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目的了解江苏省昆山市1981—2014年肝癌死亡率变化趋势及定量估计影响因素,为肝癌的预防控制工作提供科学依据。方法收集江苏省昆山市1981—2014年肝癌死亡数据,分性别和年龄组计算肝癌粗亡率与年龄标化率,采用平均年度变化百分比(APC)及其95%CI评价肝癌死亡率的变化趋势,采用差别分解法分析人口因素对肝癌死亡率变化的贡献。结果江苏省昆山市1981—2014年肝癌粗死亡率在男性(APC=-0.1%,95%CI=-0.6~0.4%)、女性(APC=-0.2%,95%CI=-0.7%~0.3%)和总人群(APC=-0.1%,95%CI=-0.6%~0.4%)中变化趋势差异均无统计学意义(均P>0.05),肝癌中国标化死亡率在男性(APC=-2.6%,95%CI=-3.1~-2.1%)、女性(APC=-2.7%,95%CI=-3.3%~-2.1%)和总人群(APC=-2.6%,95%CI=-3.0%~-2.2%)中均呈下降趋势,差异均有统计学意义(均P<0.05);肝癌死亡率的下降是人口因素与非人口因素共同作用的结果,2014年与1981年比较,男性、女性和总人群人口老龄化贡献率分别为-578.40%、-1 403.60%和-700.38%,非人口老龄化贡献率分别为478.40%、1 303.60%和600.38%。结论江苏省昆山市1981—2014年肺癌死亡率在非人口因素作用下持续下降,但受到了人口因素的阻碍。
Objective To understand the trends of liver cancer mortality and the quantitative estimation of the impact factors of liver cancer in Kunshan City, Jiangsu Province from 1981 to 2014, and to provide scientific basis for the prevention and control of liver cancer. Methods The mortality data of liver cancer from 1981 to 2014 in Kunshan City, Jiangsu Province were collected. The rate of crude liver cancer mortality and age-standardized rate were calculated by gender and age group. The average annual variation percentage (APC) and 95% CI were used to evaluate the trend of liver cancer mortality. The differential analysis method was used to analyze the contribution of demographic factors to the mortality of liver cancer. Results The crude death rate of HCC in Kunshan City, Jiangsu Province from 1981 to 2014 was (APC=-0.1%, 95%CI=-0.6~0.4%), female (APC=-0.2%, 95%CI=-0.7%~0.3). There was no statistically significant difference in the change trend of %) and total population (APC=-0.1%, 95%CI=-0.6%~0.4%) (all P>0.05). The mortality rate of liver cancer in China was standardized in men (APC= -2.6%, 95%CI=-3.1~-2.1%), females (APC=-2.7%, 95%CI=-3.3%~-2.1%) and total population (APC=-2.6%, 95% CI= (-3.0%--2.2%) showed a downward trend, the differences were statistically significant (all P<0.05); the decline in liver cancer mortality was the result of a combination of population factors and non-demographic factors, compared with 2014 and 1981. The contribution rate of the aging population of male, female and total population was -578.40%, -1 403.60% and -700.38%, respectively, and the non-population ageing contribution rates were 478.40%, 1303.60% and 600.38%, respectively. Conclusion The mortality rate of lung cancer from 1981 to 2014 in Kunshan City, Jiangsu Province, continued to decline under the influence of non-population factors but was hampered by demographic factors.