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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
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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。 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 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。 -
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