Article(id=1241023938436854499, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202409302, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1726588800000, receivedDateStr=2024-09-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812764032, onlineDateStr=2026-03-18, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812764032, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812764032, creator=13701087609, updateTime=1773812764032, updator=13701087609, issue=Issue{id=1241023927812682133, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812761500, creator=13701087609, updateTime=1773812858867, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024336258200259, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024336258200260, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=471, endPage=475, ext={EN=ArticleExt(id=1241023939745477373, articleId=1241023938436854499, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the trend in cervical cancer mortality among women in Jinan city from 2011 to 2023, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the epidemiological characteristics of cervical cancer mortality among women in Jinan city, providing reference for the prevention and control of cervical cancer.

Methods

Data on cervical cancer mortality among women in Jinan from 2011 to 2023 were collected. Using SPSS 20.0 software, mortality rates were calculated for urban and rural areas, age-standardized mortality rates for women aged 35 to 64, cumulative mortality rates for those aged 0 to 74, and years of life lost (YLL) due to premature death. The annual average percentage change (AAPC) was employed to analyze trends in cervical cancer mortality.

Results

From 2011 to 2023, the cervical cancer mortality rate for women was 3.05 per 100 000, with a standardized mortality rate of 1.83 per 100 000 and an average age at death of 61.65 years. The truncated mortality rate was 3.36 per 100 000, and the cumulative mortality rate was 0.20%. The mortality rate, standardized mortality rate, proportion of total malignant tumors, truncated mortality rate, and cumulative mortality rate for cervical cancer all exhibited an upward trend, while the age at death showed a downward trend. Mortality rates gradually increased after the age of 30, peaking in the 75 to 79 age group. The cervical cancer mortality rate and YLL rate among women aged 45 to 59 in urban areas and those over 60 in rural areas also showed increasing trends.

Conclusion

The cervical cancer mortality rate in Jinan city is on the rise, with notable urban-rural disparities. Targeted tertiary prevention measures should be implemented to effectively reduce the incidence and mortality rates of cervical cancer.

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目的

了解济南市女性宫颈癌死亡的流行病学特征,为宫颈癌预防控制提供参考。

方法

收集2011—2023年济南市女性宫颈癌死亡资料,应用SPSS 20.0软件,分城乡计算死亡率、35~64岁截缩死亡率、0~74岁累积死亡率、过早死亡损失寿命年(YLL)等指标,并用年均变化百分比(AAPC)分析宫颈癌死亡变化趋势。

结果

2011—2023年,女性宫颈癌死亡率为3.05/10万,标化死亡率为1.83/10万,平均死亡年龄为61.65岁,截缩死亡率为3.36/10万,累积死亡率为0.20%。宫颈癌的死亡率、标化死亡率、占全部恶性肿瘤的比例、截缩死亡率和累积死亡率均呈上升趋势,死亡年龄呈下降趋势。30岁后死亡率逐渐增加,直至75~79岁年龄组达最高值。城区45~59岁女性和农村60岁以上女性宫颈癌死亡率和YLL率均呈上升趋势。

结论

济南市宫颈癌死亡率呈现上升趋势,并存在城乡差异。应有针对性地做好三级预防,有效地降低宫颈癌发病、死亡率。

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王庆昌,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=ZZey9wz0NnSoa0zZUSC9Hw==, magXml=FTVWQWlBcek8fhUv5/OePg==, pdfUrl=null, pdf=Mkpg5CuZdb2+pzFeWcVGuQ==, pdfFileSize=592356, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=hHNDM9de1vPwl8aQ1k7tVg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=BbOC6NUd0CHOwvTlmqlfoQ==, mapNumber=null, authorCompany=null, fund=null, authors=

王莹(1978—),女,硕士,副主任技师,研究方向:慢性病防制

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王莹(1978—),女,硕士,副主任技师,研究方向:慢性病防制

