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| 1972—2021年江苏省启东市劳动力人口恶性肿瘤发病趋势分析及2022—2031年变化趋势预测 |
| Analysis and Prediction of the Incidence Trend of Malignant Tumors Among the Labor Force Population in Qidong City of Jiangsu Province from 1972 to 2021 |
| 投稿时间：2025-10-17 修订日期：2025-12-26 |
| DOI： |
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| 中文关键词: 劳动力人口 恶性肿瘤 发病率 趋势分析 江苏 |
| 英文关键词:labor force population malignant tumor incidence rate trend analysis Jiangsu |
| 基金项目:南通市卫生健康委员会科研项目（MSZ2025120）；南通大学校级科研基金临床医学专项资助项目（2024JY050） |
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| 中文摘要: |
| [目的]分析1972—2021年江苏省启东市劳动力人口（15~64岁）的恶性肿瘤发病情况，预测未来10年发病变化趋势。[方法]基于启东癌症登记处数据，计算粗发病率（crude rate，CR）、中国人口标化发病率（age-standardized incidence rate by Chinese standard population，ASIRC）、世界人口标化发病率（age-standardized incidence rate by world standard population，ASIRW）。应用Joinpoint 4.9.1.0计算CR、ASIRC和ASIRW的年度变化百分比（annual percent change, APC）和平均年度变化百分比（average annual percent change, AAPC）。采用SAS 9.2软件时间序列分析中的自回归差分移动平均模型（autoregressive integrated moving average, ARIMA）模型对未来10年劳动力人口恶性肿瘤ASIRW趋势进行预测。[结果]1972—2021年启东市劳动力人口恶性肿瘤累计发病77 425例，CR、ASIRC和ASIRW分别由1972—1976年的163.33/10万、185.82/10万和197.42/10万波动变化至2017—2021年的362.12/10万、205.48/10万和222.56/10万，其中CR的上升趋势有统计学意义（AAPC=2.05%，P<0.001）。男、女性恶性肿瘤发病数分别为46 164例和31 261例，男性ASIRW呈下降趋势（AAPC=-0.78%，P<0.001），女性ASIRW呈上升趋势（AAPC=1.74%，P<0.001）。年龄别发病率随年龄增长而升高，15~24岁组最低（15.18/10万），55~64岁组最高（536.88/10万）；时间趋势分析显示45~54岁、55~64岁年龄组发病率呈上升趋势（AAPC分别为0.63%和0.68%，P均<0.05），25~34岁、35~44岁年龄组呈下降趋势（AAPC分别为-0.76%和-0.44%，P均<0.05）。1972—2021年启东市劳动力人口恶性肿瘤ASIRW前10位依次为肝癌、女性乳腺癌、肺癌、胃癌、结直肠癌、宫颈癌、甲状腺癌、淋巴瘤、脑及中枢神经系统肿瘤和白血病，占所有恶性肿瘤发病的84.81%；其中女性乳腺癌、甲状腺癌、肺癌、宫颈癌、结直肠癌、脑及中枢神经系统肿瘤、白血病和淋巴瘤ASIRW呈上升趋势（AAPC分别为3.41%、12.31%、1.79%、2.54%、2.45%、2.31%、1.45%和1.39%，P均<0.001），肝癌和胃癌ASIRW呈下降趋势（AAPC分别为-1.99%和-2.08，P均<0.001）。最近一时期（2017—2021年）前五位ASIRW癌谱依次为女性乳腺癌、甲状腺癌、肺癌、肝癌和宫颈癌。预测结果显示至2031年总体劳动力人口ASIRW为216.10/10万，其中男性ASIRW降至151.32/10万，而女性ASIRW升至278.83/10万。[结论]50年来启东市劳动力人口癌谱变化较大，未来10年女性ASIRW将持续上升并继续超过男性，后续应加强女性乳腺癌、甲状腺癌、肺癌、肝癌和宫颈癌等重点癌种的综合防控。 |
| 英文摘要: |
| [Purpose] To analyze the incidence of malignant tumors among the labor force population (15~64 years old) in Qidong City, Jiangsu Province from 1972 to 2021, and predict the change trend of incidence in the next 10 years. [Methods] Based on the data from the Qidong Cancer Registry, the crude rate (CR), age-standardized incidence rate by Chinese standard population (ASIRC), and age-standardized incidence rate by world standard population (ASIRW) 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)?of CR, ASIRC, and ASIRW. The ARIMA model, a method in time series analysis of SAS 9.2 software, was used to predict the trend of ASIRW of malignant tumors among the labor force population in the next 10 years. [Results] From 1972 to 2021, a total of 77,425 cumulative cases of malignant tumors were reported among the labor force population in Qidong City. The CR, ASIRC and ASIRW fluctuated from 163.33/10?, 185.82/10? and 197.42/10? in the period 1972-1976 to 362.12/10?, 205.48/10? and 222.56/10? in 2017–2021, respectively. Among these indicators, the upward trend of CR was statistically significant (AAPC = 2.05%, P < 0.001). The number of malignant tumor cases in males and females were 46,164 and 31,261 respectively. The ASIRW showed a decreasing trend in males (AAPC = -0.78%, P < 0.001) and an increasing trend in females (AAPC = 1.74%, P < 0.001). The age-specific incidence rate increased with age: the lowest was in the 15~24 years old group (15.18/10?) and the highest was in the 55~64 years old group (536.88/10?).?Time trend analysis showed that the incidence rate presented an upward trend in the 45~54 and 55~64 years old groups (AAPC was 0.63% and 0.68%, respectively, both P < 0.05), while it showed a downward trend in the 25~34 and 35~44 years old groups (AAPC was -0.76% and -0.44%, respectively, both P < 0.05). From 1972 to 2021, the top 10 malignant tumors by ASIRW among the labor force population in Qidong City were liver cancer, female breast cancer, lung cancer, gastric cancer, colorectal cancer, cervical cancer, thyroid cancer, lymphoma, brain and central nervous system tumors, and leukemia in sequence, accounting for 84.81% of all malignant tumor incidences. Among them, the ASIRW of female breast cancer, thyroid cancer, lung cancer, cervical cancer, colorectal cancer, brain and central nervous system tumors, leukemia, and lymphoma showed an upward trend (AAPC: 3.41%, 12.31%, 1.79%, 2.54%, 2.45%, 2.31%, 1.45%, and 1.39% respectively, all P < 0.001), while the ASIRW of liver cancer and gastric cancer presented a downward trend (AAPC was -1.99% and -2.08% respectively, all P < 0.001). In the recent period (2017—2021), the top five cancers in the ASIRW spectrum were female breast cancer, thyroid cancer, lung cancer, liver cancer, and cervical cancer in sequence. The prediction results showed that by 2031, the ASIRW of malignant tumors among the total labor force population will be 216.10/10?. Among them, the ASIRW for males will decrease to 151.32/10?, while that for females will increase to 278.83/10?. [Conclusion] Over the past 50 years, the cancer spectrum among the labor force population in Qidong City has undergone significant changes. In the next 10 years, the ASIRW of females will continue to rise and remain higher than that of males. Moving forward, efforts should be strengthened to enhance the comprehensive prevention and control of key cancer types in females, including breast cancer, thyroid cancer, lung cancer, liver cancer, and cervical cancer. |
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