Analysis of death trend and life loss of liver cancer in Yunnan Province, 2015-2019
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摘要:
目的 了解2015-2019年云南省居民肝癌的死亡水平、变化趋势及寿命损失情况，为当地制定科学的防制措施提供依据。 方法 通过《人口死亡信息登记管理系统》获取云南省2015-2019年的肝癌死因监测数据，利用Stata 16软件和Excel 2019软件计算肝癌死亡和寿命损失相关指标，并用Joinpoint 4.9.0软件分析肝癌死亡和寿命损失的变化趋势，采用统计描述方法对云南省肝癌的死亡水平和寿命损失情况进行流行病学描述。 结果 2015-2019年云南省肝癌死亡累计报告30 912例，平均死亡年龄为(61.76±13.81)岁，标化死亡率(standardized mortality rate, SMR)从2015年的12.40/10万上升到2019年的14.10/10万，男性死亡率均高于女性，农村高于城市。云南省肝癌死亡率随年龄增长而增加，男性35岁死亡趋势开始快速增加。2015-2019年因肝癌死亡导致的潜在减寿年数(potential years of life lost, PYLL)为256 380人年，潜在减寿年率(potential years of life lost rate, PYLLR)为1.08‰；标化潜在减寿年数(standardized potential years of life loss, SPYLL)为266 962人年；标化潜在减寿年率(standardized potential years of life loss rate, SPYLLR)为1.12‰；男性的寿命损失高于女性；农村的寿命损失高于城市。 结论 2015-2019年云南省肝癌粗死亡率(crude death rate, CDR)和寿命损失呈上升趋势，男性和农村居民是高危人群，今后须加强对男性的早期体检，农村地区须投入更多的医疗资源，向全社会倡导合理膳食、体育锻炼等健康的生活方式，做好肝癌的早期预防工作。 Abstract:Objective To understand the level of death, changing trends and life expectancy loss of liver cancer among Yunnan residents from 2015 to 2019, and to provide a basis for the development of local scientific prevention and control measures. Methods The cause of death surveillance data of liver cancer in Yunnan Province from 2015 to 2019 were obtained through the Population Death Information Registration Management System. The epidemiological description of the level of death and life expectancy loss of liver cancer in Yunnan Province was performed by Stata16 and Excel 2019 software to calculate the indicators related to liver cancer death and life expectancy loss. And the trend of liver cancer death and life expectancy loss was analyzed by Joinpoint software. Results From 2015 to 2019, 30 912 cumulative liver cancer deaths were reported in Yunnan Province, with an average age of death of (61.76 ± 13.81) years. And the standardized mortality rate increased from 12.40/100 000 in 2015 to 14.10/100 000 in 2019, with both male mortality rates were higher than female, and rural mortality rates were higher than urban. The mortality rate of liver cancer in Yunnan Province increased with age, and the trend of death begins to increase rapidly around the age of 35 for male. The potential years of life lost due to death from liver cancer from 2015 to 2019 was 256 380 person-years, with a potential life loss rate of 1.08 per 1 000. The standardized potential years of life lost was 266 962 person-years, with a standardized potential life loss rate of 1.12 per 1 000, with higher life loss in male than in female and higher life loss in rural than in urban areas. Conclusions The crude mortality rate and life expectancy loss of liver cancer in Yunnan Province from 2015 to 2019 are on the rise. And male and rural residents are the high-risk groups, so we need to strengthen early medical checkups for male in the future, and invest more medical resources in rural areas to advocate healthy lifestyles such as reasonable diet and physical exercise to the whole society for early prevention of liver cancer. -
Key words:
- Liver cancer /
- Mortality /
- Change trend /
- Life lost
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图 1 2015-2019年云南省不同性别及城乡肝癌死亡率的年龄变化趋势
Figure 1. Age-related trends in liver cancer mortality between sexes and urban and rural areas in Yunnan, 2015-2019
表 1 2015-2019年云南省各人群肝癌死亡情况
Table 1. Liver cancer deaths by population in Yunnan Province, 2015-2019
类别 总人口数(例) 死亡数(例) 百分比(%) CDR (/105) SMR (/105) 性别 男 123 212 112 22 813 73.80 18.52 20.29 女 115 143 719 8 099 26.20 7.03 6.93 地区 城市 82 171 749 8 136 26.32 9.90 10.19 乡村 156 581 925 22 776 73.68 14.55 15.47 合计 238 355 831 30 912 100.00 12.97 13.62 