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Modern Preventive Medicine, 2020, 47(23):4344-4347.(In Chinese), articleTitle=Incidence, mortality and trend of cervical cancer in Jiangsu province, refAbstract=null), Reference(id=1241023951187538490, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, doi=null, pmid=null, pmcid=null, year=2022, volume=32, issue=6, pageStart=519, pageEnd=526, url=null, language=null, rfNumber=[18], rfOrder=31, authorNames=庞怡, 吴春晓, 顾凯, journalName=中国癌症杂志, refType=null, unstructuredReference=庞怡,吴春晓,顾凯,等.2016年上海市子宫颈癌发病和死亡情况与2002-2016年的变化趋势分析[J].中国癌症杂志202232(6):519-526., articleTitle=2016年上海市子宫颈癌发病和死亡情况与2002-2016年的变化趋势分析, refAbstract=null), Reference(id=1241023951271424573, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, doi=null, pmid=null, pmcid=null, year=2022, volume=32, issue=6, pageStart=519, pageEnd=526, url=null, language=null, rfNumber=[18], rfOrder=32, authorNames=Pang Y, Wu CX, Gu K, journalName=China Oncology, refType=null, unstructuredReference=Pang Y, Wu CX, Gu K, et al. Analysis of current status of cervical cancer incidence and mortality in Shanghai,2016 and trends of 2002-2016[J].China Oncology, 2022, 32(6): 519-526.(In Chinese), articleTitle=Analysis of current status of cervical cancer incidence and mortality in Shanghai,2016 and trends of 2002-2016, refAbstract=null)], funds=[Fund(id=1241023947613991251, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, awardId=G19, language=CN, fundingSource=2024年济南市卫生健康委科技发展计划项目(G19), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241023940999574370, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, xref=null, ext=[AuthorCompanyExt(id=1241023941012157285, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, companyId=1241023940999574370, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Jinan Center for Disease Control and Prevention, Jinan, Shandong 250021, China), AuthorCompanyExt(id=1241023941020545896, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, companyId=1241023940999574370, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=济南市疾病预防控制中心,山东 济南 250021)])], figs=[ArticleFig(id=1241023946309562599, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=EN, label=Figure 1, caption=Deaths and mortality of female cervical cancer in Jinan from 2011 to 2023, figureFileSmall=RJat7Z4i3xlKPk1gORXhTw==, figureFileBig=hHNDM9de1vPwl8aQ1k7tVg==, tableContent=null), ArticleFig(id=1241023946418614510, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=CN, label=图1, caption=2011—2023年济南市女性宫颈癌死亡数和死亡率情况, figureFileSmall=RJat7Z4i3xlKPk1gORXhTw==, figureFileBig=hHNDM9de1vPwl8aQ1k7tVg==, tableContent=null), ArticleFig(id=1241023946649301251, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=EN, label=Figure 2, caption=Average age-specific mortality of female cervical cancer in Jinan from 2011 to 2023, figureFileSmall=zhwKf8dKywBRYTc6T0dmoQ==, figureFileBig=cboKwDltF1X/bSxgUcuJcg==, tableContent=null), ArticleFig(id=1241023946770936077, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=CN, label=图2, caption=2011—2023年济南市女性宫颈癌分年龄平均死亡率情况, figureFileSmall=zhwKf8dKywBRYTc6T0dmoQ==, figureFileBig=cboKwDltF1X/bSxgUcuJcg==, tableContent=null), ArticleFig(id=1241023946871599376, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=EN, label=Table 1, caption=

