| Objective:To understand the incidence of malignant tumors from 2017 to 2021 and the mortality of malignant tumors from 2012 to 2021 in Nanchang,analyze the changing trend of some major malignant tumors,study the influence of age,time and birth cohort on the danger of death,and calculate the disease burden and indirect economic burden.To provide an effective basis for Nanchang to formulate prevention and control measures for malignant tumors and related scientific research in the future.Methods:Calculate the descriptive indexes such as mortality rate,standardization rate and rank composition of cancer;Joinpoint regression model can research the temporal changes of morbidity and mortality rates of major cancers in Nanchang.Construct an age-period-cohort model to study the age distribution characteristics,period onset trend and birth cohort effect of major cancers;The disease burden was expressed by disability-adjusted life years,and the indirect economic burden of major malignant tumors was estimated by human capital method.The ARIMA time series model is used to predict the death trend of major malignant tumors from 2022 to 2024.Results:1.From 2017 to 2021,there were 49,689 new cancer cases in Nanchang,including 27,920 males and 21,769 females.The average annual crude incidence rate is 175.98/100,000,the winning incidence rate is 162.24/100,000,the truncated incidence rate is 185.52/100,000,and the cumulative incidence rate is 14.00%.The crude incidence rate,standardized rate and cumulative incidence rate of males were bigger than those females,but the truncated incidence rate was smaller than that of females(P<0.05).The crude incidence rate,standardized rate and cumulative incidence rate showed a general fluctuation trend;The incidence of truncation showed a trend of first decreasing,then rising and then slowly decreasing.The incidence rate increased with age,maintained a low level before the age of 30,then gradually increased slowly,and showed a rapid growth trend after the age of 55.The incidence rate reached the top in the age of 85 and above,and the new cases were mainly concentrated in the age group of 65-69(6887).The incidence rate of women in city is bigger than that in rural areas(P < 0.05),while the incidence rate of men in city is lower than that in rural areas,but there is no statistical significance(P > 0.05).The top three malignant tumors in Nanchang are lung cancer(40.21/100,000),liver cancer(20.92/100,000)and stomach cancer(19.11/100,000).The incidence order of males is consistent with that of the whole population,and the top three malignant tumors of females are breast cancer(30.94/100,000),lung cancer(24.53/100,000)and gastric cancer(14.58/100,000).The incidence of other cancers in men is bigger than that in women,apart from thyroid cancer and breast cancer.2.From 2012 to 2021,there were 61,498 malignant tumor deaths in Nanchang,including 40,080 males and 21,418 females.The average annual crude death rate is113.73/100,000,the winning death rate is 110.35/100,000,the truncated death rate is97.33/100,000,and the cumulative death rate is 9.06%.These rates are higher in men than in women(P < 0.05).The crude mortality and standardized mortality of cancers were relatively stable before 2016,and they first increased and then decreased after2016.Truncation and cumulative mortality generally showed a trend of rising and falling.The mortality rate of malignant tumors increased with age,and remained at a low and stable level before the age of 45,and then rose rapidly until the peak,with the largest number of deaths in the 75-79 age group(8510 cases).The mortality rate of malignant tumors in urban areas is higher than that in villages,but there is no statistical difference(P > 0.05),and the mortality of cancers in urban areas is smaller than that in rural areas(P < 0.05).The top three cancer mortality rates in Nanchang are lung cancer(32.73/100,000),liver cancer(19.75/100,000)and stomach cancer(16.76/100,000).The ranking of male deaths is consistent with that of the whole population,and the top three ranking of female deaths are lung cancer(18.57/100,000),gastric cancer(12.42/100,000)and liver cancer(10.54/100,000).The mortality of cancer in men is bigger than that in women(except breast cancer).3.The results of Joinpoint regression analysis show that there is no inflection point in the trend of standardized incidence of lung cancer in the whole population,men and women from 2017 to 2021,and so is colorectal cancer.The average annual change percentage AAPC of the standardized incidence of lung cancer in the whole population,men and women were-6.05%,-6.25% and-5.10%,respectively,that is,the change trend was downward(P>0.05).The standardized incidence of colorectal cancer in men rose