基于年龄-时期-队列模型的1992—2021年中国卵巢癌发病和死亡分析

doi:10.11904/j.issn.1002-3070.2025.01.002

摘要/Abstract

摘要： 目的探讨年龄、时期和队列效应对1992—2021年中国卵巢癌发病和死亡的影响。方法利用全球疾病负担(Global Burden of Disease,GBD)2021数据库,分析1992—2021年中国卵巢癌的发病和死亡情况,应用Joinpoint 4.8.0.1软件分析1992—2021年卵巢癌标化发病率和标化死亡率的时间变化趋势,计算平均年度变化百分比(average annual percent change,AAPC)。采用年龄-时期-队列模型分析年龄、时期和出生队列效应对卵巢癌发病和死亡趋势变化的影响。结果 2021年中国卵巢癌发病率(3.67/10万)和死亡率(2.18/10万)比1992年分别升高了61.85%和66.06%。趋势分析结果显示,1992—2021年中国卵巢癌标化发病率和标化死亡率均有下降,AAPC分别为-0.10%(95% CI:-0.40%~0.12%,P＞0.05)和-0.60%(95% CI:-0.80%~-0.30%,P＜0.05)。分年份看,2014—2021年卵巢癌标化发病率和标化死亡率均有升高趋势,平均每年分别升高1.58%和1.42%,差异均有统计学意义(P＜0.05)。年龄效应结果显示,1992—2021年中国卵巢癌按年龄分布的发病率整体呈先升高后降低趋势,15~54岁呈快速升高趋势,55~69岁呈波动性趋势,70岁以后呈下降趋势。死亡率在15~74岁呈升高趋势,然后75岁以后呈降低趋势。时期效应结果显示,1992—2021年,中国卵巢癌发病风险的时期变化相对危险度(relative risk,RR)总体呈下降趋势,以2002—2006年为参考组(RR=1.00),1997—2001年发病风险最高(RR=1.09,95% CI:1.04~1.15);卵巢癌的死亡风险的时期变化RR值呈下降趋势,以2002—2006年为参考组(RR=1.00),1992—1996年死亡风险最高(RR=1.15,95% CI:1.09~1.20)。队列效应结果显示,出生越晚的人,卵巢癌的发病和死亡风险越低。结论 1992—2021年中国卵巢癌标化发病率趋势和标化死亡率趋势虽然下降,但2014—2021年卵巢癌标化发病率和标化死亡率均有升高趋势。时期效应显示,1997—2001年发病风险最高,1992—1996年间的死亡风险较高。队列效应表明,出生较晚的群体面临较低的卵巢癌发病和死亡风险。

关键词: 卵巢癌, 年龄-时期-队列模型, 发病率, 死亡率

Abstract: Objective The aim of this study was to explore the effects of age,period and cohort on the incidence and death of ovarian cancer in China from 1992 to 2021. Methods The incidence and mortality of ovarian cancer in China from 1992 to 2021 were analyzed using the Global Burden of Disease(GBD)2021 database.The time trend of standardized incidence and standardized mortality of ovarian cancer from 1992 to 2021 was analyzed using Join Point 4.8.0.1 software,and the average annual change percentage change(AAPC)was calculated.The age-period-cohort model was used to analyze the effects of age,period and birth cohort on the incidence and mortality trend of ovarian cancer. Results In 2021,the incidence(3.67/100,000)and mortality rate(2.18/100,000)of ovarian cancer in China increased by 61.85% and 66.06%,respectively,compared with 1992.The trend analysis showed that the standardized incidence and standardized mortality of ovarian cancer in China decreased from 1992 to 2021,and the AAPC was -0.10%(95% CI:-0.40%0.12%,P＞0.05)and-0.60%(95% CI:-0.80%-0.30%,P＜0.05),respectively.From 2014 to 2021,the standardized incidence and standardized mortality of ovarian cancer showed an increasing trend,with an average annual increase of 1.58% and 1.42%,and the differences were statistically significant(P＜0.05).The results of age-effect analysis showed that the overall incidence of ovarian cancer distributed by age in China from 1992 to 2021 increased first and then decreased,with a rapid increase trend at the age of 15 to 54,a fluctuating trend at the age of 55 to 69,and a downward trend after 70.The mortality showed an increasing trend between the ages of 15 to 74,and then a decreasing trend after the age of after 75.The results of period-effect analysis showed that from 1992 to 2021,the relative risk(RR)of ovarian cancer incidence risk in China showed an overall decreasing trend.Taking the period from 2002 to 2006 as the reference group(RR=1.00),the incidence risk was the highest from 1997 to 2001(RR=1.09,95% CI:1.04-1.15).The period change of mortality risk for ovarian cancer showed a decreasing trend in RR values,with the reference group from 2002 to 2006(RR=1.00),and the highest mortality risk from 1992 to 1996(RR=1.15,95% CI:1.09-1.20).The results of cohort-effect analysis showed that people born later had a lower risk of occurring and dying from ovarian cancer. Conclusion Although the trend of standardized incidence and mortality of ovarian cancer in China decreased from 1992 to 2021,the trend of standardized incidence and standardized mortality of ovarian cancer increased from 2014 to 2021.The period effect shows that the risk of onset was highest from 1997 to 2001,and the risk of death was higher from 1992 to 1996.The cohort effect indicates that individuals born later are at a lower risk of occurring and dying from ovarian cancer.

Key words: Ovarian cancer, Age-period-cohort model, Incidence, Mortality

中图分类号:

R737.31

寇帅, 王榆平, 孙小霞, 任娟娟. 基于年龄-时期-队列模型的1992—2021年中国卵巢癌发病和死亡分析[J]. 实用肿瘤学杂志, 2025, 39(1): 7-12.

KOU Shuai, WANG Yuping, SUN Xiaoxia, REN Juanjuan. Analysis of incidence and mortality of ovarian cancer in China from 1992 to 2021 based on age-period-cohort model[J]. Journal of Practical Oncology, 2025, 39(1): 7-12.

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