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目的肿瘤目前已成为世界性重大公共卫生问题,其造成的疾病负担已明显高于其他疾病。本研究通过计算肿瘤早死所致生命损失年(years of life lost,YLL)反映其造成的疾病负担,分析中国肿瘤疾病负担及城乡差异,为中国肿瘤防治工作提供一定依据。方法采用2012年《中国肿瘤登记年报》中的数据,包括性别、年龄、城乡间肿瘤发病死亡率以及相应人口数,计算YLL、YLL率及平均减寿年数(average years of life lost,AYLL)。采用ICD-10将各肿瘤分类。结果 2009年中国肿瘤造成的AYLL为9.42年/人,城市为8.84年/人,农村为10.33年/人。YLL男性高于女性,随年龄增长先增后减,城市与农村男女各自出现交叉后城市YLL反高于农村。2009年中国城市肺癌造成的YLL所占比例最高,为24.2%。农村肿瘤YLL中肝癌占比例最高,为21.7%。2009年中国城市和农村肿瘤死因顺位不同,除农村男性外(肝癌最高为10.50‰),其余居首位的均是肺癌(城市,男为5.29‰,女为2.40‰;农村,女为2.23‰)。肺癌、肝癌和胃癌YLL有城乡差异,肺癌影响年龄范围较大(35~80岁);肝癌是较年轻化的肿瘤(YLL 25岁时便有增长趋势),其造成的AYLL农村和城市均为最高(城市12.13年/人,农村12.87年/人);农村男性胃癌造成的YLL在所有人群中最高。结论肿瘤所造成的YLL与年龄、性别均有相关,且有城乡差异。肺癌影响人群范围最广,肝癌造成的AYLL最高。肿瘤疾病负担呈现农村高于城市,男性高于女性,政府应制定有针对性的措施,合理利用卫生资源,减少早死对人类和社会造成的负担。
The target tumor has now become a major public health problem worldwide, and the disease burden caused by it has been significantly higher than other diseases. This study calculated the burden of disease caused by the years of life lost (YLL) caused by premature death of tumors, analyzed the burden of disease in China and the differences between urban and rural areas, and provided a certain basis for the prevention and treatment of cancer in China. Methods Data from the 2012 China Cancer Registry Annual Report were used, including gender, age, incidence of cancer mortality between urban and rural areas, and corresponding population. The YLL and YLL rates and the average years of life lost (AYLL) were calculated. Each tumor was classified using ICD-10. Results The AYLL caused by Chinese tumors in 2009 was 9.42 years/person, the city was 8.84 years/person, and the rural area was 10.33 years/person. YLL males are higher than females. They increase first and then decrease with age. City and rural men and women have their own YLL, which is higher than rural. The proportion of YLL caused by lung cancer in Chinese cities was highest in 2009, which was 24.2%. The proportion of liver cancer in rural tumor YLL was the highest, which was 21.7%. In 2009, the causes of cancer deaths in urban and rural areas in China were different, with the exception of rural males (with a maximum of 10.50 肝癌 in liver cancer), and the rest were lung cancer (urban, male 5.29 ‰, female 2.40 ‰; rural women 2.23 ‰). Lung cancer, liver cancer, and gastric cancer YLL have urban-rural differences. Lung cancer affects a relatively large age range (35-80 years old). Liver cancer is a younger tumor (YLL has an increasing trend at the age of 25), resulting in both AYLL and rural areas. The highest (urban 12.13 years/person, rural 12.87 years/person); rural men’s gastric cancer YLL caused the highest in all populations. Conclusion The YLL caused by tumors is related to age and gender, and there are differences between urban and rural areas. Lung cancer affects the widest range of patients, and AYLL caused by liver cancer is the highest. The burden of tumor disease is higher in rural areas than in urban areas. Males are higher than women. The government should develop targeted measures to rationally use health resources and reduce the burden of early death on people and society.