在2012年12月期的《肿瘤学年鉴》(Annals of Oncology)杂志上,发表了我国汕头大学医学院李克教授的一篇研究报告,该研究目的为,对中国癌症死亡率的长期趋势进行综合性的概览。中国癌症死亡病例总数占世界的近四分之一,因此对全球的癌症趋势和负担具有重要影响。
研究人员通过Joinpoint分析方法,考察了中国的癌症变化趋势,并通过广义加性模型,对1987年至2009年期间,出生队列对风险因素的影响进行了研究。
研究人员发现,中国城市地区所有癌症种类的死亡率均呈稳定降低趋势,而农村地区则未表现出该趋势。此外观察发现,胃、食管、鼻咽及宫颈部位肿瘤死亡率均出现下降,而肺癌及女性乳腺癌死亡率则呈上升趋势。白血病死亡率相对稳定,而农村地区与城市地区间在肝癌、结直肠癌及膀胱癌方面,存在不同的死亡率变化趋势。代际风险峰值出现在1925-1930年出生的队列,其后出生的连续队列在除白血病外的多数癌症种类上均呈下降趋势,而其中最近的几个队列相对风险则呈上升趋势。
李教授等人认为,该研究中所观察到的趋势基本反映了在过去20年间,中国社会经济发展及生活方式方面的巨大变化,此外,肺癌及女性乳腺癌的死亡率仍是政府部门在公共卫生方面的主要优先事项。(生物谷Bioon.com)
doi:10.1093/annonc/mds069
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Trends in cancer mortality in China: an update
Guo P Huang ZL Yu P Li K
Cancer deaths of China with the world population nearly a quarter will have a severe impact on global cancer trend and burden. The study aims to provide a comprehensive overview of long-term trends in cancer mortality in China. We used joinpoint analysis to detect changes in trends and generalized additive models to study birth cohort effect of risk factors between 1987 and 2009. Mortality of all cancers declined steadily in urban areas, but not in rural areas. Decreasing mortality from cancers of the stomach, esophagus, nasopharynx, and cervix uteri was observed, while lung and female breast cancer mortality increased. Mortality from leukemia remained relatively stable, and cancer of liver, colorectal, and bladder had different trends between the rural and urban areas. Generational risks peaked in the cohorts born around 1925-1930 and tended to decline in successive cohorts for most cancers except for leukemia, whose relative risks were rising in the very recent cohorts. The observed trends primarily reflect dramatic changes in socioeconomic development and lifestyle in China over the past two decades, and mortality from cancers of lung and female breast still represents a major public health priority for the government.