| 白孟琳,王临池,黄春妍,等.2021年江苏省苏州市居民恶性肿瘤死亡特征及1987—2021年变化趋势[J].中国肿瘤,2026,35(9):718-724. |
| 2021年江苏省苏州市居民恶性肿瘤死亡特征及1987—2021年变化趋势 |
| Cancer Mortality Among Suzhou Residents in 2021 in Jiangsu Province and Trends from 1987 to 2021 |
| 投稿时间：2026-02-06 |
| DOI：10.11735/j.issn.1004-0242.2026.09.A009 |
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| 中文关键词: 恶性肿瘤 死亡率 趋势分析 因素分解 江苏 |
| 英文关键词:cancer mortality rate trend analysis factor decomposition Jiangsu |
| 基金项目:江苏省老年健康科研项目（LKM2023038）；苏州市重大疾病、传染病预防和控制关键技术（研究）项目（GWZX202301） |
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| 中文摘要: |
| 摘 要：［目的］分析2021年江苏省苏州市居民恶性肿瘤死亡情况以及1987—2021年变化趋势。［方法］ 收集1987—2021年苏州市恶性肿瘤死亡资料，计算2021年恶性肿瘤粗死亡率、中标死亡率（age-standardized mortality rate by Chinese standard population，ASMRC）、0~74岁累积死亡率、年龄别死亡率以及前10位恶性肿瘤死亡顺位等指标。运用Joinpoint模型计算平均年度变化百分比（average annual percentage change，AAPC），分析1987—2021年苏州市恶性肿瘤死亡率及死因顺位变化趋势。采用Das Gupta因素分解分析法对死亡变化的影响因素进行分解分析。［结果］ 2021年苏州市共报告恶性肿瘤死亡14 679例，粗死亡率为194.88/10万，ASMRC为77.70/10万，0~74岁累积死亡率为8.03%。恶性肿瘤年龄别死亡率在55岁前处于较低水平，55岁后随年龄增长快速升高，且男性死亡率显著高于女性。前5位恶性肿瘤死因依次为肺癌、胃癌、结直肠癌、肝癌和胰腺癌，合计占全部恶性肿瘤死亡的68.89%。1987—2021年，苏州市恶性肿瘤粗死亡率呈显著上升趋势（AAPC=0.66%，P<0.01），ASMRC呈下降趋势（AAPC=-1.74%，P<0.01）。主要癌种中，肺癌和结直肠癌粗死亡率均呈上升趋势（肺癌：AAPC=2.64%，P<0.01；结直肠癌：AAPC=2.64%，P<0.01），而ASMRC变化均无统计学意义（肺癌：AAPC=0.18%，P=0.50；结直肠癌：AAPC=-0.13%，P=0.70）。胃癌和肝癌粗死亡率及ASMRC均呈显著下降趋势，其中粗死亡率AAPC分别为-1.44%和-1.47%，ASMRC的AAPC分别为-3.84%和-3.67%（P均<0.01）。因素分解结果显示，1987—2021年苏州市恶性肿瘤死亡数增加6 096例，其中人口老龄化贡献138.71%，人口自然增长贡献64.29%，年龄别死亡率下降抵消了99.48%的增长。［结论］ 苏州市居民恶性肿瘤ASMRC呈下降趋势，但人口老龄化导致粗死亡率持续上升，疾病负担依然沉重。应重点加强肺癌和消化道恶性肿瘤防控，针对老年人群推进早诊早治，降低恶性肿瘤死亡风险。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the cancer mortality status of residents in Suzhou City， Jiangsu Province in 2021 and the changing trends from 1987 to 2021. ［Methods］ The cancer mortality data in Suzhou City from 1987 to 2021 were collected. Indicators including crude mortality rate， age-standardized mortality rate by Chinese standard population (ASMRC)， cumulative mortality rate for 0-74 years old， age-specific mortality rate and the top 10 causes of cancer death in 2021 were calculated. The Joinpoint model was used to calculate the average annual percentage change (AAPC) to analyze the trends of cancer mortality rate and cause of death ranking in Suzhou City from 1987 to 2021. The Das Gupta factor decomposition analysis method was applied to decompose and analyze the influencing factors of mortality changes. ［Results］ In 2021， a total of 14 679 cancer deaths were reported in Suzhou City， with a crude mortality rate of 194.88/105， an ASMRC of 77.70/105， and a cumulative mortality rate of 8.03% for 0-74 years old. The age-specific cancer mortality rate was at a low level before 55 years old， and increased rapidly with age after 55 years old， with the mortality rate in male significantly higher than that in female. The top 5 causes of cancer death were lung cancer， gastric cancer， colorectal cancer， liver cancer and pancreatic cancer， accounting for 68.89% of all cancer deaths. From 1987 to 2021， the crude cancer mortality rate in Suzhou City showed a significant upward trend (AAPC=0.66%， P<0.01)， while the ASMRC showed a downward trend(AAPC=-1.74%， P<0.01). Among the major cancer types， the crude mortality rates of lung cancer and colorectal cancer both showed upward trends (lung cancer： AAPC=2.64%， P<0.01； colorectal cancer： AAPC=2.64%， P<0.01)， while there was no statistically significant change in the ASMRC (lung cancer： AAPC=0.18%， P=0.50； colorectal cancer： AAPC=-0.13%， P=0.70)， respectively. Both the crude mortality rate and ASMRC of gastric cancer and liver cancer showed significant downward trends， with AAPC of crude mortality rate being -1.44% and -1.47% respectively， and AAPC of ASMRC being -3.84% and -3.67% respectively (all P<0.01). The factor decomposition results showed that the number of cancer deaths in Suzhou City increased by 6 096 cases from 1987 to 2021， among which population aging contributed 138.71%， natural population growth contributed 64.29%， and the decrease in age-specific mortality rate offset 99.48% of the increase. ［Conclusion］ The ASMRC of cancer among residents in Suzhou City shows a downward trend， but population aging leads to a continuous increase in crude mortality rate， and the disease burden remains heavy. We should focus on strengthening the prevention and control of lung cancer and digestive system cancers， and promote early diagnosis and treatment for the elderly population to reduce the risk of cancer death. |
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