2010－2021年北京市海淀区恶性肿瘤死亡特征及变化趋势分析

孙亚敏; 宋伟; 周海曦; 霍秀芳; 苏健婷; 韦再华

doi:10.3784/jbjc.202301190038

2010－2021年北京市海淀区恶性肿瘤死亡特征及变化趋势分析

doi: 10.3784/jbjc.202301190038

1.
北京市海淀区疾病预防控制中心, 北京 100094
2.
北京市疾病预防控制中心, 北京 100013

基金项目: 首都卫生发展科研专项（No. 2018–1–1011）

详细信息

作者简介:
孙亚敏，女，安徽省涡阳市人，硕士，副主任医师，主要从事传染病控制、信息统计工作，Email：xiamisun@yeah.net

通讯作者:
苏健婷，Tel：010−64407070，Email：sujt@bjcdc.org

中图分类号: R211；R730
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出版历程
- 收稿日期: 2023-01-19
- 网络出版日期: 2023-06-29
- 刊出日期: 2023-11-07

Mortality and trend of malignant tumors in Haidian district, Beijing, 2010−2021

1.
Haidian District Center for Disease Control and Prevention, Beijing 100094, China
2.
Beijing Municipal Center for Disease Control and Prevention, Beijing 100013, China

Funds: This study was supported by the fund for the Special Project of Capital Health Research and Development (No. 2018–1–1011)

More Information

Corresponding author: Su Jianting, Email: sujt@bjcdc.org

摘要

摘要: 目的分析2010—2021年北京市海淀区户籍人口恶性肿瘤死亡特征及变化趋势，为恶性肿瘤防控提供参考依据。方法收集2010—2021年海淀区户籍人口恶性肿瘤死亡资料，计算构成比、死亡粗率及标化率、早死寿命损失（YLL）率及其标化率，应用Joinpoint回归模型估计平均年度变化趋势。结果 2010—2021年海淀区户籍人口恶性肿瘤居全死因首位，全死因占比30.23%，年均粗死亡率142.47/10万，标化死亡率93.32/10万；粗死亡率男性高于女性，差异有统计学意义（t=11.18，P<0.05)，各年份标化死亡率男性均高于女性；相比2010年，2021年恶性肿瘤死因构成降至26.77%（降幅−15.37%），总人群、男性、女性粗死亡率呈逐年上升趋势［平均年度变化百分比（AAPC）分别为1.62%、1.82%、1.42%，均P<0.01］，标化死亡率呈逐年下降趋势（AAPC分别为−1.50%、−1.13%、−1.85%，均P<0.01）。前10位死因以肺癌和消化道恶性肿瘤为主，前6位死因顺位基本无变化，依次为肺癌、结直肠癌、肝癌、胃癌、胰腺癌、乳腺癌；膀胱癌、乳腺癌、结直肠癌粗死亡率上升趋势显著（AAPC分别为4.56%、3.81%、3.80%，均P<0.001），肝癌呈逐年下降趋势（AAPC=−1.24%，P<0.05）。 YLL逐年增长，YLL率变化无统计学意义（AAPC=0.30%，P>0.05），标化YLL率呈逐年下降趋势（AAPC=−2.10%，P<0.05）；结直肠癌、胰腺癌、膀胱癌、乳腺癌YLL率呈逐年上升趋势（AAPC分别为2.90%、2.60%、3.40%、1.90%，P<0.05），肝癌、胃癌呈逐年下降趋势（AAPC分别为−2.70%、−1.20%，P<0.05）。结论肺癌、消化系统恶性肿瘤是海淀区癌症死亡的主要原因，近年来主要恶性肿瘤死亡率的上升受人口老龄化影响较大，但与吸烟、环境污染、不良生活方式等相关的恶性肿瘤疾病负担仍较重。因此，应针对不同性别、主要癌种及变化趋势采取综合性防控措施。
- 恶性肿瘤 /
- 死亡率 /
- 变化趋势 /
- 平均年度变化百分比 /
- 早死寿命损失
Abstract: Objective To analyze the characteristics and trends of malignant tumors mortality in local population inHaidian district of Beijing from 2010 to 2021, and provide reference for the prevention and control of malignant tumors. Methods The death data of malignant tumors in local residents in Haidian from 2010 to 2021 were collected, and the constituent ratio, crude and standardized mortality rate, year of life lost (YLL) rate and standardized YLL rate were calculated. Joinpoint regression model was used to estimate the average annual trend. Results Malignant tumors ranked first in all causes of death in local residents of Haidian from 2010 to 2021, with deaths accounting for 30.23%. The average annual crude mortality rate standardized mortality rate were 142.47/100 000 and 93.32/100 000 respectively. The crude mortality rate was higher in men than women, the difference was statistically significant (t=11.18, P<0.05), and the standardized mortality rates in all years were higher in men than in women. Compared with 2010, the proportion of malignant tumor deaths in 2021 decreased to 26.77% (−15.37%). The crude mortality of total population, in men and in women showed increasing trends year by year with average annual percentage change (AAPC) of 1.62%, 1.82% and1.42%, respectively (all P<0.01), while the standardized mortality showed decreasing trends year by year with AAPC of −1.50%, −1.13% and −1.85%, respectively (all P<0.01).The top 10 causes of death included lung cancer and digestive system malignant tumor, the top 6 causes of death remained unchanged, i.e. lung cancer, colorectal cancer, liver cancer, gastric cancer, pancreatic cancer and breast cancer. The crude mortality of bladder cancer, breast cancer and colorectal cancer increased significantly (AAPC=4.56%, 3.81%, 3.80%, all P<0.001), and the crude mortality of liver cancer decreased year by year (AAPC=−1.24%, P<0.05). The YLL increased year by year, the change in YLL rate had no significantce (AAPC=0.30%, P>0.05), while the standardized YLL rate showed a downward trend year by year (AAPC=−2.10%, P<0.05). The YLL rates of colorectal cancer, pancreatic cancer, bladder cancer and breast cancer increased year by year (AAPC=2.90%, 2.60%, 3.40%, 1.90%, all P<0.05), but the YLL rates of liver cancer and gastric cancer decreased year by year (AAPC=−2.70% and −1.20%, all P<0.05). Conclusion Lung cancer and digestive system malignant of cancer death in Haidian. In recent years, the rising mortality rate of major malignant tumor has been greatly affected by the aging of the population, but the burden of malignant tumors related to smoking, environmental pollution and poor lifestyle is still heavy. Therefore, it is necessary to take targeted prevention and control measures in different population, for different cancer type and according to cancer incidence trend.
- Malignant tumor /
- Mortality /
- Changing trend /
- Average annual percentage change /
- Year of life lost

