| Objective Analyze the trends and characteristics of lung cancer deaths among 20-84-year-old residents in China from 1988 to 2017,and explore the impact of age,period and birth cohort on the mortality risk of lung cancer among 20-84-year-old residents in China,and provide a scientific basis for the prevention and control of lung cancer in China.Methods Using the data of the international cancer research center and the national disease surveillance system death cause monitoring data set,we collected the information about the number of 20-84-year-old residents,the number of lung cancer deaths and the lung cancer crude mortality in China from 1988 to 2017,some missing data were estimated by linear interpolation.Using the data of the sixth national census in 2010 as the standard population,the standardized mortality of lung cancer among Chinese residents aged 20 to 84 years was calculated,the annual percentage change(APC)and average annual percentage change(AAPC)of the standardized lung cancer mortality were calculated by the Joinpoint Regression Model,the Age-Period-Cohort Model combined with IE(Intrinsic Estimator)algorithm was used to analyze the age effect,period effect and birth cohort effect of lung cancer mortality.The software used for data analysis includes SPSS22.0,Origin 2018,Joinpoint4.7.0 and Stata12.1.All the tests were bilateral,with a test level of α = 0.05.Results 1 Although the standardized mortality of lung cancer in China’s total population fluctuated from 1988 to 2017,the overall trend was an upward trend,from 38.21/100,000 in 1988 to 45.20/100,000.Regardless of urban or rural areas,the male lung cancer standardized mortality was higher than that of females during 1988-2017.Regardless of whether it is male or female,the standardized mortality of lung cancer in 1988-2007 is higher in cities than in rural areas,but since 2008,it is higher in rural areas than in cities.2 From 1988 to 2017,the standardized mortality of lung cancer among the total population of 20-84 years old in China increased at an average annual percent change(AAPC)rate of 0.46%.Among them,between 1988 and 2000,the standardized mortality of lung cancer was the annual percent change(APC)increased at a rate of 1.73%;there was no change in the standardized mortality of lung cancer from 2000 to 2017.From 1988 to 2017,the average annual percentage changes in lung cancer standardized mortality for urban men,urban women,rural men,and rural women aged 20 to 84 years in China were 0.10%,-0.60%,1.90%,and 2.60%,respectively.During the period,the standardized mortality of lung cancer among urban males showed an upward trend from 1988 to 2004(APC = 0.53%),a downward trend from 2004 to 2011(APC =-2.68%),and no change trend from 2011 to 2017;the standardized mortality of lung cancer among urban female in 1988-2001(APC = 0.94%)was showed an upward trend,in 2001-2010(APC =-2.98%)showed a downward trend,and there was no change in 2010-2017;the standardized mortality of rural male lung cancer was 1988-2010((APC = 2.62%)showed an upward trend and remained stable from 2010 to 2017;the standardized mortality of lung cancer among rural women increased from 1988 to 2002 and from 2002 to 2017,with APC of 4.11% and 1.18%,respectively.3 After controlling the period effect and the effect of the birth cohort,the age effect of lung cancer death in Chinese residents aged 20 to 84 years increases with age.China ’s total population,urban male,urban female,rural male and rural female all have the least age effects in the 20-year-old age group,which are-3.132,-3.402,-3.206,-2.913,-2.667,with the increase of age,the age effect of the total population reaches the largest in the 75-age group(1.752),and slightly decreases in the 80-84 age group(1.740),the age effect of urban male,urban female,rural male and rural female all reached the maximum in the 80-84 age group,which were 1.995,1.892,1.711,and 1.754,respectively.After controlling for the effects of age and birth cohort,the period effect of lung cancer deaths among 20-84-year-old residents in China increased over time from 1988 to 2017.The total population of China,urban male,urban female,rural male and rural female in China had the smallest periodical effects of lung cancer death risk during the period from 1988 to 1992,respectively-0.371,-0.340,-0.226,-0.487,and-0.494,and the maximum period effect in the period group 2013-2017,respectively 0.405,0.349,0.267,0.528,0.496.After controlling the effects of age and period,the cohort effect of lung cancer deaths among Chinese residents aged 20 to 84 years increased first and then decreased with the birth cohort from 1988 to 2017.The cohort effect of lung cancer deaths in China’s total population of 20-84 years was the largest in 1919-1923 birth cohort group(0.995),while the cohort effects of urban men,urban women,rural men,and rural women were reached the largest in 1909-1913 birth cohort group(1.144),1919-1923 birth cohort group(1.037),1919-1923 birth cohort group(0.948),1924-1928 birth cohort group(0.812),respectively.The cohort effects of China’s total population,urban male,urban female,rural male and rural female were the smallest in the 1989-1993 birth cohort group,which were-1.798,-1.937,-1.814,-1.909,and-1.911,respectively.Conclusions 1 From 1988 to 2017,the mortality of lung cancer among residents aged 20 to 84 in China showed an overall upward trend.Whether in urban or rural areas,the mortality of lung cancer in males is higher than that in females.Whether males or females,the mortality of lung cancer in rural areas was lower than that in cities before 2008,and the mortality of lung cancer in rural areas began to be higher than that in cities since 2008.The mortality of lung cancer among urban males and females has experienced an increase and then a decline,while the mortality of lung cancer among rural males and females has been on the rise,and the increase rate is higher in rural areas than in urban areas.2 From 1988 to 2017,the change in lung cancer mortality among residents aged 20 to 84 years in China was affected by age,period,and cohort effects in both urban and rural areas,and there was a slight difference between urban and rural areas.Among them,the age effect increases with age,and the period effect also increases with the passage of time,the cohort effect increases first and then decreases with the birth cohort,among the three factors,the age effect is the most obvious.Figure 16;Table 36;Reference 116... |
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