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| 1975—2024年江苏省启东市肝癌死亡率变化及潜在寿命损失分析 |
| Analysis of Liver Cancer Mortality Trends and Potential Years of Life Lost in Qidong City, Jiangsu Province, 1975—2024 |
| 投稿时间：2026-04-21 修订日期：2026-06-12 |
| DOI： |
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| 中文关键词: 肝肿瘤 死亡率 潜在寿命损失年 趋势分析 启东 |
| 英文关键词:Liver neoplasms Mortality Potential years of life lost Trend analysis Qidong |
| 基金项目:南通市科技局2025年科研基金项 目（MSZ2025123) |
| 作者 | 单位 | 邮编 | | 陆永刚 | 南通大学公共卫生学院；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 | | 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 | | 高月霞 | 南通大学公共卫生学院 | 226019 |
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| 中文摘要: |
| [目的] 分析1975—2024年江苏省启东市肝癌死亡率长期变化趋势及潜在寿命损失，评估50年肝癌综合防控效果，识别新阶段面临挑战，为制定精准防控策略提供科学依据。[方法] 基于启东癌症登记处1975—2024年肝癌死亡登记资料，以5年为一时期将研究时段划分为10个时期。计算肝癌死亡例数、占全癌百分比、粗死亡率（CR）、中国人口标化率（中标率，ASMRC）；采用潜在寿命损失年（PYLL）、平均潜在寿命损失年（AYLL）、潜在寿命损失率（PYLLR）、标化潜在寿命损失年（SPYLL）、标化平均潜在寿命损失年（SAYLL）及标化潜在寿命损失率（SPYLLR）评估疾病早死负担；应用Joinpoint 5.1.0回归模型计算年度变化百分比（APC）和平均年度变化百分比（AAPC）。[结果] 1975—2024年启东市累计肝癌死亡32 319例，占全部恶性肿瘤死亡的27.59%，CR为57.54/10万，ASMRC为43.39/10万。ASMRC从1975—1979年的63.35/10万下降至2020—2024年的14.56/10万，降幅达77.01%，AAPC为-2.76%，2008年后下降显著加速，2008—2024年APC为-7.31%（均P<0.001）。男性ASMRC为66.98/10万，从1975—1979年的102.88/10万降至2020—2024年的20.83/10万，AAPC为-3.00%；女性ASMRC为20.23/10万，从1975—1979年的27.48/10万降至2020—2024年的8.30/10万，AAPC为-2.19%（均P<0.001）；50年男性ASMRC一直高于女性，男女性比值为3.31:1。寿命损失指标AYLL从1975—1979年的23.15年/人下降至2020—2024年的10.51年/人，AAPC为-1.69%；PYLLR从1975—1979年的11.47‰下降至2020—2024年的2.70‰，AAPC为-2.60%；SAYLL从1975—1979年的30.02年/人下降至2020—2024年的5.98年/人，降幅达80.10%，AAPC为-3.48%；SPYLLR从1975—1979年的14.87‰下降至2020—2024年的1.54‰，AAPC为 -4.38%（均P<0.001）。[结论] 1975—2024年启东市肝癌标化死亡率大幅下降，寿命损失显著改善。未来需在巩固现有成果的基础上，积极应对肝癌新危险因素的上升、人口老龄化对绝对死亡负担的推升以及男性持续高疾病负担的性别差异所带来的三大挑战。 |
| 英文摘要: |
| [Objective] To analyze the long-term trends in liver cancer mortality and potential years of life lost in Qidong City, Jiangsu Province from 1975 to 2024, evaluate the effectiveness of comprehensive liver cancer prevention and control strategies, identify challenges in the new stage and provide a scientific basis for formulating future prevention and control strategies. [Methods] Liver cancer death registration data from 1975 to 2024 were collected from the Qidong Cancer Registry. The study period was divided into ten 5-year intervals. The number of liver cancer deaths, proportion of total cancer deaths, crude mortality rate (CR), and age-standardized mortality rate by Chinese standard population (ASMRC) were calculated. Potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), standardized average years of life lost (SAYLL), and standardized potential years of life lost rate (SPYLLR) were used to assess life loss. Joinpoint 5.1.0 regression model was used to calculate the annual percent change (APC) and average annual percent change (AAPC). [Results] From 1975 to 2024, a total of 32,319 liver cancer deaths were recorded in Qidong, accounting for 27.59% of all cancer deaths, with a CR of 57.54/10? and an ASMRC of 43.39/10?. The ASMRC for liver cancer decreased from 63.35/10? in 1975—1979 to 14.56/10? in 2020—2024, with a decrease of 77.01% and an overall AAPC of -2.76%, and an accelerated decline since 2008 (APC=-7.31%, 2008—2024, all P<0.001). The ASMRC for males was 66.98/10?, decreasing from 102.88/10? in 1975—1979 to 20.83/10? in 2020—2024 (AAPC=-3.00%); the ASMRC for females was 20.23/10?, decreasing from 27.48/10? to 8.30/10? (AAPC=-2.19%, P<0.001). The overall ratio of male to female ASMRC was 3.31:1with males consistently outnumbering females.. The life loss index AYLL decreased from 23.15 years/person from 1975 to 1979 to 10.51 years/person from 2020 to 2024, and the AAPC was -1.69%; PYLLR decreased from 11.47‰ from 1975 to 1979 to 2.70‰ from 2020 to 2024, and AAPC was -2.60%; After standardization, SAYLL decreased from 30.02 years/person from 1975 to 1979 to 5.98 years/person from 2020 to 2024, a decrease of 80.10%, and AAPC was -3.48%; SPYLLR decreased from 14.87‰ from 1975 to 1979 to 1.54‰ from 2020 to 2024, and the AAPC was -4.38% (all P<0.001). [Conclusion] From 1975 to 2024, the standardized mortality rate of liver cancer in Qidong City decreased significantly, and the life loss was significantly improved. In the future, on the basis of consolidating existing achievements, it is necessary to actively respond to the three major challenges brought about by the rise of new risk factors for liver cancer, the increase in the absolute burden of death due to population aging, and the gender difference in the continued high burden of men. |
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