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摘要:目的
评估河北省肝癌的疾病负担，分析肝癌40年间的死亡率变化趋势。
方法按照全国肿瘤登记中心制定的审核方法和评价标准对河北省9个登记处上报的肿瘤登记数据进行评估、审核与合并。按性别和年龄别分层，计算发病率和死亡率，以1/10万表示。分析河北省三次全死因回顾调查的肝癌数据。采用Joinpoint回归模型分析磁县肿瘤登记处1988—2012年肝癌发病和死亡趋势。
结果河北省2010—2012年肝癌新发病例2 552例，死亡病例2 447例。肝癌发病率为18.26/10万（男性24.89/10万，女性11.40/10万），世标率（ASIRW）15.32/10万，占癌症发病的第五位。肝癌死亡率为17.51/10万（男性23.71/10万，女性11.09/10万），世标率（ASMRW）为15.05/10万，位于死亡顺位的第四位。河北省40年间死亡率总体上升了15.95%。磁县男女的肝癌发病和死亡趋势大致相同。
结论河北省肝癌的发病率和死亡率远高于世界平均水平，河北省肝癌负担依旧严重，应继续加强肝癌防治工作。
Abstract:ObjectiveTo estimate the liver cancer burden and analyze the trend of the mortality rate during last 40 years in Hebei Province.
MethodsCancer registry data from nine cancer registries in Hebei Province were qualified and checked according to the regulations from the National Cancer Registry Center. The pooled data were stratified by gender and age. Incidence and mortality rates were calculated and expressed in 1/100 000. Liver cancer mortality data during the three periods were extracted and calculated from the national death surveys. Mortality and incidence trends in Ci County from 1988 to 2012 were analyzed by Joinpoint Regression Models.
ResultsThe newly liver cancer cases and deaths from 2010 to 2012 in Hebei Province were 2 552 and 2 447,respectively. The crude incidence rate (CIR) of liver cancer was 18.26/100 000 (24.89/100 000 in male and 11.40/100 000 in female). The age-standardized incidence rate by world standard population (ASIRW) was 15.32/100 000,ranking the fifth of all cancers. The crude mortality rate(CMR) of liver cancer was 17.51/100 000(23.71/100 000 in male and 11.09/100 000 in female). The age-standardized mortality rate by world standard population(ASMRW) was 15.05/100 000,which was the fourth leading case of cancer death. The mortality rates displayed an increasing trend in Hebei Province during last 40 years as a whole,with an increased rate of 15.95%. In Ci County,the trends of incidence and mortality for both genders were similar.
ConclusionThe incidence and mortality rates of liver cancer in Hebei Province are much higher than the average level in the world. There is still a heavy health burden for liver cancer in Hebei Province. Thus,it is necessary to go on with taking measures to prevent and control liver cancer in the future.
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Key words:
- Cancer registry /
- Liver cancer /
- Incidence /
- Mortality /
- Hebei province
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图 1 1973—2012年河北省肝癌死亡指标
Figure 1 Mortality of liver cancer in Hebei Province,1973-2012
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图 2 1973—2012年河北省男性肝癌年龄别死亡率
Figure 2 Age-specific mortality rate of liver cancer in male in Hebei Province,1973-2012
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图 3 1973—2012年河北省女性肝癌年龄别死亡率
Figure 3 Age-specific mortality rate of liver cancer in female in Hebei Province,1973-2012
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图 4 1988—2012年河北省磁县肝癌发病率和死亡率
Figure 4 Incidence and mortality rate of liver cancer in Ci County,1988-2012
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图 5 Joinpoint模型拟合磁县肝癌发病和死亡趋势，1988—2012
