中国肿瘤杂志

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1972—2021年江苏省启东市劳动力人口恶性肿瘤死亡率趋势分析与预测

Trend Analysis and Prediction of Cancer Mortality in the labor force population of Qidong City, Jiangsu Province, 1972-2021

投稿时间：2025-09-29 修订日期：2025-12-23

DOI：

中文关键词: 恶性肿瘤劳动力人口死亡率趋势分析江苏

英文关键词:Malignant tumors Labor force population Mortality Trend analysis Jiangsu

基金项目:

作者	单位	邮编
蔡岩坡	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200
陈永胜	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200
张永辉	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200
王军	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200
丁璐璐	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200
徐源佑	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200
严永锋	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200
朱健^*	启东市人民医院启东肝癌防治研究所南通大学附属启东医院	226200

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中文摘要:

［目的］对启东市1972—2021年劳动力人口（15-64岁）恶性肿瘤死亡率趋势进行分析与预测，为针对性制定恶性肿瘤防控政策提供数据支持。［方法］根据启东市1972—2021年劳动力人口恶性肿瘤死亡数据和历年人口资料，计算死亡粗率（CR）、中国人口标化死亡率（ASMRC）、世界人口标化死亡率（ASMRW），应用 Joinpoint 4.9.1.0 统计软件分析恶性肿瘤死亡率的CR、ASMRC、ASMRW的年度变化百分比（APC）和平均年度变化百分比（AAPC）；采用SAS 9.2软件，用时间序列分析中的ARIMA模型对未来10年ASMRW趋势进行预测。［结果］1972—2021年间，启东市劳动力人口恶性肿瘤死亡数为53 846例， CR、ASMRC、ASMRW的AAPC分别为0.31%、-1.65%、-1.52%（P均＜0.001）。男性、女性死亡数分别为36 600例和17 246例， ASMRW的AAPC分别为-1.79%、-1.07%（P均＜0.001）。劳动力人口死亡率随年龄的增加而升高。15~24岁、25~34岁、35~44岁、45~54岁、55~64岁组的死亡率的AAPC分别为-1.38%、-3.00%、-1.85%、-1.29%、-0.99%（P均＜0.001）。1972—2021年启东市劳动力人口中，ASMRW前五位是肝癌、肺癌、胃癌、女性乳腺癌及结直肠癌，占劳动力人口所有恶性肿瘤死亡人数的78.21%，ASMRW分别为55.43/10万、16.24/10万、13.62/10万、6.49/10万和4.59/10万。肝癌在各时期的死亡率均列第1位，ASMRW从1972—1976年的80.75/10万下降至2017—2021年的18.39/10万，AAPC为-2.34%（P<0.001）；肺癌的ASMRW从1972—1976年的11.93/10万（第3位）上升至2017—2021年的13.81/10万（第2位），AAPC为0.33%（P=0.036）；胃癌的ASMRW从1972—1976年的26.98/10万（第2位）下降至2017—2021年的5.81/10万（第3位），AAPC为-3.06%（P<0.001）；女性乳腺癌的ASMRW从1972—1976年的5.35/10万（第5位）上升至2017—2021年的5.44/10万（第4位），AAPC为-0.08%（P=0.736）；结直肠癌的ASMRW从1972—1976年的3.68/10万（第6位）上升至2017—2021年的4.48/10万（第5位），AAPC为0.03%（P=0.877）；对ASMRW进行JoinPoint趋势分析显示：肝癌在2012—2021年下降幅度最大，APC为-10.11%（P<0.001）；肺癌在2013—2021年的APC为-4.33%（P<0.001）；胃癌在1972—1995年、1995—2003年、2008—2021年的APC分别为-1.82%、-6.58%、-5.57%（P均<0.001）；女性乳腺癌在1995—2021年的APC为-1.47%（P=0.002）；结直肠癌在1972—1995年的APC为2.23%（P<0.001），其后变化趋势平稳。预测至2031年男性、女性及总体ASMRW将分别下降至43.78/10万、37.59/10万、40.55/10万。［结论］50年间启东市劳动力人口恶性肿瘤标化死亡率显著下降，未来应重点加强肝癌、肺癌、胃癌、女性乳腺癌和结直肠癌的综合防控，以进一步降低劳动力人口恶性肿瘤死亡率，为保障社会生产力做出更大贡献。

