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

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。

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.

2010－2021年北京市海淀区恶性肿瘤死亡特征及变化趋势分析

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