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图 1 2010－2021年北京市海淀区主要恶性肿瘤死因顺位变化

Figure 1. Rank of deaths caused by major malignant tumors in Haidian district, Beijing city, from 2010 to 2021

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表 1 2010－2021年北京市海淀区户籍居民恶性肿瘤死亡情况

Table 1. Death of malignant tumors in local residents in Haidian district, Beijing city, from 2010 to 2021

年份	男性				女性				总计
年份	死亡数（例）	占总死亡的百分比（%）	死亡率（/10万）	标化死亡率（/10万）	死亡数（例）	占总死亡的百分比（%）	死亡率（/10万）	标化死亡率（/10万）	死亡数（例）	占总死亡的百分比（%）	死亡率（/10万）	标化死亡率（/10万）
2010	1 615	32.40	146.11	108.29	1 199	30.65	111.86	86.88	2 814	31.63	129.25	98.09
2011	1 788	35.45	158.68	113.38	1 196	31.59	108.87	82.93	2 984	33.79	134.10	98.78
2012	1 759	33.40	152.67	106.31	1 272	30.62	112.70	84.24	3 031	32.18	132.89	95.69
2013	1 790	33.05	152.51	101.96	1 340	31.48	115.89	82.33	3 130	32.36	134.34	92.34
2014	1 880	31.56	157.94	98.98	1 419	31.19	120.42	82.04	3 299	31.40	139.28	90.97
2015	1 916	32.13	159.83	99.34	1 348	29.11	113.18	73.82	3 264	30.81	136.59	86.78
2016	2 033	31.34	169.36	101.82	1 487	29.36	124.12	79.72	3 520	30.47	146.77	90.89
2017	1 990	30.48	167.75	97.92	1 462	28.43	122.65	76.46	3 452	29.58	145.15	87.41
2018	2 163	31.38	183.41	107.08	1 496	27.43	125.54	76.13	3 659	29.63	154.32	91.72
2019	2 107	29.69	176.63	99.59	1 522	27.94	126.17	73.01	3 629	28.93	151.26	86.23
2020	2 103	28.97	175.64	96.58	1 635	27.35	134.84	75.71	3 738	28.24	155.12	85.98
2021	2 125	28.13	176.34	93.69	1 464	25.00	120.01	66.19	3 589	26.77	148.01	80.03
合计	23 269	31.25	164.93^a	105.72	16 840	28.92	119.90	80.48	40 109	30.23	142.47	93.32
变化率（%）	31.58	−13.16	20.69	−13.48	22.10	−18.42	7.29	−23.81	27.54	−15.37	14.51	−18.41
AAPC（%）	−	−1.60	1.82	−1.13	−	−1.80	1.42	−1.85	−	−1.70	1.62	−1.50
t值	−	−6.60	6.90	−3.60	−	−7.00	4.50	−6.00	−	−8.30	7.50	−6.30
P值	−	<0.001	<0.001	0.005	−	<0.001	0.001	< 0.001	−	<0.001	< 0.001	< 0.001