Figure 5 Trend of incidence and mortality of liver cancer in Ci County using Joinpoint model,1988-2012
表 1 2010—2012年河北省肿瘤登记地区肝癌发病与死亡
Table 1 Incidence and mortality of liver cancer in Hebei Province cancer registry areas,2010-2012
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[1] Ferlay J, Soerjomataram I, Dikdhit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in CLOBOCAN 2012[J]. Int J Cancer, 2015, 36(1): E359-86. [1] Ferlay J,Soerjomataram I,Dikdhit R,et al. Cancer incidence and mortality worldwide: Sources,methods and major patterns in CLOBOCAN 2012[J]. Int J Cancer,2015,36(1): E359-86. http://cn.bing.com/academic/profile?id=1757407923&encoded=0&v=paper_preview&mkt=zh-cn
[2] Global Burden of Disease Cancer C,Fitzmaurice C,Dicker D,et al. The Global Burden of Cancer 2013[J]. JAMA Oncol,2015,1(4): 505-27. doi: 10.1001/jamaoncol.2015.0735
[2] Global Burden of Disease Cancer C, Fitzmaurice C, Dicker D, et al. The Global Burden of Cancer 2013[J]. JAMA Oncol, 2015, 1(4): 505-27. [3] Chen W,Zheng RS. Zeng H. et al. Annual report on status of cancer in China,2011[J]. Chin J Cancer Res,2015,27(1): 2-12. http://cn.bing.com/academic/profile?id=2129000805&encoded=0&v=paper_preview&mkt=zh-cn
[3] Chen W, Zheng RS. Zeng H. et al. Annual report on status of cancer in China, 2011[J]. Chin J Cancer Res, 2015, 27(1): 2-12. [4] 中国卫生部国家肿瘤防治办公室. 中国肿瘤死因调查报告[M]. 北京: 人民卫生出版社, 1980. 335-8. [National Office of Cancer Prevention and Treatment, Ministry of Health. Malignant tumor mortality survey report in China[M]. Beijing: People’s Medical Publishing House, 1980. 335-8] [4] 中国卫生部国家肿瘤防治办公室. 中国肿瘤死因调查报告[M]. 北京: 人民卫生出版社,1980: 335-8. National Office of Cancer Prevention and Treatment,Ministry of Health. Malignant tumor mortality survey report in China[M]. Beijing: People’s Medical Publishing House,1980: 335-8
[5] 全国肿瘤防治研究办公室. 中国1990-1992年癌症死因调查[M]. 北京: 人民卫生出版社,1993: 534-629. National Office of Cancer Prevention and Treatment. Survey of cancer mortality in China 1990-1992[M]. Beijing: People‘s Medical Publishing House,1993: 534-629.
[5] 全国肿瘤防治研究办公室. 中国1990–1992年癌症死因调查 [M]. 北京: 人民卫生出版社, 1993. 534-629. [National Office of Cancer Prevention and Treatment. Survey of cancer mortality in China 1990–1992[M]. Beijing: People‘s Medical Publishing House, 1993. 534-629.] [6] 全国肿瘤防治研究办公室. 中国肿瘤死亡报告 全国第三次死因回顾抽样调查[M]. 北京: 人民卫生出版社,2010: 256-371. National Office of Cancer Prevention and Treatment. Malignant tumor mortality report in China,the third review sampling survey for death causes[M]. Beijing: People’s Medical Publishing House,2010: 256-371.
[6] 全国肿瘤防治研究办公室. 中国肿瘤死亡报告 全国第三次死 因回顾抽样调查[M]. 北京: 人民卫生出版社, 2010. 256-371. [National Office of Cancer Prevention and Treatment. Malignant tumor mortality report in China, the third review sampling survey for death causes[M]. Beijing: People’s Medical Publishing House, 2010. 256-371.] [7] Parkin DM, Whelan SL, Ferlay J, et al. Cancer Incidence in Five Continents Vol.Ⅷ[M]. Lyon: IARC Scientific Publications, 2002, 5-217. [7] Parkin DM,Whelan SL,Ferlay J,et al. Cancer Incidence in Five Continents Vol.Ⅷ[M]. Lyon: IARC Scientific Publications,2002: 5-217.
[8] Forman D,Bray F,Brewster DH,et al. Cancer Incidence in Five Continents Vol.Ⅹ[M]. Lyon: IARC Scientific Publications,2014:14-509.
