicsizes and trends of childhood malignancies.Objective To analyze the epidemiological characteristics of childhood cancer in China from 2005 to 2015,so as to provide evidence for the formulation of prevention and control strategies and rational allocation of health resources concerning childhood cancer in China.Methods Data regarding cancer incidence and mortality in Chinese 0-14 years old children during 2008 to 2018 were collected from the Chinese Cancer Registry Annual Report.Age-standardized incidence and mortality rates were computed by dividing the number of child deaths caused by cancer by the fifth national population census(2010)and multiplying by 100000.Joinpoint Regression Program was used to compute the annual percentage change(APC)to analyze the temporal trends of annual child cancer incidence and mortality rates.Results(1)During the period of 2005 to 2015,the median crude incidence rate and median crude mortality rate of cancer in 0-14 years old were 9.35/100000,and 3.91/100000,respectively.The median crude incidence and median crude mortality rate of 0-4 years old group were higher than those of 5-9 years old group and 10-14 years old group(P<0.05).(2)The median crude incidence rate(10.21/100000 vs 8.91/100000)and median crude mortality rate(4.18/100000 vs 3.47/100000)of cancer in male children aged 0-14 years old were higher than those of female children of the same age(P<0.05).(3)The median crude incidence rate(10.87/100000 vs 7.20/100000)and median crude mortalityrate(4.08/100000 vs 3.54/100000)of cancer in urban children aged 0-14 years old were higher than those of rural children of the same age(P<0.05).(4)The median crude mortality rate of cancer showed an upward trend in 0-14 years old in the period of 2005 to 2015(APC=1.01%,P<0.05);amomg them,the median crude mortality rate in the 0-4 years old group showed an decreased trend(APC=-1.19%,P<0.05);the median crude mortality rate in the 5-9 years old group showed an increased trend(APC=2.50%,P<0.05);the median crude mortality rate in the 10-14 years old group was stable over time.(5)The median crude incidence rate and median crude mortality rate of cancer in rural 0-14 years old in rural areas presented an upward trend over the period 2005 to 2015(APC=7.73%,2.22%,P<0.05).(6)The top six cancers among children aged 0-14 years old in this period were:leukemia,brain cancer,lymphoma,bone cancer,kidney cancer and liver cancer.Conclusion The cancer incidence and mortality rate in Chinese 0-14 years old children showed different features by time,age group or geographical region(rural or urban).Priorities for containing cancer should be given to rural children,5-9 years old children or children with brain cancer or leukemia.