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| 1975—2024年江苏省启东市白血病死亡率趋势及潜在寿命损失分析 |
| Analysis of Leukemia Mortality Trends and Potential Years of Life Lost in Qidong of Jiangsu Province from 1975 to 2024 |
| 投稿时间：2026-07-28 修订日期：2026-09-12 |
| DOI： |
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| 中文关键词: 白血病 死亡率 潜在减寿年数 趋势分析 启东市 |
| 英文关键词:Leukemia Mortality Potential years of life lost Trend analysis Qidong |
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| 中文摘要: |
| [目的] 分析1975—2024年江苏省启东市白血病死亡趋势及寿命损失情况，为该地区白血病防控策略制定提供科学依据。[方法] 收集启东市肿瘤登记处1975—2024年白血病（ICD-10：C91-C95）的死亡资料，计算粗死亡率（crude mortality rate, CR）、中国人口标准化死亡率（age-standardized mortality rate by Chinese standard population, ASRC）、潜在减寿年数（potential years of life lost, PYLL）、标化潜在减寿年数（standardized PYLL, SPYLL）、平均减寿年数（average years of life lost, AYLL）及潜在减寿率（PYLL rate, PYLLR）等指标。以70岁为目标寿命，采用2000年全国标准人口进行标化，并运用Joinpoint 6.0.1回归计算年度变化百分比（annual percent change, APC）和平均年度变化百分比（average annual percent change, AAPC）。[结果] 1975—2024年启东市共报告白血病死亡2 554例，占全部恶性肿瘤死亡的2.18%。CR从1975—1979年的2.95/10万上升至2020—2024年的6.22/10万（AAPC=1.80%，P < 0.001）；ASRC从1975—1979年的3.09/10万上升至2005—2009年的4.24/10万（APC=0.80%，P = 0.004），后降至2020—2024年的2.65/10万（APC=-3.38%，P < 0.001）。全时期男性ASRC高于女性，男性在2009—2024年下降显著（APC=-3.08%，P = 0.014），女性则在2007—2024年显著下降（APC=-3.39%，P = 0.030）。年龄别死亡率随年龄增长而升高，0～29岁组最低（2.38/10万），≥80岁组最高（15.28/10万），死亡高峰由70～79岁组后移至≥80岁组。0～29岁、30～39岁和40～49岁组死亡率显著下降（P < 0.05），60～69岁、70～79岁和≥80岁组显著上升（P < 0.05）；50～59岁组全时期变化不显著，但2013年后明显下降（APC=-8.44%，P = 0.030）。全人群PYLL、AYLL和PYLLR分别为47 646.50人年、26.09年/人和0.94‰，总人群及男女性PYLLR均呈显著下降，PYLLR在2007—2008年后明显下降。经年龄标化后，SPYLL、SAYLL和SPYLLR分别为53 355.87人年、29.22年/人和1.05‰；SPYLLR在总人群和男性中显著下降（AAPC分别为-1.13%和-1.25%，均 P < 0.05），女性全时期变化不显著（AAPC=-1.07%，P = 0.066），但三者均在2005—2006年后明显下降（P均 < 0.05）。1~49岁各组PYLLR呈显著下降趋势（AAPC分别为-2.20%、-2.13%和-1.44%，P均 < 0.05），60~69岁组呈上升趋势（AAPC=0.88%，P = 0.024），50~59岁组变化趋势则无统计学意义（AAPC=0.25%，P = 0.585）。[结论] 1975—2024年启东市白血病粗死亡率持续上升但标化死亡率自2009年后下降明显，标化潜在寿命损失率自2006年后下降明显，50岁以下的年轻及中年人群的年龄别死亡率及潜在寿命损失率改善明显。男性负担较高，60岁以上老龄组死亡率和60~69岁减寿率上升。建议年龄分层管理，巩固儿童及青年规范诊疗，提升中老年药物可及性，加强职业危害控制，以降低死亡负担。 |
| 英文摘要: |
| [Purpose] To analyze long-term trends in leukemia mortality and years of life lost in Qidong, Jiangsu Province, from 1975 to 2024, and to provide a scientific basis for developing regional leukemia prevention and control strategies. [Methods] Data on deaths from leukemia (ICD-10: C91-C95) from 1975 to 2024 were collected from the Qidong Cancer Registry. The crude mortality rate (CR), age-standardized mortality rate by Chinese standard population (ASRC), potential years of life lost (PYLL), standardized potential years of life lost (SPYLL), average years of life lost (AYLL), and potential years of life lost rate (PYLLR) were calculated. A reference life expectancy of 70 years was used, and age standardization was performed using the 2000 Chinese standard population. Joinpoint regression analysis (version 6.0.1) was conducted to estimate the annual percent change (APC) and average annual percent change (AAPC). [Results] A total of 