注：a. 死亡率男性与女性比较，t =11.18，P<0.05；AAPC. 平均年度变化百分比；− 表示无数据

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表 2 2010－2021年北京市海淀区主要恶性肿瘤死亡率变化趋势

Table 2. Trend in mortality of major malignant tumors in Haidian district, Beijing city, from 2010 to 2021

癌种	男性							女性							合计
	顺位	粗死亡率			标化死亡率			顺位	粗死亡率			标化死亡率			顺位	粗死亡率			标化死亡率
	顺位	AAPC （%）	t值	P值	AAPC （%）	t值	P值	顺位	AAPC （%）	t值	P值	AAPC （%）	t值	P值	顺位	AAPC （%）	t值	P值	AAPC （%）	t值	P值
肺癌	1	1.55	3.90	0.003	−1.18	−2.60	0.024	1	−0.10	−0.20	0.825	−3.86	−8.50	< 0.001	1	0.30	0.50	0.614	−2.27	−6.50	< 0.001
结肠、直肠癌	2	4.87	10.90	<0.001	2.33	4.40	0.001	2	2.52	4.60	0.001	−1.29	−2.20	0.053	2	3.80	9.80	< 0.001	0.60	1.30	0.219
肝癌	3	−0.29	−0.50	0.655	−3.67	−5.40	< 0.001	5	−3.26	−4.30	0.002	−6.67	−7.90	< 0.001	3	−1.24	−2.90	0.017	−4.42	−9.40	< 0.001
胃癌	4	−0.70	−1.70	0.130	−3.29	−4.70	0.001	6	0.00	0.00	0.989	−2.22	−3.10	0.011	4	−0.40	−1.20	0.261	−3.00	−3.70	< 0.001
胰腺癌	5	2.78	3.00	0.014	0.31	0.30	0.771	4	3.74	3.90	0.003	0.65	0.70	0.494	5	3.28	5.10	< 0.001	0.49	0.80	0.469
乳腺癌	13	−2.36	−0.50	0.662	−6.62	−0.70	0.527	3	3.62	6.80	< 0.001	0.69	1.20	0.251	6	3.81	7.50	< 0.001	0.73	1.30	0.223
食管癌	7	0.32	0.30	0.799	−1.92	−1.40	0.181	11	−1.85	−1.30	0.218	−5.51	−4.10	0.002	7	−0.34	−0.40	0.698	−2.71	−2.90	0.017
白血病	8	0.45	0.40	0.705	−1.86	−1.50	0.172	8	0.68	0.60	0.568	−1.89	−1.60	0.146	8	0.50	0.60	0.545	−0.10	−0.10	0.943
前列腺癌	6	3.81	4.50	0.001	−1.31	−2.30	0.046	−	−	−	−	−	−	−	9	3.58	4.30	0.002	−1.73	−2.80	0.018^a
膀胱癌	9	4.85	4.70	0.001	0.71	0.70	0.515	12	4.46	2.60	0.025	−1.07	−0.60	0.582	10	4.56	5.60	< 0.001	−0.11	−0.10	0.911
脑及神经系统恶性肿瘤	10	1.58	1.70	0.126	−0.77	−0.60	0.563	9	2.25	1.30	0.210	−0.65	−0.40	0.690	11	1.94	2.10	0.064	−0.84	−0.80	0.453
卵巢癌	−	−	−	−	−	−	−	7	2.38	2.60	0.075	−0.05	0.00	0.966	12	2.60	2.20	0.056	0.04	0.00	0.974
宫颈癌	−	−	−	−	−	−	−	10	3.20	2.50	0.030	1.83	1.60	0.150	13	3.42	2.70	0.023^a	2.03	1.70	0.113
注：AAPC. 平均年度变化百分比；−表示无数据

