-
摘要:
目的 了解和掌握“一带一路”沿线国家宫颈癌流行病学负担现状。 方法 对照2018年世界卫生组织（WHO）癌症登记数据库，从“一带一路”政务网中选取127个宫颈癌流行病学数据较为完整的“一带一路”沿线国家作为研究对象。按照WHO划分的世界区域标准，对127个“一带一路”沿线国家进行归类。运用统计学参数检验法，比较分析不同WHO区域2018年“一带一路”沿线国家宫颈癌流行病学负担差异，应用聚类分析法分析不同WHO区域国家的宫颈癌流行程度。 结果 不同WHO区域“一带一路”沿线国家宫颈癌的流行病学负担差异性显著。WHO非洲区域国家的宫颈癌平均标化发病率和标化死亡率最高，分别是32.4/10万和21.9/10万；相反，东地中海地区国家的平均标化发病率为4.4/10万，标化死亡率为2.9/10万，位居六大WHO区域最低。WHO美洲区域的伤残调整寿命年（DALYs）最高（458.2/10万），东地中海地区最低（69/10万）。聚类分析结果表明，WHO非洲区域国家的宫颈癌多为中、高度流行；低度流行国家主要分布在WHO欧洲、西太平洋和东地中海地区。 讨论 地理区域是影响“一带一路”沿线国家宫颈癌流病负担的主要因素，但并不是唯一因素，未来将综合考虑国家社会经济发展水平、自然和社会环境等因素，并纳入研究范畴。 -
关键词:
- 宫颈癌 /
- 流行病学 /
- 负担 /
- "一带一路"沿线国家
Abstract:Objective To examine the disease burden of cervical cancer in 127 countries along the Belt and Road. Methods The 127 countries involved in the analysis were determined based on the information from the website of China's Belt and Road Initiative and the countries were assigned into one of the 6 World Health Organization (WHO) regions. The country-specific data of 2018 on world population based age standardized incidence and mortality rate and disability-adjusted life years (DALYs) of cervical cancer were extracted from WHO cancer registry database for analyzing and comparing between country disparities in disease burden of cervical cancer using descriptive statistics. Cluster analysis was used to assess prevalence intensity of cervical cancer among the countries in different WHO regions. Results The disease burden of cervical cancer in 2018 was significantly different among the 127 countries in various WHO regions along the Belt and Road. The mean age-standardized incidence rate (32.4/100 000) and mortality rate (21.9/100 000) of cervical cancer were the highest for the countries in the WHO African region; while, those for the countries in the WHO Mediterranean region were the lowest (age-standardized incidence and mortality rate: 4.4/100 000 and 2.9/100 000). The mean DALYs of cervical cancer was the highest (458.2/100 000) for the countries in the WHO region of America but the lowest (69 /100 000) for countries in the WHO Eastern Mediterranean region. The results of cluster analysis showed that the prevalence of cervical cancer was at medium-high level for countries in WHO African region and at low level for countries in the WHO European, Western Pacific and Eastern Mediterranean regions. Conclusion Geographical region is the main, but not the only factor affecting the disease burden of cervical cancer for countries along the Belt and Road and the influences of country-specific social and economic development, natural and social environment should be considered in cervical cancer control. -
Key words:
- cervical cancer /
- epidemiology /
- disease burden /
- the Belt and Road surrounding country
-
图 1 SSE随分类数变化曲线
Figure 1. The curve of K-value dependent sum of the squared errors in K-means clustering algorithm
表 1 不同WHO区域国家宫颈癌标化发病率、标化死亡率和DALYs
Table 1. WHO region-specific age-standardized (world population) incidence, mortality, DALYs of cervical cancer in 127 Belt and Road surrounding countries in 2018
