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[目的]探究昆山市1981~2014年食管癌死亡趋势及定量估计影响因素。[方法]食管癌死亡病例来源于死因监测;计算食管癌粗死亡率与年龄标化死亡率;使用平均年度变化百分比(annual percent change,APC)评价食管癌死亡率变化趋势。以0~74岁累积死亡率来评价食管癌历年死亡风险。采用率差别分解法分析人口因素对食管癌死亡率变化的贡献。[结果]1981~2014年食管癌年龄标化死亡率在男女合计(APC=-4.2%,95%CI:-4.8%~-3.6%)、男性(APC=-4.3%,95%CI:-4.9%~-3.7%)和女性(APC=-4.4%,95%CI:-5.1%~-3.7%)人群中均呈现明显下降趋势。食管癌0~74岁累积死亡率由1981年的2.85%下降到2014年的0.45%(APC=-5.0%,95%CI:-5.7%~-4.3%),食管癌死亡的风险在0~74岁年龄组逐渐降低。食管癌死亡率的下降是人口因素与非人口因素共同作用结果,其中人口因素贡献在男女合计、男性及女性人群中分别为-68.66%、-68.39%和-127.43%。[结论]昆山市1981~2014年食管癌死亡率在非人口因素作用下明显下降,但是这种下降趋势受到了人口因素的阻碍。
[Objective] To investigate the mortality and prognostic factors of esophageal cancer in Kunshan from 1981 to 2014. [Methods] The deaths from esophageal cancer originated from the monitoring of cause of death. The crude and age-adjusted death rates of esophageal cancer were calculated. The annual percent change (APC) was used to evaluate the change of esophageal cancer mortality. The cumulative mortality rate of 0 to 74 years to evaluate the risk of esophageal cancer over the years. Adopting Differentiation Analysis to Analyze the Contribution of Population Factors to Changes of Esophageal Cancer Mortality. [Results] The age-standardized death rates of esophageal cancer from 1981 to 2014 were statistically significant in both men and women (APC = -4.2%, 95% CI: -4.8% -3.6% 4.9% ~ -3.7%) and female (APC = -4.4%, 95% CI: -5.1% ~ -3.7%) population showed a significant downward trend. The cumulative mortality rate of esophageal cancer patients aged 0-74 decreased from 2.85% in 1981 to 0.45% in 2014 (APC = -5.0%, 95% CI: -5.7% -4.3%). The risk of death from esophageal cancer was 0 ~ 74-year-old group gradually decreased. The decline in esophageal cancer mortality is a combination of demographic and non-demographic factors. Demographic factors contribute to -68.66%, -68.39% and -127.43% of the total male-female population, respectively. [Conclusion] The mortality of esophageal cancer in Kunshan City decreased significantly from 1981 to 2014 under the influence of non-population factors, but this downward trend was hindered by population factors.