| 黄渊秀,胡劲松,黄 霜,等.2018—2022年湖南省长沙市恶性肿瘤发病与死亡变化趋势分析[J].中国肿瘤,2025,34(11):862-869. |
| 2018—2022年湖南省长沙市恶性肿瘤发病与死亡变化趋势分析 |
| Trends of Incidence and Mortality of Cancers from 2018 to 2022 in Changsha City， Hunan Province |
| 投稿时间：2025-07-10 |
| DOI：10.11735/j.issn.1004-0242.2025.11.A005 |
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| 中文关键词: 恶性肿瘤 发病率 死亡率 变化趋势 贡献率 湖南 |
| 英文关键词:cancer incidence mortality change trend contribution rate Hunan |
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| 中文摘要: |
| 摘 要：［目的］分析2018—2022年长沙市恶性肿瘤发病与死亡的时间趋势。［方法］ 基于长沙市2018—2022年肿瘤年报数据，采用SAS 9.2计算发病/死亡粗率、中国人口标化率（简称中标率）。中标率采用2000年全国普查人口年龄构成为标准进行计算。运用Joinpoint 4.9.0.0软件拟合对数线性回归模型，计算平均年度变化百分比（average annual percentage change，AAPC）及 95%置信区间（confidence interval，CI），分析其变化趋势，并通过线性回归模型计算各癌种对趋势变化的贡献率，检验水准 α为0.05。［结果］ 2018—2022年长沙市恶性肿瘤粗发病率367.98/10万（中标率为232.28/10万），粗死亡率为192.36/10万（中标率为106.11/10万），男性发病率及死亡率均高于女性。恶性肿瘤发病率与死亡率在50岁前处于较低水平，50岁后快速上升：发病率在80~84岁年龄组达峰值，死亡率在85岁及以上年龄组达峰值。发病前5位依次为肺癌、女性乳腺癌、结直肠癌、宫颈癌、甲状腺癌，死亡前5位依次为肺癌、结直肠癌、肝癌、女性乳腺癌、宫颈癌。中标发病率在全人群（AAPC=4.71%，95%CI：3.20%~6.23%）、男性（AAPC=2.44%，95%CI：0.35%~4.58%）、女性（AAPC=7.17%，95%CI：4.00%~10.43%）中均显著上升；中标死亡率在全人群（AAPC=2.94%，95%CI：0.73%~5.20%）、男性（AAPC=3.37%，95%CI：1.63%~5.15%）中显著上升，女性趋势变化无统计学意义（P>0.05）。贡献率分析显示：甲状腺癌（51.25%）、女性乳腺癌（12.18%）、口腔癌（5.28%）、淋巴瘤（6.02%）是发病率上升的主要贡献癌种；肺癌（26.10%）、结直肠癌（14.89%）、淋巴瘤（5.60%）、口腔癌（5.73%）、甲状腺癌（2.08%）是死亡率上升的主要贡献癌种；肝癌（49.82%）、食管癌（19.55%）是发病率下降的主要贡献癌种，且对死亡率下降的贡献率分别达 77.69%、11.16%。［结论］ 2018—2022 年长沙市恶性肿瘤疾病负担持续加重，需针对甲状腺癌、肺癌、结直肠癌等重点癌种及男性、中老年等高危人群强化防控，同时巩固肝癌、食管癌的防控成效。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the trends of cancer incidence and mortality in Changsha City from 2018 to 2022.［Methods］ Based on the annual cancer registry data of Changsha City from 2018 to 2022， SAS 9.2 software was used to calculate the crude incidence/mortality rates and age-standardized incidence/mortality rates by Chinese standard population(ASIRC/ASMRC). The age-standardized rate was standardized using the population composition of China in 2000. Joinpoint 4.9.0.0 software was used to fit a Log-linear regression model to calculate the average annual percentage change (AAPC) and its 95% confidence interval (CI) for trend analysis. A linear regression model was applied to calculate the contribution rate of each cancer type to the trend change， with a significance level of α=0.05. ［Results］ From 2018 to 2022， the crude incidence rate of malignant tumors in Changsha City was 367.98/105 (ASIRC：232.28/105)， and the crude mortality rate was 192.36/105(ASMRC：106.11/105). Both incidence and mortality rates were higher in male than those in female. The incidence and mortality rates remained relatively low before age 50 but rose rapidly thereafter： the incidence peaked in the age group of 80~84 years old， while mortality peaked in the age group of 85 years old and above. The top 5 cancers by incidence were lung cancer， female breast cancer， colorectum cancer， cervical cancer， and thyroid cancer； while the top 5 cancers by mortality were lung cancer， colorectum cancer， liver cancer， female breast cancer， and cervical cancer. The ASIRC increased significantly in the total population (AAPC=4.71%， 95%CI：3.20%~6.23%)， male (AAPC=2.44%， 95%CI：0.35%~4.58%)， and female (AAPC=7.17%， 95%CI：4.00%~10.43%). The ASMRC increased significantly in the total population (AAPC=2.94%，95%CI：0.73%~5.20%) and male (AAPC=3.37%， 95%CI：1.63%~5.15%)， but the trend in female was not statistically significant (P>0.05). Contribution rate analysis showed that thyroid cancer (51.25%)， female breast cancer (12.18%)， lymphoma (6.02%)， and oral cavity and pharyngeal cancer (5.28%) were the main cancer types contributing to the increased ASIRC； lung cancer (26.10%)， colorectum cancer (14.89%)， oral cavity and pharyngeal cancer(5.73%)， lymphoma (5.60%)， and thyroid cancer (2.08%) were the main ones contributing to the increased ASMRC； liver cancer (49.82%) and esophageal cancer (19.55%) were the main causes of decreased ASIRC， with their contribution rates to decreased ASMRC reaching 77.69% and 11.16%， respectively. ［Conclusion］ The disease burden of malignant tumors in Changsha City continued to increase from 2018 to 2022. It is necessary to strengthen prevention and control for cancers with a significant upward trend (such as thyroid cancer， lung cancer， and colorectum cancer) and high-risk populations (such as male and middle-aged and elderly people)， while consolidating the prevention and control effects for liver cancer and esophageal cancer. |
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