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江苏省昆山市1981-2014年胃癌死亡率趋势及率差分解分析

Gastric Cancer Mortality Trend and Difference Decomposition Analysis in Kunshan, Jiangsu Province, 1981-2014

  • 摘要:
    目的  探究江苏省昆山市1981—2014年胃癌死亡率变化趋势及定量估计影响因素。
    方法  历年胃癌死亡病例来源于全人群死因监测,计算分性别和年龄组粗死亡率与年龄标化率,使用年度变化百分比(annual percentage change, APC)及其95%CI评价死亡率在1981—2014年时间趋势。采用率差别分解法分析人口因素对胃癌死亡率变化的贡献。
    结果  胃癌年龄标化死亡率在男女合计(APC=-3.6%, 95%CI: -3.9%~-3.3%)、男性(APC=-3.9%, 95%CI: -4.3%~-3.5%)和女性(APC=-3.5%, 95%CI: -4.0%~-3.0%)人群中呈明显的下降趋势。昆山市1981—2014年间胃癌死亡率0~74岁累积率在男性和女性人群中大幅下降(APC=-4.2%, 95%CI: -4.7%~-3.7%)。胃癌死亡率的下降是人口因素与非人口因素作用结果,其中人口因素贡献在男女合计、男性及女性人群中分别为-124.92%、-154.61%和-117.52%。
    结论  江苏省昆山市过去30年高水平胃癌死亡率在非人口因素作用下持续下降,但这种下降受到了人口因素的阻碍。

     

    Abstract:
    Objective  To explore the gastric cancer mortality temporal trend and quantitatively estimate the influence factors in Kunshan, Jiangsu Province, 1981-2014.
    Methods  Gastric cancer death cases were derived from population-based vital registry system. Crude rates and age standardized rate (ASR) were calculated according to sex and age. Annual percentage changes (APC) and 95% confidence intervals (CI) were obtained to estimate the temporal trend from 1981 to 2014. Difference decomposition method was applied to estimate the contribution of demographic and non-demographic factors for the change of mortality.
    Results  The age standardized mortality of gastric cancer in both sex (APC=-3.6%, 95%CI: -3.9% to -3.3%), male (APC=-3.9%, 95%CI: -4.3% to -3.5%) and female (APC=-3.5%, 95%CI: -4.0% to -3.0%) were decreased significantly, and cumulative mortality of 0-74 years old was declined significantly in both sex (APC=-4.2%, 95%CI: -4.7% to -3.7%). The decrease of gastric cancer mortality was due to the effect of demographic and non-demographic factors, where the proportion of demography in both sex, male and female were -124.92%, -154.61%, and -117.52%, respectively.
    Conclusion  The mortality of gastric cancer in Kunshan city has declined due to the effect of non-demographic factors over the past three decades, but the decline is hindered demographic factors.

     

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