Mortality and its trend of female cervical cancer in Jinan from 2011 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份
(岁)
城区农村合计
平均年龄(岁)死亡率
(万)
标化死亡率
(/10万)
占恶性肿瘤比例(%)累积死亡率
(%)
截缩死亡率(10万)平均年龄(岁)死亡率
(/10万)
标化死亡率
(/10万)
占恶性肿瘤比例(%)累积死亡率
(%)
截缩死亡率(10万)平均年龄(岁)死亡率
(/10万)
标化死亡率
(/10万)
占恶性肿瘤比例(%)累积死亡率
(%)
截缩死亡率
(10万)
201165.241.951.151.690.111.8961.712.271.431.950.172.3663.312.111.251.820.142.04
201262.942.081.341.820.152.0868.672.201.291.950.152.3664.532.141.311.890.152.17
201364.562.141.261.780.122.2561.732.571.582.410.142.1963.002.361.402.080.142.21
201461.552.651.602.230.192.9062.313.532.192.860.203.6061.993.101.872.560.193.26
201560.573.011.902.450.214.0863.333.201.972.670.213.0862.023.111.942.560.213.60
201659.364.182.653.560.274.9564.923.952.123.310.243.4262.084.072.423.430.264.21
201760.402.901.772.420.203.2561.983.511.982.590.204.0161.263.201.892.510.203.68
201858.153.262.032.990.234.6861.493.301.932.590.223.4859.793.281.912.780.224.05
201960.492.581.602.460.173.1264.103.892.152.930.222.8362.593.211.832.720.202.97
202058.613.692.353.490.235.0260.213.462.132.620.243.7059.343.582.213.030.244.28
202160.352.641.612.320.203.4863.293.411.822.510.213.4761.903.001.722.420.213.51
202258.432.371.512.400.143.1263.294.052.133.310.233.1861.293.141.812.870.193.10
202358.473.302.033.410.214.4960.943.511.972.880.214.6259.793.392.033.140.214.55
合计60.372.761.762.550.193.4962.823.351.902.670.213.2461.653.051.832.610.203.36
AAPC
(%)
-0.802.833.094.403.115.66-0.283.892.782.693.114.09-0.453.353.073.573.174.98
95%CI
(%)
-1.15~-0.45-0.62~6.40-0.56~6.861.13~7.77-1.03~7.421.26~10.25-0.82~0.261.55~6.290.51~5.100.48~4.941.00~5.271.36~6.89-0.73~-0.170.80~5.970.37~5.831.26~5.930.56~5.841.59~8.48
t-5.0341.8031.8602.9821.6442.850-1.1513.6852.7072.6923.2653.318-3.5212.9042.5113.4212.6813.254
P<0.0010.0990.0900.0120.1280.0160.2740.0040.0200.0210.0080.0070.0050.0140.0290.0060.0210.008
), ArticleFig(id=1241023947030982943, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=CN, label=表1, caption=

2011—2023年济南市女性宫颈癌死亡情况及趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年份
(岁)
城区农村合计
平均年龄(岁)死亡率
(万)
标化死亡率
(/10万)
占恶性肿瘤比例(%)累积死亡率
(%)
截缩死亡率(10万)平均年龄(岁)死亡率
(/10万)
标化死亡率
(/10万)
占恶性肿瘤比例(%)累积死亡率
(%)
截缩死亡率(10万)平均年龄(岁)死亡率
(/10万)
标化死亡率
(/10万)
占恶性肿瘤比例(%)累积死亡率
(%)
截缩死亡率
(10万)
201165.241.951.151.690.111.8961.712.271.431.950.172.3663.312.111.251.820.142.04
201262.942.081.341.820.152.0868.672.201.291.950.152.3664.532.141.311.890.152.17
201364.562.141.261.780.122.2561.732.571.582.410.142.1963.002.361.402.080.142.21
201461.552.651.602.230.192.9062.313.532.192.860.203.6061.993.101.872.560.193.26
201560.573.011.902.450.214.0863.333.201.972.670.213.0862.023.111.942.560.213.60
201659.364.182.653.560.274.9564.923.952.123.310.243.4262.084.072.423.430.264.21
201760.402.901.772.420.203.2561.983.511.982.590.204.0161.263.201.892.510.203.68
201858.153.262.032.990.234.6861.493.301.932.590.223.4859.793.281.912.780.224.05
201960.492.581.602.460.173.1264.103.892.152.930.222.8362.593.211.832.720.202.97
202058.613.692.353.490.235.0260.213.462.132.620.243.7059.343.582.213.030.244.28
202160.352.641.612.320.203.4863.293.411.822.510.213.4761.903.001.722.420.213.51
202258.432.371.512.400.143.1263.294.052.133.310.233.1861.293.141.812.870.193.10
202358.473.302.033.410.214.4960.943.511.972.880.214.6259.793.392.033.140.214.55
合计60.372.761.762.550.193.4962.823.351.902.670.213.2461.653.051.832.610.203.36
AAPC
(%)
-0.802.833.094.403.115.66-0.283.892.782.693.114.09-0.453.353.073.573.174.98
95%CI
(%)
-1.15~-0.45-0.62~6.40-0.56~6.861.13~7.77-1.03~7.421.26~10.25-0.82~0.261.55~6.290.51~5.100.48~4.941.00~5.271.36~6.89-0.73~-0.170.80~5.970.37~5.831.26~5.930.56~5.841.59~8.48
t-5.0341.8031.8602.9821.6442.850-1.1513.6852.7072.6923.2653.318-3.5212.9042.5113.4212.6813.254
P<0.0010.0990.0900.0120.1280.0160.2740.0040.0200.0210.0080.0070.0050.0140.0290.0060.0210.008
), ArticleFig(id=1241023947161006377, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=EN, label=Table 2, caption=

