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江苏省启东市1972—2021年多发性骨髓瘤发病流行趋势分析

Epidemic Trend of multiple myeloma Incidence in Qidong, Jiangsu,1972－2021

投稿时间：2025-08-27 修订日期：2026-02-24

DOI：

中文关键词: 多发性骨髓瘤发病率趋势启东

英文关键词:multiple myeloma incidence trend age-period-cohort model Qidong

基金项目:2023年度南通市卫生健康委科研项目（MS2023121）；南通市“十四五”科教强卫工程（通卫科技[2021]15号）

作者	单位	邮编
丁璐璐	启东市人民医院	226200
张永辉	启东市人民医院	226200
徐源佑	启东市人民医院	226200
朱健^*	启东市人民医院	226200
龚海健	启东市人民医院	226200

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中文摘要:

[目的] 对启东市1972－2021 年以人群为基础的多发性骨髓瘤（multiple myeloma，MM））发病流行特征和趋势进行分析。[方法] 分10个时期（5年/时期）统计粗发病率（crude incidence rate，CR），采用2000年全国普查人口结构推算中国标化发病率（age-standardized rate by China population，ASR-C），采用Segi’s世界标准人口结构推算世界标化发病率（age-standardized rate by World population，ASR-W）、35~64岁截缩率、0~74岁累积发病风险等。用Joinpoint Regression Program 4.9.1.0统计软件，计算启东市MM平均年度变化百分比（average annual percentage change，AAPC）。采用年龄-时期-队列模型分析MM发病率的年龄、时期和队列效应。使用SAS9.2软件采用自回归求和滑动平均（autoregressive integrated moving average, ARIMA）模型进行趋势预测等。[结果] 启东市MM的ASR-W值从1972－1976年的0.96/10万升至2017－2021年的1.56/10万，35~64岁截缩率从1972－1976年的1.76/10万升至2017－2021年的2.37/10万，0~74岁累积发病风险从1972－1976年的0.12%升至2017－2021年的0.19%。启东市男性MM的ASR-W值从1972－1976年的1.09/10万升至2017－2021年的1.87/10万；女性MM的ASR-W值从1972－1976年的0.90/10万升至2017－2021年的1.29/10万。1972－2021年启东市MM年龄组发病率随年龄的升高而升高，且55~64岁、65~74岁、75岁及以上年龄组发病率的AAPC值依次为1.63%（t=3.05，P=0.016）、1.62%（t=5.06，P=0.001）、2.94%（t= 4.09，P=0.003）。MM标化平均发病年龄后移，从1972－1976年的58.77岁升至2017－2021年的64.61岁。MM的趋势分析结果显示合计CR、ASR-C、ASR-W的AAPC值分别为4.11%（t = 11.53，P<0.001）、1.17%（t = 3.65，P=0.006）、1.22%（t = 3.78，P=0.005）。年龄-时期-队列分析发现，发病率的总年龄偏差、总时期偏差、全时期RR值、全队列RR值均有统计学意义（P均<0.05）。预计至2031年启东市MM粗发病率将达到5.75/10万。[结论] 启东市MM发病率50年来持续上升，中老年人群增幅显著，发病年龄后移，预测MM的疾病负担将日益加重，应针对性制定MM的防控措施。

英文摘要:

Abstract [Objective] To analyze the epidemiological characteristics and trends of population-based multiple myeloma (MM) incidence in Qidong City from 1972 to 2021. [Methods] The crude incidence rate (CR) was calculated in 10 periods (5 years per period). The age-standardized rate by China population (ASR-C) was estimated using the population structure from the 2000 National Population Census, while the age-standardized rate by World population (ASR-W), truncated rate for the 35-64 age group, and cumulative incidence risk for the 0-74 age group were calculated based on Segi’s World Standard Population. Joinpoint Regression Program 4.9.1.0 was used to compute the average annual percentage change (AAPC) of MM in Qidong City. An age-period-cohort model was applied to analyze the age, period, and cohort effects on MM incidence. SAS 9.2 software was employed to conduct trend prediction using the autoregressive integrated moving average (ARIMA) model. [Results] In Qidong City, the ASR-W of MM increased from 0.96 per 100,000 in 1972-1976 to 1.56 per 100,000 in 2017-2021; the truncated rate for the 35-64 age group rose from 1.76 per 100,000 in 1972-1976 to 2.37 per 100,000 in 2017-2021; and the cumulative incidence risk for the 0-74 age group increased from 0.12% in 1972-1976 to 0.19% in 2017-2021. For males, the ASR-W of MM increased from 1.09 per 100,000 in 1972-1976 to 1.87 per 100,000 in 2017-2021; for females, it rose from 0.90 per 100,000 in 1972-1976 to 1.29 per 100,000 in 2017-2021. From 1972 to 2021, the age-specific incidence rate of MM in Qidong City increased with age. The AAPC values of incidence rates for the 55-64, 65-74, and ≥75 age groups were 1.63% (t=3.05, P=0.016), 1.62% (t=5.06, P=0.001), and 2.94% (t=4.09, P=0.003). The age-standardized average age at MM onset shifted to an older age, increasing from 58.77 years in 1972-1976 to 64.61 years in 2017-2021. Trend analysis showed that the AAPC values of the overall CR, ASR-C, and ASR-W of MM were 4.11% (t=11.53, P<0.001), 1.17% (t=3.65, P=0.006), and 1.22% (t=3.78, P=0.005). Age-period-cohort analysis revealed that the total age deviation, total period deviation, overall period relative risk (RR) value, and overall cohort RR value of incidence rate were all statistically significant (all P<0.05). The crude incidence rate of MM in Qidong City is projected to reach 5.75 per 100,000 by 2031. [Conclusion] Over the past 50 years, the incidence rate of MM in Qidong City has continued to rise, with a significant increase in the middle-aged and elderly populations, and the age at onset has shifted to an older age. It is predicted that the disease burden of MM will increase increasingly, and targeted prevention and control measures for MM should be formulated.

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