Analysis for mortality trend and age-period-cohort of kidney cancer in China from 1990 to 2019
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摘要:
目的 分析全球健康数据交换(the Global Health Data Exchange, GHDx)数据库中中国肾癌的死亡趋势及其流行病学特征。 方法 收集GHDx数据库中1990―2019年间20~<90岁中国人群肾癌死亡数据,运用Joinpoint回归模型分析肾癌死亡率的变化趋势,用年龄-时期-队列(age-period-cohort, APC)模型探讨影响肾癌死亡风险的年龄效应、时期效应与出生队列效应。 结果 1990―2019年全国、男性、女性肾癌标化死亡率均呈波动增长的趋势,平均年度变化百分比分别为2.04%、2.92%、0.70%;APC模型分析结果显示,无论男女,肾癌死亡风险均随着年龄的增长而增加,均随着时间的推移而增加,较晚出生的队列,其肾癌死亡风险均低于之前出生的队列。 结论 1990―2019年中国肾癌死亡率总体呈上升趋势,越早出生,年龄越大,生活在当代的人其肾癌死亡风险更高,肾癌造成的疾病负担仍是一个严重的公共卫生问题。 -
关键词:
- 肾癌 /
- 死亡率 /
- 变化趋势 /
- 年龄-时期-队列模型
Abstract:Objective To analyze the mortality trends and epidemiological characteristics of kidney cancer in China from the Global Health Data Exchange (GHDx) database. Methods We collected the kidney cancer mortality data in China among adults aged 20- < 90 years in GHDx database from 1990 to 2019. Joinpoint regression model was used to estimate the mortality trends. Age-period-cohort model was used to explore the age effect, period effect and cohort effect. Results The standardized mortality of kidney cancer from 1990 to 2019 showed a fluctuating growth trend in the whole population and the subgroups of male and female, with the average annual change percentage of 2.04%, 2.92% and 0.70% respectively; For both male and female, the relative risk of kidney cancer mortality increased with advancing age and time period, but decreased from earlier birth cohorts to more recent birth cohorts. Conclusions The overall trends of the mortality of kidney cancer in China increased from 1990 to 2019. People who born earlier, being older, and living in modern times have a higher risk of kidney cancer mortality. The disease burden caused by kidney cancer is still a serious public problem. -
Key words:
- Kidney neoplasms /
- Mortality /
- Trends /
- Age-period-cohort model
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表 1 1990―2019年中国肾癌ASMR的变化趋势
Table 1. Trends of ASMR of kidney cancer in China from 1990 to 2019
变量 ASMR(/10万) 1990年 2019年 年份 APC(95% CI)值 AAPC AAPC值 t值 P值 全国 0.70 1.27 1990―1996 -0.64(-0.98~-0.31) a 2.04 14.61 < 0.001 1996―1999 3.25(1.20~5.35) a 1999―2004 8.51(7.82~9.20) a 2004―2011 2.11(1.77~2.46) a 2011―2016 -1.51(-2.14~-0.89) a 2016―2019 1.71(0.69~2.73) a 女性 0.59 0.72 1990―1998 -1.21(-1.50~-0.92) a 0.70 5.34 < 0.001 1998―2004 5.67(5.03~6.32) a 2004―2009 0.87(0.01~1.75) a 2009―2016 -1.69(-2.15~-1.24) a 2016―2019 1.52(0.15~2.91) a 男性 0.85 1.96 1990―1996 0.08(-0.33~0.49) 2.92 16.73 < 0.001 1996―1999 4.50(2.00~7.07) a 1999―2004 9.87(9.03~10.71) a 2004―2011 3.34(2.92~3.76) a 2011―2017 -0.82(-1.35~-0.28) a 2017―2019 2.33(-0.12~4.84) 注:a表示P < 0.05。 表 2 中国肾癌死亡率年龄-时期-队列模型分析结果
