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| 1995-2024年上海市浦东新区结直肠癌死亡趋势与疾病负担分析 |
| Analysis of Colorectal Cancer Mortality Trends and Disease Burden in Pudong New Area, Shanghai, 1995-2024 |
| 投稿时间：2026-05-20 修订日期：2026-08-04 |
| DOI： |
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| 中文关键词: 结直肠癌 死亡率 减寿年数 时间趋势 |
| 英文关键词:Colorectal cancer mortality rate years of life lost time trend |
| 基金项目:浦东新区卫生健康委员会联合攻关项目(PW2023D-15)； 浦东新区卫生健康委员会领先人才培养计划（PWRI2024-10）；浦东新区卫生健康委员会公共卫生学科（PWGW2025-06）；浦东新区卫生健康委员会研究者发起的临床研究项目（临床研究队列专项）（2024-PWDL-03） |
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| 中文摘要: |
| 目的 分析上海市浦东新区1995-2024年结直肠癌的死亡趋势及负担，为防治策略的制定提供参考。方法 利用浦东新区死亡登记系统数据，采用Segi’s世界标准人口计算粗死亡率和年龄标准化死亡率（ASMR）。运用Joinpoint回归模型分析死亡率及疾病负担指标的时间趋势，计算年变化百分比（annual percentage change，APC）和平均年变化百分比（average annual percentage change, AAPC）。采用世界卫生组织推荐方法计算寿命损失年数（years of life lost, YLL）、寿命损失年数率（years of life lost rate, YLLR）和平均寿命损失年数（average years of life lost, AYLL），并按性别和年龄组进行分层分析。结果 1995—2024年浦东新区因结直肠癌死亡共18 677例，粗死亡率为22.97/10万，ASMR为9.77/10万。时间趋势分析显示，研究期间粗死亡率呈显著上升趋势（AAPC=4.14%，95%CI：3.43%~4.85%，Z=11.590，P＜0.001），其增长幅度高于ASMR（AAPC=0.95%，95%CI：0.48%~1.43%，Z=3.987，P＜0.001）。≥80岁人群死亡率上升最为明显。同期结直肠癌共造成198 079.82人年的YLL，YLL和YLLR均呈显著上升趋势，而AYLL呈持续下降趋势。男性死亡率及YLL、YLLR水平均高于女性，且男性疾病负担增长速度更快。结论 1995—2024年浦东新区结直肠癌死亡率和疾病负担总体呈上升趋势，人口老龄化可能是其主要驱动因素。男性和高龄人群的疾病负担尤为突出。进一步提高结直肠癌筛查覆盖率和筛查质量，有望减缓浦东新区结直肠癌死亡负担的持续上升。 |
| 英文摘要: |
| 【Objective】To analyze the mortality trends and disease burden of colorectal cancer in Pudong New Area, Shanghai, from 1995 to 2024, providing a reference for the formulation of prevention and control strategies. 【Methods】 Using data from the Pudong New Area Mortality Registry System, crude mortality rate and age-standardized mortality rate (ASMR) were calculated using the Segi’s World Standard Population. Joinpoint regression models were used to analyze the time trends of mortality and disease burden indicators, calculating the annual percentage change (APC) and average annual percentage change (AAPC). Years of life lost (YLL), years of life lost rate (YLLR), and average years of life lost (AYLL) were calculated using methods recommended by the World Health Organization, and stratified analyses were performed by gender and age group. 【Results】From 1995 to 2024, a total of 18,677 people died from colorectal cancer in Pudong New Area, with a crude mortality rate of 22.97/100,000 and an average disease burden (ASMR) of 9.77/100,000. Time trend analysis showed a significant upward trend in the crude mortality rate during the study period (AAPC=4.14%, 95%CI:3.43%~4.85%, Z=11.590, P＜0.001),with a higher growth rate than the ASMR (AAPC=0.95%, 95%CI:0.48%~1.43%, Z=3.987, P＜0.001). The mortality rate increased most significantly among individuals aged ≥80 years. During the same period, colorectal cancer caused 198,079.82 person-years of colorectal cancer (YLL). Both YLL and YLLR showed significant upward trends, while AYLL showed a continuous downward trend. The mortality rate, YLL, and YLLR levels were higher in men than in women, and the disease burden increased at a faster rate in men. 【Conclusion】From 1995 to 2024, the overall mortality rate and disease burden of colorectal cancer in Pudong New Area showed an upward trend, and population aging is likely the main driving factor. The disease burden is particularly pronounced in men and the elderly. Further improving the coverage and quality of colorectal cancer screening is expected to slow the continued rise in colorectal cancer mortality in Pudong New Area. |
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