| 徐源佑,朱 健,陈永胜,等.1972—2021年江苏省启东市育龄妇女恶性肿瘤死亡率趋势分析及2022—2031年变化趋势预测[J].中国肿瘤,2026,35(1):48-54. |
| 1972—2021年江苏省启东市育龄妇女恶性肿瘤死亡率趋势分析及2022—2031年变化趋势预测 |
| Analysis of the Mortality Trend of Malignant Tumors Among Women of Childbearing Age in Qidong City of Jiangsu Province from 1972 to 2021 and Prediction of the Change Trend from 2022 to 2031 |
| 投稿时间：2025-06-19 |
| DOI：10.11735/j.issn.1004-0242.2026.01.A007 |
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| 中文关键词: 恶性肿瘤 育龄妇女 死亡率 趋势分析 预测 江苏 |
| 英文关键词:malignant tumor women of childbearing age mortality trend analysis forecast Jiangsu |
| 基金项目:南通大学临床医学专项科研基金（2024JY050） |
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| 中文摘要: |
| 摘 要：［目的］ 分析1972—2021年江苏省启东市育龄妇女（15~49岁）恶性肿瘤死亡率的长期变化趋势，并预测其后10年死亡率水平。［方法］ 基于启东市1972—2021年连续肿瘤登记数据，提取15~49岁户籍女性恶性肿瘤死亡病例，计算粗死亡率（crude mortality rate，CMR）、中国人口标化死亡率（age-standardized mortality rate by Chinese standard population，ASMRC）、世界人口标化死亡率（age-standardized mortality rate by world standard population，ASMRW），采用Joinpoint 4.9.1.0软件计算平均年度变化百分比（average annual percentage change，AAPC），分析死亡率时间趋势变化；通过SAS 9.2软件构建ARIMA模型，预测2022—2031年育龄妇女恶性肿瘤粗死亡率。［结果］ 1972—2021年启东市育龄妇女恶性肿瘤累计死亡6 371例，50年间CMR从1972—1976年的38.89/10万降至2017—2021年的26.75/10万，趋势变化无统计学意义（AAPC=-0.04%，P=0.844）；ASMRC从45.81/10万降至19.89/10万（AAPC=-1.56%，P<0.001），ASMRW从43.94/10万降至19.51/10万（AAPC=-1.48%，P<0.001），呈现显著下降趋势。年龄别死亡率随年龄增长呈显著上升趋势，15~19岁组最低（5.84/10万），45~49岁组最高（112.51/10万）；除15~19岁年龄组死亡率无明显趋势变化外（AAPC=-0.99%，P=0.299），其余年龄组均存在显著下降趋势（P均<0.05）。1972—2021年启东市育龄妇女恶性肿瘤死亡顺位前10位依次为肝癌、胃癌、乳腺癌、肺癌、白血病、结直肠癌、脑及中枢神经系统肿瘤、淋巴瘤、宫颈癌和胰腺癌，占总恶性肿瘤死亡的89.81%；其中肝癌、胃癌和结直肠癌的ASMRW呈现明显下降趋势（AAPC分别为-3.14%、-1.64%和-1.88%，P均<0.05）；而宫颈癌的ASMRW呈现明显上升趋势（AAPC=3.41%，P=0.001）。预测结果显示，2026年启东市育龄妇女恶性肿瘤CMR将降至21.07/10万，2031年进一步降至19.69/10万。［结论］ 50年来启东市育龄妇女恶性肿瘤标化死亡率显著下降，反映区域癌症防控成效，但粗死亡率无明显变化，且宫颈癌死亡率上升趋势突出，需重点关注；未来10年死亡率将持续降低，仍需针对重点恶性肿瘤（如宫颈癌）和高危年龄组强化早筛早治与健康干预。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the long-term trend of mortality from malignant tumors among women of childbearing age (15~49 years old) in Qidong City， Jiangsu Province from 1972 to 2021， and predict the mortality level in the next 10 years. ［Methods］ Based on the continuous cancer registration data of Qidong City from 1972 to 2021， death cases of malignant tumors among registered women aged 15~49 years old were extracted. The crude mortality rate (CMR)， age-standar-dized mortality rate by Chinese standard population (ASMRC)， and age-standardized mortality rate by world standard population (ASMRW) were calculated. The Joinpoint 4.9.1.0 software was used to calculate the average annual percentage change (AAPC) for analyzing the temporal trend of mortality; SAS 9.2 software was employed to construct an ARIMA model， so as to predict the crude mortality rate of malignant tumors among women of childbearing age from 2022 to 2031. ［Results］ A total of 6 371 women of childbearing age in Qidong City died of malignant tumors from 1972 to 2021. Over the 50 years， the CMR decreased from 38.89/105 during 1972—1976 to 26.75/105 during 2017—2021， with no statistical significant trend (AAPC=-0.04%， P=0.844). The ASMRC decreased from 45.81/105 to 19.89/105 (AAPC=-1.56%， P<0.001)， and the ASMRW decreased from 43.94/105 to 19.51/105(AAPC=-1.48%， P<0.001)， both showing a significant downward trend. The age-specific mortality rate increased significantly with age: the lowest was in the 15~19 years old group (5.84/105)， and the highest was in the 45~49 years old group (112.51/105). Except for the 15~19 years old group with no obvious trend in mortality (AAPC=-0.99%， P=0.299)， all other age groups showed a significant downward trend (all P<0.05). From 1972 to 2021， the top 10 causes of death from malignant tumors among women of childbearing age in Qidong City were liver cancer， gastric cancer， breast cancer， lung cancer， leukemia， colorectal cancer， brain and nervous system tumors， lymphoma， cervical cancer， and pancreatic cancer， accounting for 89.81% of the total malignant tumor deaths. Among these， the ASMRW of liver cancer， gastric cancer， and colorectal cancer showed a significant downward trend (AAPC: -3.14%， -1.64%， and -1.88% respectively， all P<0.05)， while the ASMRW of cervical cancer showed a significant upward trend (AAPC=3.41%， P=0.001). The prediction results indicated that the CMR of malignant tumors among women of childbearing age in Qidong City would decrease to 21.07/105 in 2026 and further drop to 19.69/105 in 2031. ［Conclusion］ Over the past 50 years， the standardized mortality rate of malignant tumors among women of childbearing age in Qidong City has decreased significantly， which reflects the effectiveness of regional cancer prevention and control. However， the crude mortality rate has no obvious change， and the upward trend of cervical cancer mortality is prominent， which requires focused attention. The mortality rate will continue to decrease in the next 10 years， and it is still necessary to strengthen early screening， early treatment and health interventions for key cancers (such as cervical cancer) and high-risk age groups. |
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