WHO区域 标化发病率（1/10万） 标化死亡率（1/10万） DALYs（1/10万） 范围 M IQR 范围 M IQR 范围 M IQR 非洲 7.9～65.5 32.4 21.2 4.5～43.4 21.9 17.0 54.5～633.5 371.3 117.6 东南亚 9.2～24.5 15.8 a 9.9 4.9～14.4 8.6 d 7.0 93.5～299.9 197.1 bc 79.8 美洲 11.1～36.6 17.0 a 8.9 5.2～18.0 10.3 a 6.3 252.9～660.8 458.2 a 233.8 西太平洋 5.6～29.8 12.2 bd 12.2 1.8～20.7 6.3 b 9.1 99.7～669.6 296.1 b 184.8 欧洲 3.7～26.2 11.4 bd 9.1 1.1～9.4 5.2 bc 3.6 72.6～552.2 253.3 bcd 133.4 东地中海 2.2～25.1 4.4 b 4.0 1.5～18.7 2.9 b 3.4 32.5～529.4 69.0 b 66.5 注：与东地中海区域比较，a P < 0.01，d P < 0.05；与非洲区域比较，b P < 0.001；与美洲比较，c P < 0.001。 
下载: 导出CSV
表 2 聚类分析结果（均值）（1/10万）
Table 2. Prevalence intensity category of cervical cancer based on mean age-standardized incidence and mortality rate (1/100 000) and DALYs in 127 Belt and Road surrounding countries – clustering analysis
流行强度 标化发病率 标化死亡率 DALYs I中度流行 20.45 12.18 302.81 II低度流行 7.24 3.87 104.18 III高度流行 31.47 20.67 534.18 F 值 42.76 32.09 419.34 P 值 0.00 0.00 0.00
下载: 导出CSV
表 3 不同WHO区域分布“一带一路”沿线国家宫颈癌流行程度分布
Table 3. WHO region-specific number (ratio) of countries with moderate, low, and high prevalence intensity of cervical cancer in 2018 in 127 Belt and Roadsurrounding countries
WHO区域 I中度流行 II低度流行 III高度流行 国家数 占比（%） 国家数 占比（%） 国家数 占比（%） 非洲 20 31.7 2 4.9 14 60.9 欧洲 22 34.9 9 22.0 — — 西太平洋 9 14.3 4 9.7 — — 美洲 7 11.1 — — 9 39.1 东南亚 4 6.4 4 9.7 — — 东地中海 1 1.6 22 53.7 — — 合计 63 100.0 41 100.0 23 100.0 注：“—”代表此区域无研究国家，数据为零。
下载: 导出CSV
-
[1] 李玉兰, 刘晓, 韩逢皎, 等. 高危型人乳头瘤病毒阴性宫颈癌的研究进展[J]. 国际生殖健康/计划生育杂志, 2022, 41(4): 342 – 346. [2] Ginsburg O, Bray F, Coleman MP, et al. The global burden of women's cancers: a grand challenge in global health[J]. The Lancet, 2017, 389(10071): 847 – 860. doi: 10.1016/S0140-6736(16)31392-7 [3] 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读[J]. 肿瘤综合治疗电子杂志, 2021, 7(2): 1 – 13. [4] 张宇薇, 李辉, 孙晓丽, 等. “一带一路”沿线66国全民健康覆盖现状与预测[J]. 中国公共卫生, 2019, 35(10): 1388 – 1392. [5] International Agency for Research on Cancer, World Health Organization. Global cancer observatory: cancer today[DB/OL]. [2023 – 03 – 20]. http://gco.iarc.fr/today. [6] 中国一带一路网. “一带一路”大数据指数[DB/OL]. [2022 – 01 – 11]. https://www.yidaiyilu.gov.cn/dataChart [7] 伍信怡, 汪璐, 史富存. 基于K-means聚类分析法的三峡货物分类研究[J]. 中国水运, 2021(6): 97 – 99. [8] World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem[EB/OL]. (2020 – 11 – 17)[2023 – 04 – 06]. http://www.wgo.int/publications/i/item/9789240014107. [9] Tran KN, Park Y, Kim BW, et al. Incidence and mortality of cervical cancer in Vietnam and Korea (1999 – 2017)[J]. Epidemi-ology and Health, 2020, 42: e2020075. [10] Ploysawang P, Rojanamatin J, Prapakorn S, et al. National cervical cancer screening in Thailand[J]. Asian Pac J Cancer Prev, 2021, 22(1): 25 – 30. doi: 10.31557/APJCP.2021.22.1.25 [11] 邱增辉, 蒋祎, 刘娅莉, 等. “一带一路”国家公共卫生与卫生服务现况[J]. 中国公共卫生, 2020, 36(12): 1755 – 1758. [12] Ministry of Health, New Zealand. New Zealand cancer plan: better, faster cancer care 2015-2018[EB/OL]. [2023 – 04 – 28]. https://www.health.govt.nz/publication/new-zealand-cancer-plan-better-faster-cancer-care-2015-2018. -
点击查看大图
计量
- 文章访问数: 371
- HTML全文浏览量: 99
- PDF下载量: 105
- 被引次数: 0