2010－2021年中国老年人恶性肿瘤死亡情况及变化趋势分析

王娜; 任达飞; 王伟忠; 代彪; 胡君; 田玉洁; 洪峰

doi:10.3784/jbjc.202411010611

2010－2021年中国老年人恶性肿瘤死亡情况及变化趋势分析

Analysis on malignant tumor death and its changing trend in the elderly in China, 2010−2021

摘要

摘要:
目的了解2010—2021年中国老年人恶性肿瘤的死亡趋势，为中国开展恶性肿瘤预防工作提供科学依据。
方法收集中国死因监测数据集（2010—2021）中老年人死亡数据和人口资料，通过粗死亡率和标化死亡率描述恶性肿瘤的死亡状况，利用Joinpoint回归分析模型分析其变化趋势。
结果 2010—2021年中国老年人恶性肿瘤粗死亡率为679.86/10万，标化死亡率为673.78/10万，2015—2021年标化死亡率呈下降趋势［年度变化百分比（APC）=−2.54%，P=0.020］。男性粗死亡率和标化死亡率均高于女性（χ²=319 759.721、317 584.837；均P＜0.001）；城市粗死亡率和标化死亡率高于农村（χ²=2 017.298、3 770.360；均 P＜0.001）；东部地区粗死亡率和标化死亡率均高于中部（χ²=5 369.488、6 177.088；均P＜0.001），中部地区粗死亡率和标化死亡率均高于西部（χ²=4 310.508、4 462.661，均P＜0.001）。死因顺位前6位分别是肺癌、胃癌、肝癌、食管癌、结直肠癌和胰腺癌。胃癌、食管癌的粗死亡率和标化死亡率均呈下降趋势（胃癌：AAPC=−4.16%，AAPC=−4.93%；食管癌：AAPC=−3.06%，AAPC=−4.31%，均P＜0.05）；肝癌标化死亡率呈下降趋势（AAPC=−3.23%，P=0.002）；胰腺癌粗死亡率呈上升趋势（AAPC=1.80%，P=0.027）。宫颈癌标化死亡率呈增长趋势（AAPC=3.23%，P=0.036）。
结论中国恶性肿瘤死亡高风险群体主要集中在男性、城市和东部地区居民，应重点关注。

Abstract:
Objective To understand the death trend of malignant tumor in the elderly in China from 2010 to 2021, and provide evidence for the prevention of malignant tumor in China.
Methods Death data and population data of the elderly were collected from China Cause of Death Surveillance Dataset (2010−2021). The deaths of malignant tumor was described by crude mortality rate and standardized mortality rate, and the change trend was analyzed by Joinpoint regression analysis model.
Results The crude mortality rate of malignant tumor was 679.86/100 000, and the standardized mortality rate was 673.78/100000 in the elderly in China from 2010 to 2021. The standardized mortality rate showed a decreasing trend from 2015 to 2021 annual percent change (APC)=−2.54%, P=0.020. The crude mortality rate and standardized mortality rate were higher in men than in women (χ²=319 759.721, 317 584.837; all P<0.001). The crude mortality rate and standardized mortality rate were higher in urban area than in rural area (χ²=2 017.298, 3 770.360; all P<0.001). The crude mortality rate and standardized mortality rate were higher in eastern China than in central China (χ²=5 369.488, χ²=6 177.088; all P<0.001). The crude mortality rate and standardized mortality rate were higher in central China than in western China (χ²=4 310.508, χ²=4 462.661; all P<0.001). The top six causes of deaths were lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer and pancreatic cancer. The crude mortality and standardized mortality of gastric cancer and esophageal cancer showed decreasing trends (AAPC=−4.16%, AAPC=−4.93% for gastric cancer; AAPC=−3.06%, AAPC=−4.31% for esophageal cancer, all P <0.05). The standardized mortality of liver cancer showed a decreasing trend (AAPC=−3.23%, P=0.002). The crude mortality of pancreatic cancer showed an increasing trend (AAPC=1.80%, P=0.027). The standardized mortality rate of cervical cancer increased at an average annual rate of 3.23% (P=0.036).
Conclusion In China, the groups at high-risk for malignant tumor death were mainly men, residents in urban area and in eastern China, to whom close attention needs to be paid.

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