[8] Forman D, Bray F, Brewster DH, et al. Cancer Incidence in Five Continents Vol.Ⅹ[M]. Lyon: IARC Scientific Publications, 2014, 14-509. [9] Bray F, Parkin DM. Evaluation of data quality in the cancer registry: principles and methods. PartⅠ: comparability, validity and timelines[J]. Eur J Cancer, 2009, 45(5): 747-55. [9] Bray F,Parkin DM. Evaluation of data quality in the cancer registry: principles and methods. PartⅠ: comparability,validity and timelines[J]. Eur J Cancer,2009,45(5): 747-55. doi: 10.1016/j.ejca.2008.11.032
[10] Parkin DM, Chen VW, Ferlay J, et al. Comparability and Quality Control in Cancer Registratio[M]. Lyon: IARC Technical Report, 1996. 1-116. [10] Parkin DM,Chen VW,Ferlay J,et al. Comparability and Quality Control in Cancer Registratio[M]. Lyon: IARC Technical Report,1996: 1-116.
[11] Felay J,Burkhard C,Whelan S,et al. Check and Conversion Program for Cancer Registries[M]. Lyon: IARC Technical Report,2005: 1-46.
[11] Felay J, Burkhard C, Whelan S, et al. Check and Conversion Program for Cancer Registries[M]. Lyon: IARC Technical Report, 2005. 1-46. [12] McGlynn KA,Petrick JL,London WT. Global Epidemiology of Hepatocellular Carcinoma: an emphasis on demographic and regional variability[J]. Clin Liver Dis,2015,19(2): 223-38. doi: 10.1016/j.cld.2015.01.001
[12] McGlynn KA, Petrick JL, London WT. Global Epidemiology of Hepatocellular Carcinoma: an emphasis on demographic and regional variability[J]. Clin Liver Dis, 2015, 19(2): 223-38. [13] Bosetti C,Turati F,La Vecchia C. Hepatocellular carcinoma epidemiology[J]. Best Pract Res Clin Gastroenterol,2014,28(5): 753-70. doi: 10.1016/j.bpg.2014.08.007
[13] Bosetti C, Turati F, La Vecchia C. Hepatocellular carcinoma epidemiology[J]. Best Pract Res Clin Gastroenterol, 2014, 28(5): 753-70. [14] 陈建国,张思维,陈万青. 中国2004-2005年全国死因回顾抽样调查肝癌死亡率分析[J]. 中华预防医学杂志,2010,44(5): 383-9. Chen JG,Zhang SW,Chen WQ. Analysis of liver cancer mortality in the national retrospective sampling survey of death causes in China,2004-2005[J]. Zhonghua Yu Fang Yi Xue Za Zhi,2010,44(5): 383-9.
[14] 陈建国, 张思维, 陈万青. 中国2004-2005年全国死因回顾抽 样调查肝癌死亡率分析[J]. 中华预防医学杂志, 2010, 44(5): 383-9. [Chen JG, Zhang SW, Chen WQ. Analysis of liver cancer mortality in the national retrospective sampling survey of death causes in China, 2004-2005[J]. Zhonghua Yu Fang Yi Xue Za Zhi, 2010, 44(5): 383-9.] [15] Zuo TT, Zheng RS, Zhang SW, et al. Incidence and mortality of liver cancer in China in 2011[J]. Chin J Cancer, 2015, 34(11): 508-13. [15] Zuo TT,Zheng RS,Zhang SW,et al. Incidence and mortality of liver cancer in China in 2011[J]. Chin J Cancer,2015,34(11): 508-13. http://cn.bing.com/academic/profile?id=2107211154&encoded=0&v=paper_preview&mkt=zh-cn
[16] McGlynn KA,Tsao L,Hsing AW,et al. International trends and patterns of primary liver cancer[J]. Int J Cancer,2001,94(2): 290-6. doi: 10.1002/(ISSN)1097-0215
[16] McGlynn KA, Tsao L, Hsing AW, et al. International trends and patterns of primary liver cancer[J]. Int J Cancer, 2001, 94(2): 290-6. [17] Jemal A,Center MM,DeSantis C,et al. Global patterns of cancer incidence and mortality rates and trends[J]. Cancer Epidemiol Biomarkers Prev,2010,19(8): 1893-907. doi: 10.1158/1055-9965.EPI-10-0437