Age-specific mortality (/100 000) and its trend of female cervical cancer in Jinan from 2011 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)城区农村合计
15~44岁45~59岁≥60岁15~44岁45~59岁≥60岁15~44岁45~59岁岁≥60岁
20110.462.366.440.773.565.410.615.90
20120.462.646.770.463.555.710.466.21
20130.762.636.380.912.727.580.847.02
20140.773.727.531.264.539.141.018.38
20151.014.378.590.583.7810.530.799.62
20162.045.869.280.494.8811.221.2810.29
20170.466.905.281.174.378.750.807.08
20180.607.096.651.362.529.360.968.03
20190.594.156.651.034.4310.310.798.49
20201.447.696.721.403.169.181.427.94
20210.704.766.240.534.558.600.637.40
20221.075.145.650.894.2510.780.998.12
20231.064.968.240.724.549.450.928.89
合计0.884.866.780.884.228.580.887.69
AAPC(%)4.777.07-0.381.791.663.823.281.86
95%CI(%)-2.54~12.622.03~12.36-3.07~2.39-4.71~8.72-1.77~5.210.80~6.93-1.44~8.248.49-5.86~4.36
t1.4193.116-0.3100.5911.0552.7941.51901.669
P0.1840.0100.7620.5660.3140.0170.15710.123
), ArticleFig(id=1241023947253281073, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=CN, label=表2, caption=

2011—2023年济南市女性宫颈癌分年龄死亡率(/10万)及趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)城区农村合计
15~44岁45~59岁≥60岁15~44岁45~59岁≥60岁15~44岁45~59岁岁≥60岁
20110.462.366.440.773.565.410.615.90
20120.462.646.770.463.555.710.466.21
20130.762.636.380.912.727.580.847.02
20140.773.727.531.264.539.141.018.38
20151.014.378.590.583.7810.530.799.62
20162.045.869.280.494.8811.221.2810.29
20170.466.905.281.174.378.750.807.08
20180.607.096.651.362.529.360.968.03
20190.594.156.651.034.4310.310.798.49
20201.447.696.721.403.169.181.427.94
20210.704.766.240.534.558.600.637.40
20221.075.145.650.894.2510.780.998.12
20231.064.968.240.724.549.450.928.89
合计0.884.866.780.884.228.580.887.69
AAPC(%)4.777.07-0.381.791.663.823.281.86
95%CI(%)-2.54~12.622.03~12.36-3.07~2.39-4.71~8.72-1.77~5.210.80~6.93-1.44~8.248.49-5.86~4.36
t1.4193.116-0.3100.5911.0552.7941.51901.669
P0.1840.0100.7620.5660.3140.0170.15710.123
), ArticleFig(id=1241023947345555769, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=EN, label=Table 3, caption=

