1990—2019年中国归因于饮酒的口腔癌死亡趋势及年龄-时期-队列模型分析

doi:10.13591/j.cnki.kqyx.2024.03.004

摘要/Abstract

摘要：

目的研究1990—2019年中国归因于饮酒的口腔癌死亡趋势变化。方法利用2019年全球疾病负担中国及全球数据,采用死亡人数、死亡率、标化死亡率进行描述,运用Joinpoint回归模型分析口腔癌死亡趋势,构建年龄-时期-队列(age-period-cohort,APC)模型,定量评估年龄、时期、出生队列对死亡的独立影响。结果 2019年中国口腔癌死亡人数9 296例,较1990年增长309.70%,高于全球平均水平;标化死亡率全人群、男性呈增长趋势,女性保持不变。死亡率以平均每年4.23%的速度上升,2019年为0.65/10万,较1990年增长242.11%。死亡高发年龄段1990年集中在55~69岁,2019年后推至60~74岁。1990—2019年总体净偏移值为2.38%,死亡率随年龄增长而增高,在85~89岁达峰值8.36/10万,随时期推移呈现先降后升再降趋势,2010—2014时期组相对危险度(relative risk,RR)达最大1.64,出生队列效应RR值呈上升趋势,2000—2004年出生队列RR达最大2.95。结论中国归因于饮酒的口腔癌死亡负担逐年加重,60岁以上老年人群尤其男性是高危对象,年轻人群饮酒习惯和口腔健康需引起关注。

关键词: 口腔癌, 饮酒, 死亡, 年龄-时期-队列模型, 中国

Abstract:

Objective To study the trends of oral cancer deaths attributed to alcohol consumption in China from 1990 to 2019. Methods The global burden of disease in China and the world in 2019 was described by the number of deaths, mortality rate and standardized mortality rate. The Joinpoint regression model was used to analyze the death trend of oral cancer, and the age-period-cohort(APC) model was established. The independent effects of age, period and birth cohort on death were quantitatively assessed. Results In 2019, the number of deaths from oral cancer in China was 9 296, an increase of 309.70% compared to 1990, higher than the global average. The standardized mortality rate is on the rise for the entire population and males, while females remain unchanged. The mortality rate is increasing at an average annual rate of 4.23%, reaching 0.65/100 000 in 2019, an increase of 242.11% compared to 1990. In 1990, the highest death rate was concentrated in 55-69 years old, and after 2019, it increased to 60-74 years old. The overall net offset from 1990 to 2019 was 2.38%. The mortality rate increased with age, reaching a peak value of 8.36/100 000 at the age of 85-89. The relative risk(RR)of the 2010—2014 period group was the maximum, 1.64. The RR value of the birth cohort effect showed an increasing trend, and the RR value of the birth cohort from 2000 to 2004 reached a maximum of 2.95. Conclusion The death burden of oral cancer attributable to alcohol consumption is increasing year by year in China. Elderly people over 60 years old, especially men, are high-risk subjects. Attention should be paid to the drinking habits and oral health of young people.

Key words: oral cancer, drinking alcohol, death, age-period-cohort model, China

中图分类号:

R739.8

张亮亮, 古建昌, 刘云, 王晓岚, 柳云霞. 1990—2019年中国归因于饮酒的口腔癌死亡趋势及年龄-时期-队列模型分析[J]. 口腔医学, 2024, 44(3): 177-183.

ZHANG Liangliang, GU Jianchang, LIU Yun, WANG Xiaolan, LIU Yunxia. Trends in oral cancer deaths attributable to alcohol consumption in China from 1990 to 2019 and an age-period-cohort model analysis[J]. Stomatology, 2024, 44(3): 177-183.

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组别	时期/年	APC/%(95%CI)	t	P	AAPC/%(95%CI)	t	P
全人群	1990—1999	1.11(0.86~1.35)	9.65	<0.001	4.23 4.04~4.43	44.20	<0.001
	1999—2006	7.24(6.77~7.71)	33.12
	2006—2012	9.03(8.40~9.67)	30.98
	2012—2019	1.37(1.02~1.73)	8.18
男性	1990—1999	1.15(0.93~1.37)	11.12	<0.001	4.46 4.28~4.63	51.49	<0.001
	1999—2006	7.89(7.46~8.32)	39.86
	2006—2012	9.37(8.79~9.95)	35.54
	2012—2019	1.34(1.02~1.66)	8.81
女性	1990—1994	3.13(2.61~3.65)	13.27	<0.001	2.35(2.16~2.53)	24.88	<0.001
	1994—1999	-0.56(-1.06~-0.06)	-2.43	0.030
	1999—2006	1.62(1.35~1.89)	12.93	<0.001
	2006—2010	4.86(4.03~5.69)	12.91	<0.001
	2010—2016	2.40(2.03~2.76)	14.41	<0.001
	2016—2019	4.55(3.72~5.38)	12.12	<0.001

人群类别	净偏移值/(%/年)(95%CI)
中国全人群	2.38(2.09~2.68)
中国男性	2.64(2.33~2.96)
中国女性	-0.74(-1.66~0.19)

人群类别	零假设
中国全人群	净偏移=0	251.09	1	<0.001	中国女性	净偏移=0	2.42	1	0.12^*
	总年龄偏差=0	1 021.64	15	<0.001		总年龄偏差=0	21.05	15	0.14^*
	总时期偏差=0	252.44	4	<0.001		总时期偏差=0	2.62	4	0.62^*
	总队列偏差=0	103.43	20	<0.001		总队列偏差=0	2.35	20	1.00^*
	全时期RR=1	517.16	5	<0.001		全时期RR=1	4.48	5	0.48^*
	全队列RR=1	1 325.95	21	<0.001		全队列RR=1	7.38	21	1.00^*
	所有局部偏移=净偏移	102.84	17	<0.001		所有局部偏移=净偏移	2.18	17	1.00^*
中国男性	净偏移=0	275.75	1	<0.001	全球女性	净偏移=0	12.89	1	<0.001
	总年龄偏差=0	758.99	15	<0.001		总年龄偏差=0	1 112.49	15	<0.001
	总时期偏差=0	263.10	4	<0.001		总时期偏差=0	6.95	4	0.14^*
	总队列偏差=0	98.23	20	<0.001		总队列偏差=0	49.78	20	<0.001
	全时期RR=1	552.12	5	<0.001		全时期RR=1	23.70	5	<0.001
	全队列RR=1	1 433.51	21	<0.001		全队列RR=1	92.03	21	<0.001
	所有局部偏移=净偏移	97.33	17	<0.001		所有局部偏移=净偏移	48.09	17	<0.001