[17] Jemal A, Center MM, DeSantis C, et al. Global patterns of cancer incidence and mortality rates and trends[J]. Cancer Epidemiol Biomarkers Prev, 2010, 19(8): 1893-907. [18] Zhu Q,Li N,Zeng X,et al. Hepatocellular carcinoma in a large medical center of China over a 10-year period: evolving therapeutic option and improving survival[J]. Oncotarget,2015,6(6): 4440-50. doi: 10.18632/oncotarget
[18] Zhu Q, Li N, Zeng X, et al. Hepatocellular carcinoma in a large medical center of China over a 10-year period: evolving therapeutic option and improving survival[J]. Oncotarget, 2015, 6(6): 4440-50. [19] Chien YC, Jan CF, Chiang CJ, et al. Incomplete hepatitis B immunization, maternal carrier status, and increased risk of liver diseases: a 20-year cohort study of 3.8 million vaccinees[J]. Hepatology, 2014, 60(1): 125-32. [19] Chien YC,Jan CF,Chiang CJ,et al. Incomplete hepatitis B immunization,maternal carrier status,and increased risk of liver diseases: a 20-year cohort study of 3.8 million vaccinees[J]. Hepatology,2014,60(1): 125-32. doi: 10.1002/hep.v60.1
[20] 郑荣寿, 左婷婷, 曾红梅, 等. 中国肝癌死亡状况与生存分析[J]. 中华肿瘤杂志, 2015, 37(9): 697-702. [Zheng RS, Zuo TT, Zeng HM, et al. [Mortality and survival analysis of liver cancer in China[J]. Zhonghua Zhong Liu Za Zhi, 2015, 37(9): 697-702.] [20] 郑荣寿,左婷婷,曾红梅,等. 中国肝癌死亡状况与生存分析[J]. 中华肿瘤杂志,2015,37(9): 697-702. Zheng RS,Zuo TT,Zeng HM,et al. [Mortality and survival analysis of liver cancer in China[J]. Zhonghua Zhong Liu Za Zhi,2015,37(9): 697-702.
[21] Chen WQ,Zheng RS,Zeng HM,et al. The updated incidences and mortalities of major cancers in China,2011[J]. Chinese J Cancer,2015,34(11): 502-7. http://cn.bing.com/academic/profile?id=2102927853&encoded=0&v=paper_preview&mkt=zh-cn
[21] Chen WQ, Zheng RS, Zeng HM, et al. The updated incidences and mortalities of major cancers in China, 2011[J]. Chinese J Cancer, 2015, 34(11): 502-7. [22] Wang N, Zheng Y, Yu X, et al. Sex-modified effect of hepatitis B virus infection on mortality from primary liver cancer[J]. Am J Epidemiol, 2009, 169(8): 990-5. [22] Wang N,Zheng Y,Yu X,et al. Sex-modified effect of hepatitis B virus infection on mortality from primary liver cancer[J]. Am J Epidemiol,2009,169(8): 990-5. doi: 10.1093/aje/kwn418
[23] Liang X, Bi S, Yang W, et al. Epidemiological serosurvey of hepatitis B in China-declining HBV prevalence due to Hepatitis B vaccination[J]. Vaccine, 2009, 27(47): 6550-7. [23] Liang X,Bi S,Yang W,et al. Epidemiological serosurvey of hepatitis B in China-declining HBV prevalence due to Hepatitis B vaccination[J]. Vaccine,2009,27(47): 6550-7. doi: 10.1016/j.vaccine.2009.08.048
[24] 陈建国. 中国肝癌发病趋势和一级预防[J]. 临床肝胆病杂志, 2012, 28(4): 256-60. [Chen JG. Trends in the incidence of liver cancer and its primary prevention in China[J]. Lin Chuang Gan Dan Bing Za Zhi, 2012, 28(4): 256-60.] [24] 陈建国. 中国肝癌发病趋势和一级预防[J]. 临床肝胆病杂志,2012,28(4): 256-60. http://www.cnki.com.cn/Article/CJFDTOTAL-LCGD201204011.htm Chen JG. Trends in the incidence of liver cancer and its primary prevention in China[J]. Lin Chuang Gan Dan Bing Za Zhi,2012,28(4): 256-60. http://www.cnki.com.cn/Article/CJFDTOTAL-LCGD201204011.htm
