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| 1975—2024年江苏省启东市胰腺癌死亡特征及潜在寿命损失分析 |
| Analysis on Mortality Characteristics and Potential Years of Life Lost of Pancreatic Cancer in Qidong City, Jiangsu Province, 1975–2024 |
| 投稿时间：2026-07-01 修订日期：2026-08-26 |
| DOI： |
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| 中文关键词: 胰腺癌 死亡率 潜在寿命损失年 趋势 |
| 英文关键词:Pancreatic cancer Mortality rate Potential years of life lost Trend |
| 基金项目:南通大学校级科研基金临床医学专项资助项目（2025LQ017） |
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| 摘要点击次数: 47 |
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| 中文摘要: |
| [目的] 分析1975—2024年江苏省启东市胰腺癌流行特征及潜在寿命损失，为胰腺癌分层精准防控提供流行病学依据。[方法] 本研究利用1975—2024年江苏省启东市肿瘤登记报告系统数据，按每5年为一个时期将1975—2024年分为十个时期，计算胰腺癌死亡例数、占全部恶性肿瘤死亡百分比、粗死亡率（CR）、中国人口标化死亡率（ASMRC）、潜在寿命损失年（PYLL）、标化潜在寿命损失年（SPYLL）、平均潜在寿命损失年（AYLL）、标化平均潜在寿命损失年（SAYLL）、潜在寿命损失率（PYLLR）、标化潜在寿命损失率（SPYLLR）等指标。采用Joinpoint 6.0.1计算年度变化百分比（APC）、平均年度变化百分比（AAPC）及95%可信区间，分性别、年龄组分析胰腺癌死亡率与减寿指标的长期变化趋势。[结果] 1975—2024年启东市胰腺癌累计死亡5 757例，占全部肿瘤死亡的4.92%，CR和ASMRC分别为10.25/10万和5.71/10万。1975—2024年启东市全人群胰腺癌CR和ASMRC均呈显著上升趋势，AAPC值分别为3.85%和0.81%（均P<0.05），其中2000—2024年CR和ASMRC增长速率大幅提升，APC值分别达到6.13%和2.35%（均P<0.05）。男性CR和ASMRC分别为11.43/10万和6.54/10万，女性CR和ASMRC分别为9.11/10万和4.93/10万，男性各时期CR、ASMRC 均高于女性。分性别长期趋势结果显示1975—2024年男女性胰腺癌CR和ASMRC均整体显著上升，男性CR和ASMRC的AAPC值为3.77%和0.58%（均P<0.05），女性CR和ASMRC的AAPC值分别为3.98%和1.09%（均P<0.05）。1975—2024年因胰腺癌造成的全人群PYLLR和SPYLLR分别为0.53‰和0.41‰，男性各项寿命损失指标高于女性。寿命损失长期趋势分析显示PYLLR整体呈上升趋势，年均增幅为1.78%（P<0.05）；AYLL、SAYLL整体呈下降趋势，AAPC值依次为-0.85%、-2.95%（均P<0.05）；SPYLLR整体变化无统计学意义（P=0.143）。年龄分层趋势存在显著分化，40～49岁与60～69岁组胰腺癌CR呈先降后升的拐点变化；80岁及以上人群全时段CR年均增幅达3.19%，其中1999年后增速升至6.84%（均P<0.05）。PYLLR变化与CR高度同步，40～49岁组1975—2001年年均下降6.88%，2001年后反弹至年均增长7.55%（均P<0.05）。[结论] 1975—2024年启东市胰腺癌死亡负担呈上升趋势，近25年来上升趋势尤为明显。男性ASMRC与PYLLR均高于女性，但女性增长速率更快。老年群体死亡风险快速升高，中年群体死亡风险回升成为突出问题。应推行精准综合防控以遏制胰腺癌死亡负担的持续增长。 |
| 英文摘要: |
| [Objective] To analyze the epidemiological characteristics and potential years of life lost due to pancreatic cancer in Qidong City, Jiangsu Province from 1975 to 2024, so as to provide epidemiological evidence for the hierarchical and targeted prevention and control of pancreatic cancer. [Methods] This study used data from the cancer registry and reporting system of Qidong City, Jiangsu Province from 1975 to 2024. The entire study period was divided into ten 5-year intervals. We calculated the number of pancreatic cancer deaths, the proportion of pancreatic cancer deaths in all malignant tumor deaths, crude mortality rate (CR), age-standardized mortality rate by Chinese standard population (ASMRC), potential years of life lost (PYLL), standardized potential years of life lost (SPYLL), average years of life lost (AYLL), standardized average years of life lost (SAYLL), potential years of life lost rate (PYLLR), and standardized potential years of life lost rate (SPYLLR). Joinpoint Regression Program 6.0.1 was adopted to calculate the annual percent change (APC), average annual percent change (AAPC) together with their 95% confidence intervals. Long-term trends of pancreatic cancer mortality and life loss indicators were analyzed stratified by gender and age group. [Results] A total of 5 757 deaths from pancreatic cancer were recorded in Qidong City during 1975–2024, accounting for 4.92% of all deaths from malignant tumors. The CR and ASMRC were 10.25/10? and 5.71/10?, respectively. Both the CR and ASMRC of pancreatic cancer among the overall population in Qidong City showed significant increasing trends from 1975 to 2024, with AAPC values of 3.85% and 0.81% respectively (both P<0.05). The growth rates of CR and ASMRC increased markedly from 2000 to 2024, with APC reaching 6.13% and 2.35% respectively (both P<0.05). The CR and ASMRC for males were 11.43/10? and 6.54/10?, respectively, while the corresponding figures for females were 9.11/10? and 4.93/10?. The CR and ASMRC of males were consistently higher than those of females across all periods. Stratified gender trend analysis demonstrated that both CR and ASMRC of pancreatic cancer increased significantly for males and females during 1975—2024. The AAPC of CR and ASMRC among males were 3.77% and 0.58% (both P<0.05), while the corresponding AAPC values for females were 3.98% and 1.09% (both P<0.05). The overall population PYLLR and SPYLLR caused by pancreatic cancer from 1975 to 2024 were 0.53‰ and 0.41‰, respectively. All indicators of life loss in males were higher than those in females. Long-term trend analysis of life loss indicators revealed that PYLLR presented an overall upward trend with an average annual increase of 1.78% (P<0.05), AYLL and SAYLL declined continuously, with AAPC values of -0.85% and -2.95%, respectively (both P<0.05). No statistically significant long-term change was observed for SPYLLR (P=0.143). There were significant disparities in age-stratified trends. The CR of pancreatic cancer in the 40～49 years and 60～69 years age groups showed an inflection trend of decreasing first and then increasing. The average annual growth rate of CR reached 3.19% among residents aged 80 years and older throughout the period, and the growth rate jumped to 6.84% after 1999 (all P<0.05). The trend of PYLLR was highly consistent with that of CR. In the 40~49 years age group, PYLLR decreased by 6.88% annually from 1975 to 2001, and then rebounded with an annual increase of 7.55% after 2001(all P<0.05). [Conclusion] The mortality burden of pancreatic cancer in Qidong City showed an upward trend from 1975 to 2024, with a particularly remarkable upward trend in the recent 25 years. Both ASMRC and PYLLR were higher in males than in females, whereas females had a faster growth rate. The death risk increased rapidly among the elderly, and the rebound of premature death burden in middle-aged populations became a prominent concern. Targeted comprehensive prevention and control strategies should be implemented to curb the continuous rise of pancreatic cancer mortality burden. |
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