2,554 leukemia deaths were reported in Qidong during 1975 to 2024, accounting for 2.18% of all cancer deaths. The CR increased from 2.95/105 in 1975-1979 to 6.22/105 in 2020-2024 (AAPC=1.80%, P < 0.001). The ASRC increased from 3.09/105 in 1975-1979 to 4.24/105 in 2005-2009 (APC=0.80%, P = 0.004), and subsequently decreased to 2.65/105 in 2020-2024 (APC=-3.38%, P < 0.001). Throughout the study period, the ASRC was higher in males than in females. A significant decline was observed among males during 2009 to 2024 (APC=-3.08%, P = 0.014) and among females during 2007 to 2024 (APC=-3.39%, P = 0.030). Age-specific mortality increased with age, ranging from 2.38/105 in the 0-29-year age group to 15.28/105 among individuals aged ≥80 years. The peak mortality shifted from the 70-79-year age group to the ≥80-year age group. Mortality declined significantly in the age groups of 0-29, 30-39, and 40-49 years old (all P < 0.05), but increased significantly in the 60-69-, 70-79-, and ≥80-year age groups (all P < 0.05). No significant overall change was observed in the 50-59-year age group, although mortality declined markedly after 2013 (APC=-8.44%, P = 0.030). In the total population, PYLL, AYLL, and PYLLR were 47,646.50 person-years, 26.09 years per death, and 0.94‰, respectively. PYLLR declined significantly in the total population and in both sexes, with the rate of decline accelerating after 2007-2008. After age standardization, SPYLL, SAYLL and SPYLLR were 53,355.87 person-years, 29.22 years per death, and 1.05‰, respectively. SPYLLR declined significantly in the total population and among males, with AAPCs of -1.13% and -1.25%, respectively (both P < 0.05). The overall trend among females was not statistically significant (AAPC=-1.07%, P = 0.066), however, marked declines were observed in the total population and in both sexes after 2005-2006 (all P < 0.05). PYLLR decreased significantly in the 1-29-, 30-39-, and 40-49-year age groups, with AAPCs of -2.20%, -2.13%, and -1.44%, respectively (all P < 0.05), but increased in the 60-69-year age group (AAPC=0.88%, P = 0.024). No statistically significant trend was observed in the 50-59-year age group (AAPC=0.25%, P = 0.585). [Conclusion] From 1975 to 2024, the CR for leukemia in Qidong continued to rise, but the ASRC has declined significantly since 2009, and the SPYLLR has also declined significantly since 2006. There has been a marked improvement in age-specific mortality rates and PYLLR among young and middle-aged people under 50 years of age. The burden is higher among men, with mortality rates rising in the over-60s age group and the rate of life-years lost increasing in the 60-69 age group. It is recommended that age-stratified management be implemented, standardized diagnosis and treatment for children and young people be consolidated, access to medication for middle-aged and elderly people be improved, and control of occupational hazards be strengthened, in order to reduce the burden of mortality. |
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