英文摘要:

[ Purpose ] Based on mortality data of malignant tumors and annual population data of the labor force population in Qidong City from 1972 to 2021, the crude mortality rate (CR), age-standardized mortality rate by Chinese standard population (ASMRC), and age-standardized mortality rate by world standard population (ASMRW) were calculated. The Joinpoint Regression Program (Version 4.9.1.0) was used to analyze the annual percent change (APC) and average annual percent change (AAPC) for CR, ASMRC, and ASMRW. The ARIMA model in SAS 9.2 software was employed to forecast the ASMRW trend for the next 10 years. [ Results ] From 1972 to 2021, there were 53,846 malignant tumor deaths in the labor force population of Qidong City. The AAPCs for CR, ASMRC, and ASMRW were 0.31%, -1.65%, and -1.52% (all P < 0.001), respectively. There were 36,600 deaths in males and 17,246 in females, withAAPCs of ASMRW were -1.79% and -1.07% (both P < 0.001). Mortality rates increased with age. The AAPCs for the mortality rates in the 15-24, 25-34, 35-44, 45-54, and 55-64 age groups were -1.38%, -3.00%, -1.85%, -1.29%, and -0.99% (all P < 0.001), respectively. From 1972 to 2021, the top five malignancies by ASMRW in the labor force population were liver cancer, lung cancer, Stomach cancer, female breast cancer, and colorectal cancer, constituting 78.21% of all malignant tumor deaths, with ASMRWs of 55.43/10?, 16.24/10?, 13.62/10?, 6.49/10?, and 4.59/10?, respectively. Liver cancer ranked first in all periods, with ASMRW decreasing from 80.75/10? in 1972-1976 to 18.39/10? in 2017-2021 (AAPC = -2.34%, P < 0.001). Lung cancer ASMRW increased from 11.93/10? (3rd rank) in 1972-1976 to 13.81/10? (2nd rank) in 2017-2021 (AAPC = 0.33%, P = 0.036). Stomach cancer ASMRW decreased from 26.98/10? (2nd rank) to 5.81/10? (3rd rank) (AAPC = -3.06%, P < 0.001). Female breast cancer ASMRW increased from 5.35/10? (5th rank) to 5.44/10? (4th rank) (AAPC = -0.08%, P = 0.736). Colorectal cancer ASMRW increased from 3.68/10? (6th rank) to 4.48/10? (5th rank) (AAPC = 0.03%, P = 0.877). Joinpoint analysis of ASMRW showed the most significant decline for liver cancer occurred in 2012-2021 (APC = -10.11%, P < 0.001). For lung cancer, the APC was -4.33% during 2013-2021 (P < 0.001). For Stomach cancer, the APCs were -1.82% (1972-1995), -6.58% (1995-2003), and -5.57% (2008-2021) (all P < 0.001). For female breast cancer, the APC was -1.47% during 1995-2021 (P = 0.002). For colorectal cancer, the APC was 2.23% during 1972-1995 (P < 0.001), with stable trends thereafter. The ASMRW for males, females, and the overall population is projected to decrease to 43.78/10?, 37.59/10?, and 40.55/10? by 2031, respectively. [ Conclusion ] Over the past 50 years, the standardized mortality rates of malignant tumors in the labor force population of Qidong City have decreased significantly. Future strategies should focus on strengthening comprehensive prevention and control for liver cancer, lung cancer, Stomach cancer, female breast cancer, and colorectal cancer to further reduce cancer mortality in this population and contribute more to safeguarding social productivity.

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