[25] Wang FS,Fan JG,Zhang Z,et al. The global burden of liver disease: the major impact of China[J]. Hepatology,2014,60(6): 2099-108. doi: 10.1002/hep.v60.6
[25] Wang FS, Fan JG, Zhang Z, et al. The global burden of liver disease: the major impact of China[J]. Hepatology, 2014, 60(6): 2099-108. [26] Yang G,Wang Y,Zeng Y,et al. Rapid health transition in China,1990-2010: findings from the Global Burden of Disease Study 2010[J]. Lancet,2013,381(9882): 1987-2015. doi: 10.1016/S0140-6736(13)61097-1
[26] Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010[J]. Lancet, 2013, 381(9882): 1987-2015. [27] Fan JH, Wang JB, Jiang Y, et al. Attributable causes of liver cancer mortality and incidence in China[J]. Asian Pac J Cancer Prev, 2013, 14(12): 7251-6. [27] Fan JH,Wang JB,Jiang Y,et al. Attributable causes of liver cancer mortality and incidence in China[J]. Asian Pac J Cancer Prev,2013,14(12): 7251-6. doi: 10.7314/APJCP.2013.14.12.7251
[28] Calle EE,Rodriguez C,Walker-Thurmond K,et al. Overweight,obesity,and mortality from cancer in a prospectively studied cohort of U.S. adults[J]. N Enql J Med,2003,348(17): 1625-38. doi: 10.1056/NEJMoa021423
[28] Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults[J]. N Enql J Med, 2003, 348(17): 1625-38. [29] Setiawan VW, Lim U, Lipworth L, et al. Sex and ethnic differences in the association of obesity with risk of hepatocellular carcinoma[J]. Clin Gastroenterol Hepatol, 2016, 14(2): 309-16. [29] Setiawan VW,Lim U,Lipworth L,et al. Sex and ethnic differences in the association of obesity with risk of hepatocellular carcinoma[J]. Clin Gastroenterol Hepatol,2016,14(2): 309-16. doi: 10.1016/j.cgh.2015.09.015
[30] Schlesinger S, Aleksandrova K, Pischon T, et al. Abdominal obesity, weight gain during adulthood and risk of liver and biliary tract cancer in a European cohort[J]. Int J Cancer, 2013, 132(3): 645-57. [30] Schlesinger S,Aleksandrova K,Pischon T,et al. Abdominal obesity,weight gain during adulthood and risk of liver and biliary tract cancer in a European cohort[J]. Int J Cancer,2013,132(3): 645-57. doi: 10.1002/ijc.v132.3
[31] Chen CL,Yang HI,Yang WS,et al. Metabolic factors and risk of hepatocellular carcinoma by chronic hepatitis B/C infection: a follow-up study in Taiwan[J]. Gastroenterology,2008,135(1): 111-21. doi: 10.1053/j.gastro.2008.03.073
[31] Chen CL, Yang HI, Yang WS, et al. Metabolic factors and risk of hepatocellular carcinoma by chronic hepatitis B/C infection: a follow-up study in Taiwan[J]. Gastroenterology, 2008, 135(1): 111-21. [32] Bosch FX, Ribes J, Diaz M, et al. Primary liver cancer: worldwide incidence and trends[J]. Gastroenterology, 2004, 127(5 Suppl 1): S5-16. [32] Bosch FX,Ribes J,Diaz M,et al. Primary liver cancer: worldwide incidence and trends[J]. Gastroenterology,2004,127(5 Suppl 1):S5-16. doi: 10.1053/j.gastro.2004.09.011
