中国女性1987—2014 年乳腺癌死亡趋势的Joinpoint 回归分析

目的：分析中国女性乳腺癌死亡现况及过去近30年间的变化趋势，为制定中国乳腺癌的防控策略提供科学依据。方法：收集1987—2014年中国女性乳腺癌死亡率数据，描述年龄标化死亡率和年龄别死亡率的特征及趋势，利用Joinpoint回归模型分析乳腺癌死亡率的时间变化趋势。结果：1987—2014年城市女性乳腺癌死亡率整体高于农村，城市女性年均变化呈下降趋势，平均每年下降0.3%(P=0.06)，而农村女性年均变化呈上升趋势，平均每年上升1.26%(P<0.01)。城乡差距逐渐缩小，城市女性40~59岁乳腺癌年龄别死亡率随年份先下降后上升，而农村女性呈逐年上升趋势。结论：1987—2014年中国城市女性乳腺癌死亡率整体高于农村女性，农村女性乳腺癌死亡率随时间呈上升趋势，城乡差距正在缩小，需特别关注农村女性的乳腺癌防治情况。

Joinpoint regression analysis for the mortality trend of breast cancer in Chinese female from 1987 to 2014

Objective: To analyze the current situation for the mortality of Chinese female breast cancer andthe trend of change in the past thirty years, and to provide scientifi c basis for prevention and controlof breast cancer in China.Methods: Th e mortality data of breast cancer in Chinese female from 1987 to 2014 were collected,the trends of age-standardized rates and age-adjusted rates were described, and the variations viaJoinpoint regression models were analyzed.Results: From 1987 to 2014, the mortality for the urban female breast cancer was greater than thatfor the rural females. Th ere was a downward trend for urban women with an average decrease of 0.3% for each year (P=0.06). While the average annual change for rural females showed an upwardtrend (AAPC=1.26%, P<0.01). The gap between urban and rural females is narrowing gradually.The 40–59 age-adjusted rate for urban females decreased first and then it was increased with timemoving forward. The mortality for rural females was continuously increased.Conclusion: From 1987 to 2014, the breast cancer mortality for urban females was overall higherthan that for rural females. The mortality for rural females was continuously increased in the pastyears. The gap between urban and rural females is narrowing. We should pay specific attention tothe prevention and treatment of breast cancer for the rural females.