关键词: 宫颈癌, 死亡率, 潜在减寿年数, 潜在工作损失年, 疾病负担

Abstract: Objective The aim of this study was to investigate the epidemiological characteristics of cervical cancer mortality in Chinese women and its impact on lifespan and labor loss,so as to provide scientific basis for the development of targeted cervical cancer prevention and control strategies. Methods Data were sourced from the “Chinese Cause of Death Surveillance Dataset” from 2004 to 2021,including cervical cancer mortality cases and demographic data.Joinpoint regression models were used to analyze trends of cervical cancer mortality,potential years of life lost(PYLL),average potential years of life lost(APYLL),work years of potential life lost(WYPLL),and average work years of potential life lost(AWYPLL).The annual percentage change(APC)and average annual percentage change(AAPC)were calculated. Results The average annual mortality of cervical cancer among Chinese women from 2004 to 2021 was 4.65/100,000,with a significantly higher rate in rural areas(4.85/100,000)than that in urban areas(4.26/100,000),and the difference was statistically significant(χ²=244.322,P＜0.001).The overall mortality of cervical cancer among Chinese women from 2004 to 2021 showed an upward(AAPC=3.89%,P=0.021).Time period analysis showed that the upward trend was most significant from 2012 and 2015(APC=25.53%,P=0.024).The mortality in rural areas was higher than that in urban areas,and it showed an upward trend over the years(AAPC=4.34%,P=0.005),while the trend of urban mortality change was not statistically significant(P=0.311).The age-specific mortality gradually increased with age,and significantly increased after the age of 50.The overall,rural,and urban populations reached their highest values in the age group ≥85 years old.From 2004 to 2021,the potential years of life lost(PYLL)due to cervical cancer was 1,283,829.79 years,with an average PYLL(APYLL)of 20.51 person-years.The PYLL in rural areas was 866,304.72 years(APYLL:20.12 person-years),while in urban areas it was 417,525.07 years(APYLL:21.36 person-years).The APYLL for the overall population,rural areas,and urban areas all showed a declining trend over time(AAPC:-1.33%,-1.35%,and-1.35%,respectively,P＜0.001).During the same period,the working-years potential of life lost(WYPLL)was 197,579 years,with an average WYPLL(AWYPLL)of 7.83 person-years.The WYPLL in rural areas was 130,083 years(AWYPLL:7.78 person-years),while in urban areas it was 67,496 years(AWYPLL:7.93 person-years).The AWYPLL for the overall population,rural areas,and urban areas also demonstrated a declining trend(AAPC:-2.24%,-2.53%,and -1.72%,respectively,P＜0.001). Conclusion From 2004 to 2021,the overall disease burden of cervical cancer among Chinese women was heavy,and its mortality showed an upward trend.However,the life expectancy and work years lost due to cervical cancer declined annually.Middle aged and elderly women aged 50 and above are still the key population for prevention and control,and rural areas are the key areas for prevention and control.In the future,it is necessary to continue exploring suitable comprehensive prevention and control models for cervical cancer to reduce the disease burden.

Key words: cervical cancer, mortality, potential years of life lost, work years of potential life lost, disease burden