slowly while that in women declined slightly,and there was no statistical criteria(P>0.05).Analyzing the trend of standardized mortality from 2012 to 2021,only the whole population and male lung cancer have an inflection point on the trend line.During2012-2018,the standardized mortality of lung cancer in the whole group and men increased(P < 0.05).During the period of 2018-2021,the trend was downward(P <0.05).There is no inflection point on the mortality trend line of female lung cancer and colorectal cancer in the three groups,and the standardized mortality rate of female lung cancer is on a declining curve from 2012 to 2021,but there is no statistical criteria(P > 0.05).From 2012 to 2021,the mortality of colorectal cancer in men and women was going up(P < 0.05).4.The consequences of APC model indicated the death risk of lung cancer and colorectal cancer rose obviously with year.Taking 20-24 years old as the control group,the mortality risk of lung cancer for men and women aged 80-84 years is 79 times and 24 times,and the death risk of CRC for men and women aged 80-84 years is 26 times and 31 times,respectively.The period effect of lung cancer and colorectal cancer mortality showed a monotonic increasing trend,but the cohort effect showed a downward trend as a whole.Taking the earliest birth cohort as a reference,the death risk of lung cancer and colorectal cancer in the cohort with the least effect decreased to 1/31 and 1/48 respectively,and 1/34 and 1/17 respectively.5.The consequences of the disease burden study show that the DALY rate of lung cancer in Nanchang from 2012 to 2021 was 4.13 per thousand men and 1.73 per thousand women,and the DALY rate of colorectal cancer was 0.86 per thousand men and 0.62 per thousand women,respectively.In the loss of healthy life,the proportion of lost life years caused by premature death is higher than that caused by disability.Their DALY rate was very small before the age of 30,and after the age of 30,although there were differences in different malignant tumors,they all showed a rapid upward trend.Among them,the DALY rate of lung cancer reached its top at the age of70-79,and the DALY rate of CRC was the highest at the age of 60.Over the years,the DALY rate of men is higher than that of women,and the DALY rate of men of all ages is also higher than that of women.In 2021,the indirect economic burden caused by lung cancer and colorectal cancer was 634,045,500 yuan and 219,709,900 yuan respectively,increasing by 119%and 183% compared with that in 2012.Every year,the indirect economic burden caused by cancer in men is greater than that in women.6.The predictable consequences of ARIMA model demonstrate that the mortality rate of lung cancer will decrease in 2022-2024,while the mortality rate of colorectal cancer will increase first and then decrease.Conclusions:1.From 2017 to 2021,the standardized incidence of malignant tumor in Nanchang was lower than that in the entire country and some cities in Jiangxi Province,and the standardized mortality of malignant tumor in 2012-2021 was slightly bigger than that in the whole nation and some cities in Jiangxi Province.The standardized morbidity(mortality),cumulative morbidity(mortality)at 0-74 years old and truncated mortality at 35-64 years old in males are higher than those in females,while the truncated morbidity rate at 35-64 years old in males is lower than that in females.The incidence and mortality of cancers grew rapidly after the age of 55 and45,respectively,and middle-aged and elderly persons were high-risk groups of cancers.On the whole,the incidence and mortality of cancers in city are bigger than those in villages,but the incidence and mortality of male cancers in villages are higher than those in city.2.Lung cancer and colorectal cancer are the most harmful malignant tumors in Nanchang,and their standardized incidence rates have a downward trend,but most of them are not statistically significant,with slight differences between men and women.The standardized mortality rate of lung cancer has experienced a process of rising first and then falling,while that of colorectal cancer is on the rise.Their death risks are all affected by age,period and cohort effect.The age effect grows obviously with the enlargement of age,the period effect is also positively relevant to the year,and the cohort effect shows a downward trend as a whole.The disease burden caused by these malignant tumors is higher in DALY men than in women,and basically increases with age,and the loss of cancer burden is greater in people over 60 years old.The disease burden caused by lung cancer is the largest,while the disease burden of colorectal cancer has the largest growth rate. |
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