[33] Seeff LB,Hoofnagle JH. Epidemiology of hepatocellular carcinoma in areas of low hepatitis B and hepatitis C endemicity[J]. Oncogene,2006,25(27): 3771-7. doi: 10.1038/sj.onc.1209560
[33] Seeff LB, Hoofnagle JH. Epidemiology of hepatocellular carcinoma in areas of low hepatitis B and hepatitis C endemicity[J]. Oncogene, 2006, 25(27): 3771-7. [34] Chuang SC,La Vecchia C,Boffetta P. Liver cancer: descriptive epidemiology and risk factors other than HBV and HCV infection[J]. Cancer Lett,2009,286(1): 9-14. doi: 10.1016/j.canlet.2008.10.040
[34] Chuang SC, La Vecchia C, Boffetta P. Liver cancer: descriptive epidemiology and risk factors other than HBV and HCV infection[J]. Cancer Lett, 2009, 286(1): 9-14. [35] 刘英, 赵桐, 徐英, 等. 河北省原发性肝癌易感因素的病例对照 研究[J]. 中国煤炭工业医学杂志, 2014, 17(12): 2009-12. [Liu Y, Zhao T, Xu Y, et al. A Case-Control Study on risk factors of Primary Hepati Caricnoma in Hebei[J]. Zhongguo Mei Tan Gong Ye Yi Xue Za Zhi, 2014, 17(12): 2009-12.] [35] 刘英,赵桐,徐英,等. 河北省原发性肝癌易感因素的病例对照研究[J]. 中国煤炭工业医学杂志,2014,17(12): 2009-12. http://www.cnki.com.cn/Article/CJFDTOTAL-ZMGY201412038.htm Liu Y,Zhao T,Xu Y,et al. A Case-Control Study on risk factors of Primary Hepati Caricnoma in Hebei[J]. Zhongguo Mei Tan Gong Ye Yi Xue Za Zhi,2014,17(12): 2009-12. http://www.cnki.com.cn/Article/CJFDTOTAL-ZMGY201412038.htm
[36] Zeng H, Zheng R, Guo Y, et al. Cancer survival in China, 2003-2005: a population-based study[J]. Int J Cancer, 2015, 136(8): 1921-30. [36] Zeng H,Zheng R,Guo Y,et al. Cancer survival in China,2003-2005: a population-based study[J]. Int J Cancer,2015,136(8): 1921-30. doi: 10.1002/ijc.29227
[37] Wang JH, Changchien CS, Hu TH, et al. The efficacy of treatment schedules according to Barcelona Clinic Liver Cancer staging for hepatocellular carcinoma-Survival analysis of 3892 patients[J]. Eur J Cancer, 2008, 44(7): 1000-6. [37] Wang JH,Changchien CS,Hu TH,et al. The efficacy of treatment schedules according to Barcelona Clinic Liver Cancer staging for hepatocellular carcinoma-Survival analysis of 3892 patients[J]. Eur J Cancer,2008,44(7): 1000-6. doi: 10.1016/j.ejca.2008.02.018
[38] Chen JG,Zhang SW. Liver cancer epidemic in China: past,present and future[J]. Semin Cancer Biol,2011,21(1): 59-69. doi: 10.1016/j.semcancer.2010.11.002
[38] Chen JG, Zhang SW. Liver cancer epidemic in China: past, present and future[J]. Semin Cancer Biol, 2011, 21(1): 59-69. [39] Wang CH, Wey KC, Mo LR, et al. Current trends and recent advances in diagnosis, therapy, and prevention of hepatocellular carcinoma[J]. Asian Pac J Cancer Prev, 2015, 16(9): 3595-604. [39] Wang CH,Wey KC,Mo LR,et al. Current trends and recent advances in diagnosis,therapy,and prevention of hepatocellular carcinoma[J]. Asian Pac J Cancer Prev,2015,16(9): 3595-604. doi: 10.7314/APJCP.2015.16.9.3595
[40] Miller ZA, Lee KS. Screening for hepatocellular carcinoma in high-risk populations[J]. Clin Imaging, 2016, 40(2): 311-4. [40] Miller ZA,Lee KS. Screening for hepatocellular carcinoma in high-risk populations[J]. Clin Imaging,2016,40(2): 311-4. doi: 10.1016/j.clinimag.2015.11.010
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