Table 2. Age-period-cohort (APC) model analysis results of kidney cancer mortality in China by gender
分组 男性 女性 效应系数 标准误 Z值 P值 效应系数 标准误 Z值 P值 年龄(岁) 20~<25 -2.37 1.50 -1.57 0.115 -1.78 1.65 -1.08 0.282 25~<30 -2.03 1.11 -1.83 0.068 -1.60 1.35 -1.19 0.233 30~<35 -1.52 0.87 -1.75 0.081 -1.40 1.19 -1.17 0.241 35~<40 -0.94 0.69 -1.36 0.174 -1.16 1.05 -1.11 0.267 40~<45 -0.55 0.59 -0.93 0.351 -0.83 0.89 -0.94 0.348 45~<50 -0.15 0.50 -0.30 0.761 -0.45 0.74 -0.62 0.538 50~<55 0.22 0.42 0.54 0.591 -0.05 0.61 -0.09 0.931 55~<60 0.55 0.35 1.58 0.114 0.26 0.50 0.52 0.600 60~<65 0.57 0.29 1.94 0.053 0.61 0.40 1.54 0.124 65~<70 0.70 0.24 2.89 0.004 0.87 0.33 2.68 0.007 70~<75 0.94 0.21 4.58 < 0.001 1.14 0.28 4.09 <0.001 75~<80 1.27 0.19 6.60 <0.001 1.32 0.28 4.71 <0.001 80~<85 1.42 0.22 6.47 <0.001 1.44 0.32 4.47 <0.001 85~<90 1.87 0.26 7.07 <0.001 1.64 0.39 4.19 <0.001 时期(年) 1990―1994 -0.76 0.24 -3.11 0.002 -0.39 0.32 -1.21 0.225 1995―1999 -0.58 0.18 -3.20 0.001 -0.36 0.24 -1.48 0.138 2000―2004 -0.11 0.13 -0.86 0.387 -0.07 0.18 -0.36 0.721 2005―2009 0.28 0.12 2.36 0.018 0.20 0.17 1.16 0.248 2010―2014 0.53 0.15 3.52 <0.001 0.27 0.22 1.25 0.212 2015―2019 0.64 0.20 3.17 0.002 0.34 0.29 1.18 0.239 队列(年) 1903―1907 0.94 0.48 1.93 0.053 0.81 0.66 1.24 0.217 1908―1912 0.83 0.39 2.13 0.033 0.75 0.52 1.44 0.150 1913―1917 0.72 0.32 2.28 0.023 0.68 0.42 1.63 0.102 1918―1922 0.68 0.26 2.66 0.008 0.63 0.34 1.83 0.067 1923―1927 0.68 0.22 3.13 0.002 0.60 0.29 2.05 0.041 1928―1932 0.58 0.20 2.85 0.004 0.54 0.28 1.92 0.055 1933―1937 0.43 0.24 1.78 0.075 0.45 0.33 1.35 0.176 1938―1942 0.22 0.30 0.75 0.451 0.33 0.41 0.80 0.424 1943―1947 0.07 0.36 0.20 0.844 0.21 0.50 0.42 0.678 1948―1952 -0.05 0.43 -0.11 0.909 0.09 0.60 0.15 0.877 1953―1957 -0.19 0.49 -0.38 0.706 -0.08 0.72 -0.12 0.907 1958―1962 -0.29 0.56 -0.51 0.608 -0.25 0.84 -0.30 0.766 1963―1967 -0.36 0.63 -0.56 0.572 -0.39 0.96 -0.41 0.681 1968―1972 -0.49 0.72 -0.68 0.495 -0.53 1.08 -0.49 0.628 1973―1977 -0.61 0.84 -0.73 0.468 -0.61 1.26 -0.48 0.628 1978―1982 -0.66 0.98 -0.68 0.500 -0.67 1.45 -0.46 0.644 1983―1987 -0.70 1.24 -0.56 0.575 -0.77 1.75 -0.44 0.660 1988―1992 -0.84 1.76 -0.48 0.634 -0.87 2.28 -0.38 0.704 1993―1997 -0.98 3.21 -0.30 0.761 -0.93 3.86 -0.24 0.809 AIC 3.46 2.86 BIC -212.22 -212.59 偏差 0.45 0.09 对数似然比 -109.31 -84.14 注:a表示P < 0.05。 -
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