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表 2 2015-2019年云南省肝癌死亡的平均年龄情况(x±s)
Table 2. Average age of liver cancer deaths among residents in Yunnan, 2015-2019 (x±s)
年份(年) 合计(岁) 男性(岁) 女性(岁) 城市(岁) 农村(岁) 2015 61.71±13.85 59.88±13.50 66.41±13.64 63.31±13.63 61.09±13.88 2016 61.42±14.00 59.94±13.59 65.74±14.30 62.48± 14.29 61.01± 13.87 2017 61.82±13.80 60.30±13.42 66.37±13.90 63.78±13.98 61.15±13.67 2018 61.60±13.79 59.91±13.41 66.29±13.73 63.22±13.91 61.07±13.70 2019 62.15±13.66 60.61±13.33 66.56±13.63 63.74±13.43 61.63±13.69 合计 61.76±13.81 60.15±13.44 66.29±13.83 63.31±13.86 61.21±13.75
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表 3 2015-2019年云南省肝癌分性别死亡率
Table 3. Crude and standardized rates of liver cancer deaths by sex in Yunnan, 2015-2019
年份(年) 男性 女性 合计 死亡数(例) CDR(/105) SMR(/105) 死亡数(例) CDR(/105) SMR(/105) 死亡数(例) CDR(/105) SMR(/105) 2015 3 793 15.73 18.07 1 479 6.48 6.76 5 272 11.24 12.40 2016 4 259 17.32 19.29 1 459 6.39 6.38 5 718 12.06 12.87 2017 4 824 19.65 22.31 1 636 7.06 7.19 6 460 13.54 14.72 2018 4 808 19.30 21.25 1 730 7.49 7.41 6 538 13.62 14.39 2019 5 129 20.47 21.09 1 795 7.72 7.14 6 924 14.34 14.10 APC(%) 6.37 a 4.00 5.22 a 2.59 6.17 a 3.67 t值 4.30 1.87 5.67 1.66 5.88 2.04 P值 0.023 0.158 0.011 0.195 0.010 0.134 注：a P < 0.05为差异有统计学意义。
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表 4 2015-2019年云南省肝癌分城乡死亡率
Table 4. Mortality of liver cancer in urban and rural areas in Yunnan, 2015-2019
年份(年) 城市 农村 合计 死亡数(例) CDR(/105) SMR(/105) 死亡数(例) CDR(/105) SMR(/105) 死亡数(例) CDR(/105) SMR(/105) 2015 1 493 9.07 9.90 3 779 12.32 13.80 5 272 11.24 12.40 2016 1 637 9.86 10.33 4 081 13.24 14.30 5 718 12.06 12.87 2017 1 660 9.94 10.60 4 800 15.48 17.03 6 460 13.54 14.72 2018 1 612 9.52 9.85 4 926 15.76 16.87 6 538 13.62 14.39 2019 1 734 11.19 10.79 5 190 15.82 15.74 6 924 14.34 14.10 APC(%) 3.97 1.29 6.74 a 4.27 6.17a 3.67 t值 2.18 1.01 3.83 1.63 5.88 2.04 P值 0.117 0.388 0.031 0.200 0.010 0.134 注：a P < 0.05为差异有统计学意义。
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表 5 2015-2019年云南省不同性别的肝癌寿命损失情况
Table 5. Loss of life span of liver cancer residents by sex in Yunnan, 2015-2019
年份(年) 男性 女性 合计 PYLL (人年) PYLLR (‰) SPYLL (人年) SPYLLR (‰) PYLL (人年) PYLLR (‰) SPYLL (人年) SPYLLR (‰) PYLL (人年) PYLLR (‰) SPYLL (人年) SPYLLR (‰) 2015 38 323 1.59 39 106 1.62 5 438 0.24 6 485 0.28 43 760 0.93 46 036 0.98 2016 43 088 1.75 45 406 1.85 6 398 0.28 8 288 0.36 49 485 1.04 54 454 1.15 2017 47 340 1.93 48 836 1.99 6 015 0.26 7 311 0.32 53 355 1.12 56 965 1.19 2018 48 665 1.95 50 468 2.03 6 585 0.29 8 574 0.37 55 250 1.15 59 734 1.24 2019 48 173 1.92 44 831 1.79 6 358 0.27 6 888 0.30 54 530 1.13 52 733 1.09 合计 225 588 1.83 226 417 1.84 30 793 0.27 36 859 0.32 256 380 1.08 266 962 1.12 APC(%) 4.83 2.79 2.80 0.97 4.74 2.83 t值 2.96 0.96 1.35 0.22 3.11 0.95 P值 0.059 0.409 0.270 0.843 0.054 0.414
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表 6 2015-2019年云南省城乡间的肝癌寿命损失情况
Table 6. Loss of life span of liver cancer residents in Yunnan, 2015-2019
年份(年) 城市 农村 合计 PYLL (人年) PYLLR (‰) SPYLL (人年) SPYLLR (‰) PYLL (人年) PYLLR (‰) SPYLL (人年) SPYLLR (‰) PYLL (人年) PYLLR (‰) SPYLL (人年) SPYLLR (‰) 2015 9 963 0.61 10 196 0.62 33 798 1.10 36 363 1.19 43 760 0.93 46 036 0.98 2016 12 453 0.75 13 420 0.81 37 033 1.20 41 313 1.34 49 485 1.04 54 454 1.15 2017 10 450 0.63 10 727 0.64 42 905 1.38 46 663 1.50 53 355 1.12 56 965 1.19 2018 11 065 0.65 11 706 0.69 44 185 1.41 48 465 1.55 55 250 1.15 59 734 1.24 2019 10 850 0.70 9 976 0.64 43 680 1.33 43 155 1.32 54 530 1.13 52 733 1.09 合计 54 780 0.67 55 261 0.67 201 600 1.29 213 774 1.37 256 380 1.08 266 962 1.12 APC(%) 5.31 3.44 1.22 -1.22 4.74 2.83 t值 2.25 0.96 0.38 -0.30 3.11 0.95 P值 0.110 0.409 0.270 0.785 0.054 0.414
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