| 秦家胜,陈 蓉,方 杨,等.2021年浙江省肿瘤登记地区肝癌发病与死亡特征及2000—2021年变化趋势分析[J].中国肿瘤,2025,34(11):838-846. |
| 2021年浙江省肿瘤登记地区肝癌发病与死亡特征及2000—2021年变化趋势分析 |
| Incidence and Mortality of Liver Cancer in Zhejiang Cancer Registration Areas in 2021 and Trends from 2000 to 2021 |
| 投稿时间：2025-05-23 |
| DOI：10.11735/j.issn.1004-0242.2025.11.A002 |
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| 中文关键词: 肝癌 发病率 死亡率 趋势 浙江 |
| 英文关键词:liver cancer incidence mortality epidemic trends Zhejiang |
| 基金项目:浙江省医药卫生科技计划项目（2023KY1188） |
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| 中文摘要: |
| 摘 要：［目的］ 分析2021年浙江省肿瘤登记地区肝癌的发病和死亡状况及2000—2021年变化趋势。［方法］ 利用浙江省肿瘤登记处上报的肝癌数据，按性别、年龄、城乡分层，计算粗发病率、粗死亡率、中标发病率、中标死亡率、世标发病率、世标死亡率等指标。采用Joinpoint回归模型（5.3.0版本）拟合率与年份的对数线性关系，计算年度变化百分比（annual percentage change，APC）及平均年度变化百分比（average annual percentage change，AAPC），并估计95%置信区间（confidence interval，CI）。［结果］ 2021年浙江省肿瘤登记地区肝癌的粗发病率为26.93/10万（中标发病率13.35/10万），粗死亡率为20.87/10万（中标死亡率9.52/10万），发病数和死亡数分别占所有恶性肿瘤发病和死亡的5.07%和11.33%。男性肝癌的发病率和死亡率均显著高于女性（粗发病率：40.17/10万 vs 13.85/10万；中标发病率：20.60/10万 vs 6.34/10万；粗死亡率：30.78/10万 vs 11.07/10万；中标死亡率：14.67/10万 vs 4.57/10万）。农村地区肝癌的发病率和死亡率均高于城市地区（粗发病率：30.39/10万 vs 24.79/10万；中标发病率：15.35/10万 vs 12.10/10万；粗死亡率：24.32/10万 vs 18.72/10万；中标死亡率：11.30/10万 vs 8.40/10万）。2021年肝癌发病率在30岁前处于较低水平，30岁后随年龄增长显著上升，男性85岁及以上年龄组达发病峰值（170.04/10万），女性在80~84岁年龄组达发病峰值（84.74/10万）；死亡率在30岁前较低，30岁后随年龄增长显著上升，男性在85岁及以上年龄组达死亡峰值（211.64/10万），女性80~84岁年龄组达死亡峰值（98.31/10万）。2000—2021年，肝癌粗发病率呈上升趋势（AAPC=1.01%，95%CI：0.44%~1.58%），中标发病率相对平稳（AAPC=-0.81%，95%CI：-1.48%~0.02%），2010年后中标发病率下降趋势显著；粗死亡率（AAPC=-0.84%，95%CI：-1.23%~-0.36%）及中标死亡率（AAPC=-2.78%，95%CI：-3.28%~-2.20%）均呈显著下降趋势，且中标死亡率下降幅度更大。［结论］ 2000—2021年浙江省肿瘤登记地区肝癌发病率呈波动下降、死亡率呈稳步下降趋势，但疾病负担仍较重。农村地区、老年人及男性为高风险人群，需作为肝癌防控重点对象。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the incidence and mortality of liver cancer in cancer registration areas of Zhejiang Province in 2021 and the epidemiological trends of liver cancer from 2000 to 2021. ［Methods］ Using liver cancer data from 2000 to 2021 reported by Zhejiang Provincial Cancer Registries， stratified by sex， age， and urban-rural areas， indicators including crude incidence rate， crude mortality rate， age-standardized incidence rate by Chinese standard population (ASIRC)， age-standardized mortality rate by Chinese standard population (ASMRC)， age-standardi-zed incidence rate by world standard population (ASIRW)， age-standardized mortality rate by world standard population (ASMRW) were calculated. Joinpoint Regression Program (Version 5.3.0) was used to fit the log-linear relationship between rates and years， and calculate the annual percentage change (APC) and average annual percentage change (AAPC) with 95% confidence interval (CI). ［Results］ In 2021， the crude incidence rate of liver cancer in Zhejiang cancer registration areas was 26.93/105(ASIRC： 13.35/105)， and the crude mortality rate was 20.87/105(ASMRC： 9.52/105). The number of new cases and deaths of liver cancer accounted for 5.07% and 11.33% of all malignant tumor cases and deaths， respectively. The incidence and mortality rates of liver cancer in male were significantly higher than those in female (crude incidence rate： 40.17/105 vs 13.85/105； ASIRC： 20.60/105 vs 6.34/105； crude mortality rate： 30.78/105 vs 11.07/105； ASMRC： 14.67/105 vs 4.57/105)， and those in rural areas were higher than those in urban areas (crude incidence rate： 30.39/105 vs 24.79/105； ASIRC： 15.35/105 vs 12.10/105； crude mortality rate： 24.32/105 vs 18.72/105； ASMRC： 11.30/105 vs 8.40/105). In 2021， the incidence rate of liver cancer was low before the age of 30 years old， and increased significantly with age after 30 years old， reaching the peak in male aged 85 years old and above (170.04/105) and in female aged 80~84 years old (84.74/105). The mortality rate showed a similar trend to the incidence rate， which was low before the age of 30 years old and increased significantly with age after 30 years old， peaking in male aged 85 years old and above (211.64/105) and in female aged 80~84 years old (98.31/105). From 2000 to 2021， the crude incidence rate of liver cancer in Zhejiang Province showed an overall upward trend (AAPC=1.01%， 95%CI：0.44%~1.58%)， while the ASIRC remained relatively stable (AAPC=-0.81%， 95%CI：-1.48%~0.02%) with a significant remained relatively stable (AAPC=-0.81%， 95%CI：-1.48%~0.02%)， after 2010， the ASIRC remained relatively stable (AAPC=-0.81%， 95%CI：-1.48%~0.02%) with a significant decreased significantly. Both the crude mortality rate (AAPC=-0.84%， 95%CI：-1.23%~-0.36%) and ASMRC (AAPC=-2.78%， 95%CI：-3.28%~-2.20%) showed significant downward trends， and the decline of ASMRC was more obvious. ［Conclusion］ From 2000 to 2021， the incidence of liver cancer in cancer registration areas of Zhejiang Province showed a fluctuating downward trend， and the mortality showed a steady downward trend， but the disease burden remains heavy. Rural areas， the elderly， and males are high-risk populations， which should be the key targets of liver cancer prevention and control. |
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