| 杨晓莹,王宁,魏楚楚,何凤蝶,齐金蕾,王宝华.2009-2019年中国4省农村重点地区肝癌死亡相关行为危险因素及其滞后效应分析[J].中华流行病学杂志,2023,44(10):1583-1590 |
| 2009-2019年中国4省农村重点地区肝癌死亡相关行为危险因素及其滞后效应分析 |
| Study on behavioral risk factors and lagging effect analysis with liver cancer mortality in rural critical areas of 4 provinces of China from 2009 to 2019 |
| 收稿日期:2023-02-24 出版日期:2023-10-12 |
| DOI：10.3760/cma.j.cn112338-20230224-00107 |
| 中文关键词: 肝癌 死亡率 行为危险因素 滞后效应 |
| 英文关键词: Liver cancer Mortality Behavioral risk factors Lag effect |
| 基金项目:国家重点研发计划（2016YFC1302603，2016YFC1302600） |
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| 中文摘要: |
| 目的 分析2009-2019年我国江苏省、安徽省、山东省、河南省（4省）农村重点地区肝癌死亡率变化趋势，探讨行为危险因素对肝癌死亡的影响及其滞后效应，为我国肝癌防治工作提供参考。方法 基于2009-2019年全国死因监测数据库及3次4省农村重点地区居民肿瘤及危险因素调查数据，采用Joinpoint 4.2软件计算平均年度变化百分比（AAPC），分析肝癌标化死亡率的时间变化趋势；采用χ2检验与趋势χ2检验分析行为习惯因素的地区分布差异和时间变化趋势；采用Stata 16软件建立面板数据模型，分析行为危险因素与肝癌死亡的相关性及其滞后效应。结果 2009-2019年4省金湖县、射阳县、灵璧县、寿县、蒙城县、汶上县、巨野县、罗山县、沈丘县、西平县农村重点地区肝癌标化死亡率呈下降趋势（AAPC<0，P<0.05）。4省农村重点地区咸菜/咸鱼类、红肉类、水产品类食物摄入频率呈下降趋势，新鲜蔬菜、新鲜水果、乳制品等健康食品的摄入频率呈上升趋势，油炸类食物、泡菜、烟熏类食物、霉变食物、咖啡、豆制品摄入频率一直处于较低水平（P<0.05）；豆制品、乳制品的摄入频率<20.00%。油炸类、咸菜/咸鱼类食物、现在吸烟率、饮酒率、未接种乙型肝炎疫苗率与肝癌死亡呈正相关且存在滞后效应，滞后期分别为4、1、6、5、4年。结论 2009-2019年我国4省农村重点地区肝癌死亡率均呈下降趋势，油炸类食物和吸烟、饮酒等行为危险因素与肝癌死亡存在相关关系及滞后效应。 |
| 英文摘要: |
| Objective To analyze the trend of liver cancer mortality in rural key areas of Jiangsu Province, Anhui Province, Shandong Province, and Henan Province (4 provinces) from 2009 to 2019 and to explore the influence of behavioral risk factors on liver cancer mortality and its lagging effect, and provide a reference for the prevention and treatment of liver cancer in China. Methods Based on the 2009-2019 National Cause of Death Surveillance Database of the Chinese Center for Disease Control and Prevention, and the survey data of tumor and risk factor behavior of residents in key areas of 4 provinces, Joinpoint 4.2 software was used to calculate the average annual percentage change (AAPC) for assessing the temporal trend of standardized mortality of liver cancer; Chi-square test and trend Chi-square test were used to analyze the regional distribution difference and temporal change trend of behavioral habit factors. Stata 16 was used to establish a panel model to analyze the correlation and lagging effect of behavioral risk factors with liver cancer. Results The standardized mortality rate of liver cancer in Jinhu County, Sheyang County, Lingbi County, Shou County, Mengcheng County, Wenshang County, Juye County, Luoshan County, Shenqiu County, and Xiping County showed a downward trend (AAPC<0, P<0.05) from 2009 to 2019. The consumption frequency of pickles/salted fish, red meat, and aquatic products showed a downward trend. The consumption frequency of healthy foods such as fresh vegetables, fresh fruits, and dairy products in all counties and districts showed an upward trend, and the consumption frequency of fried foods, kimchi, smoked foods, moldy foods, coffee, and soy products remained at a low level (P<0.05); but the consumption frequency of soy products and dairy products was still <20.00%. Fried food, pickles/salted fish, current smoking rate, alcohol consumption rate, and unvaccinated hepatitis B vaccine rate were positively correlated with liver cancer death, and there was a lag effect, and the lag period was 4, 1, 6, 5, 4 years respectively. Conclusions From 2009 to 2019, the mortality rate of liver cancer in rural key areas of 4 provinces shows a downward trend. There is a correlation and lagging effect between behavioral risk factors such as fried food, smoking, and alcohol consumption and liver cancer death. |
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