Age-specific YLL rate (/1 000) and its trend of female cervical cancer in Jinan from 2011 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)城区农村合计
15~44岁45~59岁≥60岁15~44岁45~59岁≥60岁15~44岁45~59岁≥60岁
201121.4091.64100.5737.80123.0997.7729.58107.4999.09
201222.07102.20
120.5822.18127.81101.0422.12115.47110.24
201336.1097.5698.9047.5895.68129.1441.8396.58114.89
201436.85133.76149.6464.49172.89152.4350.56154.02151.12
201549.36156.39170.4728.71142.75210.2039.01149.32191.47
2016101.83214.83175.0523.73182.22211.3463.64198.23194.01
201726.88243.3691.8456.10166.97164.5540.19204.57129.49
201829.55262.90149.0368.2590.93202.9147.71175.08176.44
201929.29157.70136.8454.35164.11179.0540.82160.99158.01
202070.93281.62123.2772.11114.86201.4471.46196.01162.07
202134.58168.13136.4625.74172.07159.8130.69170.15147.89
202252.09187.24113.2644.54156.55212.0848.85171.62170.29
202354.00183.80165.0234.52296.10159.5245.76240.72162.17
合计43.60178.01129.9544.31155.40163.4649.93166.41147.01
AAPC(%)5.286.721.531.753.914.483.465.543.28
95%CI(%)-1.88~12.961.90~ 11.77-1.97~5.16-5.08~9.06-0.77~8.820.89~8.19-1.43~8.582.62~8.540.31~6.34
t1.6083.0960.9520.5491.8312.7621.5474.2312.433
P0.1360.0100.3610.5940.0940.0810.1500.0010.033
), ArticleFig(id=1241023947479773508, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023938436854499, language=CN, label=表3, caption=

2011—2023年济南市女性宫颈癌分年龄YLL率(/1 000)及趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)城区农村合计
15~44岁45~59岁≥60岁15~44岁45~59岁≥60岁15~44岁45~59岁≥60岁
201121.4091.64100.5737.80123.0997.7729.58107.4999.09
201222.07102.20
120.5822.18127.81101.0422.12115.47110.24
201336.1097.5698.9047.5895.68129.1441.8396.58114.89
201436.85133.76149.6464.49172.89152.4350.56154.02151.12
201549.36156.39170.4728.71142.75210.2039.01149.32191.47
2016101.83214.83175.0523.73182.22211.3463.64198.23194.01
201726.88243.3691.8456.10166.97164.5540.19204.57129.49
201829.55262.90149.0368.2590.93202.9147.71175.08176.44
201929.29157.70136.8454.35164.11179.0540.82160.99158.01
202070.93281.62123.2772.11114.86201.4471.46196.01162.07
202134.58168.13136.4625.74172.07159.8130.69170.15147.89
202252.09187.24113.2644.54156.55212.0848.85171.62170.29
202354.00183.80165.0234.52296.10159.5245.76240.72162.17
合计43.60178.01129.9544.31155.40163.4649.93166.41147.01
AAPC(%)5.286.721.531.753.914.483.465.543.28
95%CI(%)-1.88~12.961.90~ 11.77-1.97~5.16-5.08~9.06-0.77~8.820.89~8.19-1.43~8.582.62~8.540.31~6.34
t1.6083.0960.9520.5491.8312.7621.5474.2312.433
P0.1360.0100.3610.5940.0940.0810.1500.0010.033
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2011—2023年济南市女性宫颈癌死亡疾病负担趋势分析
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王莹 , 曹艳民 , 郑文华 , 马霞 , 王子瑜 , 王庆昌
现代预防医学 | 儿少卫生与妇幼保健 2025,52(3): 471-475
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现代预防医学 | 儿少卫生与妇幼保健 2025, 52(3): 471-475
2011—2023年济南市女性宫颈癌死亡疾病负担趋势分析
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王莹, 曹艳民, 郑文华, 马霞, 王子瑜, 王庆昌
作者信息
  • 济南市疾病预防控制中心,山东 济南 250021
  • 王莹(1978—),女,硕士,副主任技师,研究方向:慢性病防制

通讯作者:

王庆昌,E-mail:
Analysis of the trend in cervical cancer mortality among women in Jinan city from 2011 to 2023
Ying WANG, Yan-min CAO, Wen-hua ZHENG, Xia MA, Zi-yu WANG, Qing-chang WANG
Affiliations
  • Jinan Center for Disease Control and Prevention, Jinan, Shandong 250021, China
出版时间: 2025-02-10 doi: 10.20043/j.cnki.MPM.202409302
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目的