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表 3 2010－2021年北京市海淀区户籍人口恶性肿瘤YLL总体变化情况

Table 3. Change of malignant tumor YLL in local residents in Haidian district, Beijing city, from 2010 to 2021

年份	YLL（人年）	YLL率（/10万）	标化YLL率（/10万）
2010	65 592	3 012.68	2 218.75
2011	69 606	3 128.04	2 263.39
2012	71 107	3 117.64	2 245.73
2013	71 229	3 057.22	2 360.30
2014	71 837	3 032.88	2 243.05
2015	71 652	2 998.40	2 190.48
2016	77 040	3 212.18	2 049.18
2017	73 904	3 107.62	1 963.79
2018	78 009	3 290.18	2 005.22
2019	76 254	3 178.39	1 866.16
2020	77 438	3 213.46	1 868.53
2021	72 783	3 001.52	1 718.30
AAPC（%）	−	0.30	−2.10
t值	−	1.20	−4.30
P值	−	0.268	< 0.001
注：AAPC. 平均年度变化百分比；YLL. 寿命损失年；−表示无数据

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表 4 2010－2021年北京市海淀区户籍人口主要恶性肿瘤YLL率变化情况

Table 4. Change of YLL rate of major malignant tumors in local residents in Haidian district, Beijing city, from 2010 to 2021

主要疾病	YLL率（/10万）					标化YLL率（/10万）
主要疾病	2010年	2021年	AAPC（%）	t值	P值	2010年	2021年	AAPC（%）	t值	P值
肺癌	842.81	768.86	−0.30	−0.80	0.465	585.65	413.67	−3.00	−4.40	<0.001
结直肠癌	267.10	357.38	2.90	6.00	<0.001	183.27	192.44	0.20	0.40	0.720
肝癌	344.87	256.62	−2.70	−5.50	<0.001	267.44	148.83	−5.20	−10.70	<0.001
胃癌	261.06	226.20	−1.20	−3.40	0.007	183.37	130.82	−3.40	−6.10	<0.001
胰腺癌	183.76	202.39	2.60	3.70	0.004	128.38	114.56	0.10	0.10	0.919
乳腺癌	145.64	178.72	1.90	2.80	0.019	111.86	113.55	−0.10	−0.10	0.941
白血病	109.16	108.97	−1.40	−1.30	0.212	104.53	76.55	−4.50	−2.80	0.020
食管癌	88.06	89.25	−0.20	−0.20	0.872	61.74	49.99	−2.60	−2.40	0.036
脑及神经系统恶性肿瘤	96.89	81.50	−0.60	−0.50	0.631	96.61	63.11	−3.70	−2.20	0.054
卵巢癌	77.64	61.73	1.50	1.20	0.273	59.91	38.51	−0.70	−0.50	0.641
前列腺癌	50.07	55.55	1.40	2.10	0.062	30.47	22.19	−3.00	−1.50	0.136
膀胱癌	43.24	55.19	3.40	3.60	0.005	27.32	24.30	−0.80	−0.50	0.652
宫颈癌	24.30	31.90	2.50	2.00	0.077	17.86	22.67	3.40	1.10	0.257
注：AAPC. 平均年度变化百分比；YLL. 寿命损失年

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