Time trends in cancer mortality in China: 1987-1999
Time trends in cancer mortality in China: 1987-1999
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DOI：
10.1002/ijc.11300
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发表时间：
2003-09-20
影响因子：
6.4
通讯作者：
Chen, YD
中科院分区：
文献类型：
--
作者：
Yang, L;Parkin, DM;Chen, YD
本文首次分析了中国癌症死亡率的时间趋势。本文利用中国全国死亡率报告系统（CHIS）的资料，采用联合点回归模型，分析了9种主要恶性肿瘤死亡率的时间趋势。1987年至1999年期间，所有癌症的年龄标准化死亡率在农村地区略有下降，但自1996年以来在城市地区有所上升。食道癌、胃癌、宫颈癌、白血病（1996年以后城市男性除外）和鼻咽癌的死亡率下降，而肺癌和女性乳腺癌的死亡率在城市和农村地区以及男女都有明显上升的趋势。结肠直肠癌和肝癌的死亡率在城市和农村人口中有不同的趋势。按年龄分列的死亡率趋势表明，在年轻人口中有一些不同的趋势，这可能预示着未来的总体趋势，例如，子宫颈癌死亡率上升。观察到的趋势主要反映了中国在过去20年中社会经济环境和生活方式的巨大变化。吸烟仍然是一个主要问题，肺癌死亡率增加。社会经济地位、饮食和营养的改善可能是某些癌症（食道癌、胃癌和鼻咽癌）风险下降的原因，而其他癌症（乳腺癌和结肠直肠癌）风险增加。筛查项目（特别是宫颈癌）以及更多更好的癌症治疗设施可能有助于降低几种癌症的死亡率。人口增长和老龄化导致的绝对死亡人数的大幅增加在决定未来癌症负担方面比风险变化导致的任何变化都重要得多，强调癌症作为21世纪世纪中国健康问题的重要性日益增加。(C)2003 Wiley-Liss，Inc.
A first analysis of time trends in cancer mortality in China at the national level is presented. Using a joinpoint regression model, based on data from a national mortality routine reporting system in China (CHIS), time trends in mortality for 9 major cancers are analyzed. Between 1987 and 1999, the age-standardized mortality rates for all cancers combined declined slightly in rural areas but have increased since 1996 in urban areas. The mortality rates for cancers in oesophagus, stomach, cervix uteri, leukaemia (except for urban males after 1996) and nasopharynx declined, while lung cancer and female breast cancer showed significant increasing trends in both urban and rural areas and for both sexes. Cancers of the colon-rectum and liver had different trends in mortality in urban and rural populations. The trends in age-specific mortality rates suggest some different trends in the younger population, which may presage future overall trends, for example, increasing mortality from cancer of the cervix. The observed trends primarily reflect the dramatic changes in socioeconomic circumstances and lifestyles in China in the last 2 decades. Tobacco smoking remains a major problem, with increases in mortality from lung cancer. The improvements in socioeconomic status, diet and nutrition may be responsible for the declining risk of some cancers (oesophagus, stomach and nasopharynx), while increasing the risk for others (breast and colon-rectum). Screening programs (especially for cervix cancer), and more available and better facilities for cancer therapy, may have helped to reduce mortality for several cancers. The large increases in the absolute number of deaths that resulted from the increasing and aging population are much more important in determining the future cancer burden than any changes due to change in risk, emphasizing the increasing importance of cancer as a health problem in the 21st century in China. (C) 2003 Wiley-Liss, Inc.