了解济南市女性宫颈癌死亡的流行病学特征,为宫颈癌预防控制提供参考。

方法

收集2011—2023年济南市女性宫颈癌死亡资料,应用SPSS 20.0软件,分城乡计算死亡率、35~64岁截缩死亡率、0~74岁累积死亡率、过早死亡损失寿命年(YLL)等指标,并用年均变化百分比(AAPC)分析宫颈癌死亡变化趋势。

结果

2011—2023年,女性宫颈癌死亡率为3.05/10万,标化死亡率为1.83/10万,平均死亡年龄为61.65岁,截缩死亡率为3.36/10万,累积死亡率为0.20%。宫颈癌的死亡率、标化死亡率、占全部恶性肿瘤的比例、截缩死亡率和累积死亡率均呈上升趋势,死亡年龄呈下降趋势。30岁后死亡率逐渐增加,直至75~79岁年龄组达最高值。城区45~59岁女性和农村60岁以上女性宫颈癌死亡率和YLL率均呈上升趋势。

结论

济南市宫颈癌死亡率呈现上升趋势,并存在城乡差异。应有针对性地做好三级预防,有效地降低宫颈癌发病、死亡率。

宫颈癌  /  死亡率  /  过早死亡损失寿命年  /  趋势分析  /  济南
Objective

To understand the epidemiological characteristics of cervical cancer mortality among women in Jinan city, providing reference for the prevention and control of cervical cancer.

Methods

Data on cervical cancer mortality among women in Jinan from 2011 to 2023 were collected. Using SPSS 20.0 software, mortality rates were calculated for urban and rural areas, age-standardized mortality rates for women aged 35 to 64, cumulative mortality rates for those aged 0 to 74, and years of life lost (YLL) due to premature death. The annual average percentage change (AAPC) was employed to analyze trends in cervical cancer mortality.

Results

From 2011 to 2023, the cervical cancer mortality rate for women was 3.05 per 100 000, with a standardized mortality rate of 1.83 per 100 000 and an average age at death of 61.65 years. The truncated mortality rate was 3.36 per 100 000, and the cumulative mortality rate was 0.20%. The mortality rate, standardized mortality rate, proportion of total malignant tumors, truncated mortality rate, and cumulative mortality rate for cervical cancer all exhibited an upward trend, while the age at death showed a downward trend. Mortality rates gradually increased after the age of 30, peaking in the 75 to 79 age group. The cervical cancer mortality rate and YLL rate among women aged 45 to 59 in urban areas and those over 60 in rural areas also showed increasing trends.

Conclusion

The cervical cancer mortality rate in Jinan city is on the rise, with notable urban-rural disparities. Targeted tertiary prevention measures should be implemented to effectively reduce the incidence and mortality rates of cervical cancer.

