中国2006-2012年子宫颈癌死亡情况与变化趋势分析

摘要

Objective To analyze the mortality of cervical cancer and its temporal trend in women in China between 2006 and 2012.Methods The cause-of-death data about cervical cancer,which was abstracted from National Disease Surveillance Points and adjusted by special survey for underreporting,was used to analyze the age and area specific crude mortality rates of cervical cancer in China during 2006-2012.The age-standardized mortality rate was calculated by using world standardized population (Segi's).The Joinpoint regression model was used to obtain annual percentage change and 95％CI for assessing the time trend of mortality rate of cervical cancer from 2006 to 2012.Results In 2012,the crude mortality rate of cervical cancer was 3.15 per 100 000 in women in China.The mortality rate in rural area (3.45/100 000) was higher than that in urban area (2.76/100 000),while the central area had the highest mortality rate of cervical cancer (3.77/100 000) compared with western area (3.23/100 000) and eastern area (2.54/100 000).The Segi's age-standardized mortality rate in eastern area increased by 2.9％ (95％CI:0.8％-5.0％) annually,an increase of 6.0％ was observed in age group 30-59 years (95％CI:1.6％-10.5％).However,the Segi's age-standardized mortality rate in central area declined by 4.6％ (95％CI:-5.9％--3.3％),where the declines of 3.2％ and 5.7％ were observed in age groups 30-59 years and ≥60 years (95％ CI:-5.0％--1.4％ and 95％ CI:-9.3％--2.0％) and respectively.There was no significant change in cervical cancer mortality in western area.The similar trends were observed in the age-standardized mortality rate calculated according to the population of China.Conclusions The decline of overall mortality rate of cervical cancer tended to stop in China and significant differences still exist among different areas.Our results suggest that the central/western areas and rural areas are still key areas for cervical cancer prevention and control and close attention should be paid to the increase of cervical cancer mortality in women aged 35-59 years in eastern area.It is essential to establish a systematic cervical cancer prevention network with larger population coverage to reduce the deaths caused by cervical cancer.%目的 分析2006-2012年中国女性人群子宫颈癌死亡情况及变化趋势.方法 利用全国疾病监测死因上报系统2006-2012年子宫颈癌死亡数据,通过死因漏报调查进行调整,分析不同城乡和东、中、西部地区我国女性子宫颈癌粗死亡率及年龄分布特征;采用全国第六次普查人口和Segi's世界人口计算年龄标化死亡率;采用加权最小二乘法拟合Joinpoint回归模型分析2006-2012年子宫颈癌死亡率的变化趋势.结果 2012年,我国女性子宫颈癌粗死亡率为3.15/10万,其中农村地区粗死亡率为3.45/10万,高于城市地区(2.76/10万);中部地区粗死亡率为3.77/10万,高于西部地区(3.23/10万)和东部地区(2.54/10万).2006-2012年,全国子宫颈癌世界人口年龄标化死亡率的变化无统计学意义,但是不同地区间存在明显差异.东部地区平均每年上升2.9％(95％CI:0.8％ ～ 5.0％),其中30 ～59岁组上升6.0％(95％CI:1.6％ ～ 10.5％);中部地区平均每年下降4.6％(95％CI:-5.9％ ～-3.3％),其中30～ 59岁组-3.2％(95％CI:-5.0％ ～-1.4％)和≥60岁组-5.7％(95％CI:-9.3％ ～-2.0％)的下降有统计学意义;而西部地区的变化无统计学意义.中国人口年龄标化率变化趋势与世标率相近.结论 我国子宫颈癌下降趋于停滞,不同地区存在差异;中西部地区和农村地区仍然是我国子宫颈癌防控的重点区域;而东部地区30 ～ 59岁女性子宫颈癌死亡率上升现象亟需引起重视;建立综合的子宫颈癌防控体系是继续降低我国女性子宫颈癌死亡率的有效途径.