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1995－2023年上海市浦东新区居民胃癌死亡特征及减寿率分析

Analysis on mortality of gastric cancer and related years of life lost in residents in Pudong new area, Shanghai, 1995−2023

    摘要
  • 摘要:
    目的 分析上海市浦东新区居民在1995—2023年胃癌死亡特征与寿命损失特征，为制定针对性干预措施提供依据。
    方法 通过浦东新区死因监测系统收集21 422例胃癌死亡患者数据进行分析，采用粗死亡率（CMR）、标准化死亡率（SMR）、潜在减寿年数（PYLL）、潜在减寿率（PYLLR）、平均减寿年数（AYLL）和标准化潜在减寿年数（SPYLL）等指标分析胃癌死亡情况，性别间粗死亡率、标准化死亡率差异性比较分别采用泊松分布的Z检验和M-H检验；通过Joinpoint回归分析计算死亡率的平均年度变化百分比（AAPC）和年度变化百分比（APC），分析胃癌死亡率的变化趋势。
    结果 1995—2023年浦东新区居民胃癌粗死亡率为27.48/10万，标准化死亡率为12.29/10万。 男性粗死亡率为35.14/10万，标准化死亡率为16.82/10万；女性粗死亡率为19.86/10万，标准化死亡率为8.36/10万，男性高于女性（ZCMR=40.693，P<0.001；ZSMR=−53.341，P<0.001）。 1995—2023年浦东新区全人群和男女性胃癌死亡率总体均呈逐年下降趋势，其中男性标准化死亡率下降速度快于女性。 胃癌死亡人数集中在60～79岁中老年人，1995—2003年死亡率缓慢下降，2003—2014年下降速度达到高峰，2014年后保持稳定。 浦东新区胃癌PYLL为220 095人年，潜在减寿率为2.82‰，AYLL为10.27年/人。
    结论 胃癌死亡率随时间的变化呈下降趋势，但随着年龄的增加而逐渐升高，疾病负担高于世界平均水平。 男性和老年人是发生胃癌死亡的高危人群，通过分析浦东新区胃癌死因流行特征制定适当的防控措施，提高筛查的早期检出率和延长患者的生存时间。

     

    Abstract:
    Objective To understand the characteristics of gastric cancer mortality and related life loss in residents in Pudong new area, Shanghai, from 1995 to 2023, and provide evidence for the development of targeted intervention measures.
    Methods The data of 21 422 gastric cancer deaths in Pudong were collected from local mortality surveillance system. The crude mortality rate (CMR), standardized mortality rate (SMR) of gastric cancer, potential years of life loss (PYLL), average years of life loss (AYLL), and standardized years of life loss (SPYLL) were analyzed. The Z-test and M-H test of Poisson Distribution were used to compare the differences of CMR and SMR between men and women. The average annual percentage change (AAPC) and annual percentage change (APC) of mortality rate were calculated through Joinpoint regression analysis to analyze the trend of changes in gastric cancer mortality rate.
    Results From 1995 to 2023, the CMR of gastric cancer was 2 748/100 000 and the SMR was 1 229/100 000 in residents in Pudong. The CMR was 35.14/100 000 and the SMR was 16.82/100 000 in men. The CMR was 19.86/100 000 and the SMR was 8.36/100 000 in women, which were higher in men than in women (ZCMR=40.693, P<0.001; ZSMR=−53.341, P<0.001). From 1995 to 2023, the overall mortality rate and gender specific mortality rate of gastric cancer in Pudong showed decreasing trends year by year, the decrease rate of SMR was more obvious in men than in women. The gastric cancer deaths mainly occurred in middle-aged and elderly people (60−79 years). The mortality rate showed slow decrease from 1995 to 2003, and became the lowest during 2003−2014, and remained stable after 2014. The PYLL for gastric cancer in Pudong was 220 095 person years, with a potential life loss rate (PYLLR) of 2.82‰ and an AYLL of 10.27 years per person.
    Conclusion Gastric cancer mortality decreased over time, but gradually increased with age in Pudong, and the disease burden level was higher than the world average. Men and the elderly were the groups at high-risk for gastric cancer death. By analyzing the epidemiological characteristics of gastric cancer deaths in Pudong, appropriate prevention and control measures can be development to facilitate the early detection of gastric cancer and improve the survival of the patients.

     

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