Cervical cancer  /  Mortality rate  /  Years of life lost  /  Trend analysis  /  Jinan
王莹, 曹艳民, 郑文华, 马霞, 王子瑜, 王庆昌. 2011—2023年济南市女性宫颈癌死亡疾病负担趋势分析. 现代预防医学, 2025 , 52 (3) : 471 -475 . DOI: 10.20043/j.cnki.MPM.202409302
Ying WANG, Yan-min CAO, Wen-hua ZHENG, Xia MA, Zi-yu WANG, Qing-chang WANG. Analysis of the trend in cervical cancer mortality among women in Jinan city from 2011 to 2023[J]. Modern Preventive Medicine, 2025 , 52 (3) : 471 -475 . DOI: 10.20043/j.cnki.MPM.202409302
宫颈癌是女性最常见的恶性肿瘤之一。国际癌症研究机构显示,2020年我国女性新发宫颈癌约11万例,发病率为15.6/10万,死亡约6万例,死亡率为8.4/10万,在我国女性恶性肿瘤发病与死亡顺位中分列第六位和第七位[1]。宫颈癌严重威胁女性健康,防治形势严峻。本文通过分析2011—2023年济南市女性宫颈癌死亡流行病学特征和疾病负担水平及其趋势,了解和掌握济南市宫颈癌死亡的流行现况,为宫颈癌防控工作提供参考。
女性宫颈癌死亡数据来源于2011年1月1日—2023年12月31日各医疗卫生机构录入至中国疾病预防控制中心“人口死亡信息登记管理系统”中的济南市户籍死亡资料。人口数据来自济南市公安部门。
宫颈癌分类按照《疾病和有关健康问题的国际统计分类(第十次修订本)》(ICD-10),编码范围为C53。依据非农业人口比例、地理位置及经济状况等因素,将历下区、市中区、槐荫区、天桥区、历城区、高新区、南山区列为城区,将长清区、章丘区、济阳区、平阴县、商河县列为农村。莱芜区、钢城区于2019年并入济南市,考虑数据分析的连续性,相关数据未纳入分析。
2010年济南市启动全人群死因登记报告工作。市、区两级疾控机构每年均对辖区死因报告单位进行督导和业务培训,定期开展人群死亡漏报调查。定期与公安、民政、妇幼等部门交换死亡数据。2011—2023年全市死因填报准确率和报告及时率均≥95%,死因不明比例均≤5%,全死因粗死亡率波动于641.52/10万~754.11/10万。
用SPSS 20.0对数据进行分析,统计指标包括死亡率、标化死亡率,0~74岁累积死亡率、35~64岁截缩死亡率等。利用2000年全国人口普查数据标化死亡率。疾病负担指标采用过早死亡损失寿命年(years of life lost,YLL)、YLL率[2],根据GBD 2019提供的标准寿命表[3]计算。使用Joinpoint Regression Program 4.2.0.2估算各指标的平均年度变化百分比(average annual percentage of change,AAPC)和95%置信区间(confidengce interval,CI),采用双侧t检验,检验水准α=0.05。
2011—2023年济南市女性前12位恶性肿瘤合计粗死亡率为99.62/10万,占全部恶性肿瘤死亡的86.39%。期间,前12位恶性肿瘤种类稳定,顺位稍有不同。其中,宫颈癌由2011年的第12位上升到2023年的第9位。
同期,济南市女性宫颈癌年均死亡率为3.05/10万,标化死亡率为1.83/10万,占女性全部恶性肿瘤死亡的2.61%,平均死亡年龄为61.65岁,累积死亡率为0.20%,截缩死亡率为3.36/10万。宫颈癌的死亡率、标化死亡率、占全部恶性肿瘤的比例、累积死亡率和截缩死亡率均呈上升趋势(P均<0.05)。宫颈癌的死亡年龄呈下降趋势(P=0.005)。见表1
2011—2023年济南市农村女性宫颈癌的平均死亡率和平均标化死亡率均高于城区女性,且死亡率和标化死亡率分别以年均3.89%和2.78%的速度上升(P均<0.05),城区女性未见明显变化趋势,但死亡年龄以年均0.80%的速度下降(P<0.001)。城区和农村女性宫颈癌占全部恶性肿瘤的比例及截缩死亡率均呈上升趋势(P均<0.05)。农村女性宫颈癌累积死亡率以年均3.11%的速度上升(P=0.008)。见图1表1
2011—2023年济南市女性15岁前无宫颈癌死亡,15~29岁出现个别死亡病例,30岁后死亡率逐渐增加,直至75~79岁达最高值。城区女性50~54岁年龄组出现第一个小高峰,随后趋势稍有下降后再逐渐上升,直至75~79岁年龄组时达最高值。农村女性宫颈癌死亡率随年龄增长逐渐升高,同样在75~79岁年龄组达最高值。城乡女性在40岁前宫颈癌死亡率相差不大,40~54岁年龄段城区女性宫颈癌死亡率高于农村女性,55岁后农村女性宫颈癌死亡率高于城区女性。见图2。济南市45~59岁女性宫颈癌死亡率以年均5.33%的速度上升(P=0.001)。城区45~59岁女性宫颈癌死亡率年均上升速度为7.07%(P=0.010)。农村60岁以上女性宫颈癌死亡率年均上升速度为3.82%(P=0.017)。城乡其他年龄段变化趋势不明显。见表2
2011—2023年济南市女性宫颈癌YLL为3.73万人年,城区为1.83万人年,农村为1.90万人年。城区45~59岁女性宫颈癌YLL率年均上升速度为6.72%(P=0.010),农村60岁以上女性宫颈癌YLL率年均上升速度为4.48%(P=0.018),城乡其他年龄段YLL率变化趋势不明显。见表3
宫颈癌的流行病学特征与社会环境、生活环境、个体行为、遗传等因素密切相关[4]。人类乳头瘤病毒(HPV)是宫颈癌的主要致病原因[5-6]。2011—2023年济南市女性宫颈癌死亡率和标化死亡率年均上升速度分别是3.35%和3.07%,累积死亡率和截缩死亡率的年均上升速度分别是3.17%和4.98%。恶性肿瘤死因顺位由2011年的第12位上升到2023年的第9位,且占全部恶性肿瘤的比例以年均3.57%的速度上升。济南市宫颈癌防控任务严峻。
济南市农村女性宫颈癌的死亡率和标化死亡率均高于城区,与国内相关研究一致[7-12]。农村女性宫颈癌死亡率、标化死亡率和0~74岁累积死亡率均高于城区女性,且均呈上升趋势。与城区相比,农村医疗资源相对不足,居民自我保健意识较差、健康素养水平较低、主动参与宫颈癌筛查的意识较弱[13],导致农村地区死亡率高于城市,同时在一定程度上导致农村宫颈癌的死亡率呈上升态势。对不同年龄组人群变化趋势分析发现,农村死亡率的升高主要源自60岁以上女性,其YLL率也呈上升趋势,同时还发现,其死亡率及YLL率均高于同年龄段城区女性。农村老年女性,由于受教育程度、经济条件、健康意识相对更低,思想更加保守,有的甚至认为下生殖道疾病难以启齿,诊断时多为晚期,或者确诊后没有及时救治,使生命更容易受到宫颈癌的严重威胁。
济南市城区女性宫颈癌平均死亡年龄由2011年的65.24岁下降到2023年的58.47岁,以年均0.80%的速度下降,呈现年轻化趋势。这可能与城区女性近年来性观念更为开放、初潮年龄较早、性生活发生时间提早、HPV反复感染等[14]有关。进一步分析发现,城区45~59岁女性的死亡率和YLL率,及35~64岁截缩死亡率呈上升趋势,并且此年龄段城区女性的死亡率和YLL率均高于农村女性。既往研究表明,宫颈癌死亡年龄较发病年龄滞后10年[15]。城区青壮年女性的宫颈癌防控应受到更多关注。
济南市2009年启动农村适龄妇女宫颈癌筛查项目。近几年,项目逐步覆盖至城市低保35~64岁妇女及城镇灵活就业和无业适龄妇女。截至2020年,项目累积完成宫颈癌检查99.60万人次,确诊宫颈癌225例,妇女健康指标得到持续改善。但是,宫颈癌防控体系尚待完善,妇女健康意识薄弱,诊疗技术水平参差不齐。针对30岁后宫颈癌死亡率开始逐渐增加,宫颈癌筛查应从30岁或更早开始,扩大受益人群的范围。接种HPV疫苗是预防宫颈癌的最有效手段,能够减少宫颈癌的发病与死亡[16],应积极倡导适龄女性主动接种HPV疫苗。另外,扎实做好健康科普宣传,避免首次性行为年龄过早或性伴侣过多,控制人工流产次数[17],降低暴露于危险因素的机会,减少HPV的感染风险,提高自我保健意识,倡导健康生活方式。同时,加强癌前病变的监测[18],提高医疗机构,特别是农村地区的诊治能力,有效地降低宫颈癌发病率、死亡率。
  • 2024年济南市卫生健康委科技发展计划项目(G19)
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2025年第52卷第3期
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doi: 10.20043/j.cnki.MPM.202409302
  • 接收时间:2024-09-18
  • 首发时间:2026-03-18
  • 出版时间:2025-02-10
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  • 收稿日期:2024-09-18
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2024年济南市卫生健康委科技发展计划项目(G19)
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    济南市疾病预防控制中心,山东 济南 250021

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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