| [Objectives]The study was aimed to understand the situation of mortality in malignant tumors through analyzing mortality of malignant tumors from2007to2012in Wendeng district, Weihai city of Shandong province, China. Compared with the level of mortality of malignant tumors between the70’s and90’s in the20th century and2007-2012, the study was to describe the change trend of mortality in malignant tumors and the change of disease chart and death chart. Disability adjusted life years (DALYs) and indirect economic burden were calculated in different population, regions, and malignant tumor diseases using morbidity and mortality of malignant tumors in2012. These indexes could assess health burden and economic burden of malignant tumors comprehensively. Results will contribute to assist health policy makers in developing health strategies to reduce the future burden of malignant tumors.[Methods]Data on malignant tumors death monitoring in the70’s and90’s of the20th century and2007-2012in Wendeng district, Weihai city of Shandong province were used to describe the local resident death level of malignant tumors with mortality, cause-specific mortality, age-specific mortality and age-adjusted mortality rates. The Joinpoint Model was adpoted to explore change trend of malignant tumors death and describe change tendency of all tumors and different tumors. The annual change contribution was applied to calculate every tumor contribution to the general trend of change.Life expectancy table was used to calculate life expectancy and life expectancy attributed malignant tumors with data on malignant tumors death monitoring in Wendeng district, Weihai city from2007to2012.Years of life lost (YLLs) of all tumors and different tumors were calculated with using data on malignant tumors death monitoring in2012in Wendeng district, Weihai city. Data on morbidity of malignant tumors in2012were used to calculate years lived with disability (YLDs) of all tumors and different tumors based on the formula of the global burden of disease with direct approach and the disability weights of malignant tumors from the survey data in Shandong province in2008. Indirect economic burden of malignant tumors in Wendeng district, Weihai city were estimated by human capital method and DALYs.[Results]1. A total of23489cases of death cases were reported in Wendeng district, Weihai city from2007to2012. The crude mortality rate was656.93/105(per100000population), and the age-standardized mortality (China’s population) was173.24/105, which in males was higher than that in females. The top3causes of death were cardiovascular and cerebrovascular diseases, malignant tumors, and injury.2. A total of5622cases of death cases from malignant tumors were reported in Wendeng district, Weihai city between2007and2012, which accounted for23.93%of all deaths. The rank of death causes from malignant tumors was the2nd for the whole population. The average annual report crude mortality was157.92/105with higher rate in males. Malignant tumor deaths mainly concentrated in the middle-aged and old people with highest rate in the age of45-49year-old. The top3ranks of death causes from malignant tumors during2007-2012were lung cancer, liver cancer and stomach cancer.3. The average life expectancy was80.63in Wendeng district, Weihai city from2007to2012with79.07years old in males and82.30years old in females. After the removal of malignant tumor death factor, the average life expectancy could increase 2.4years. Among these, the highest growth was from lung cancer with0.58years, followed by liver cancer, gastric cancer, colorectal cancer and leukemia.4. The age-standardized mortality of malignant tumors in Wendeng district, Weihai city was from60.10/5to57.31/105between1970and2012. Standardized mortality rates fell by0.48%per year (P>0.05). The rate of lung cancer showed a rising trend in general with statistically significant. The rate of esophageal and gastric cancer showed downward trend with statistically significant.The fold point was2010in Joinpoint trend analysis. The results were firstly decreased but increased latter. The results in males and females had same trend, however, only the age-standardized mortality in two stages of females had statistical significance.Lung cancer had the highest contribution to malignant tumor death in the cause of the rising trend between1970and2012, which accounted for84.21%, followed by liver cancer. In the decline of the cause of death, the contribution of stomach cancer was the highest (61.29%), followed by cervical cancer and esophageal cancer.5. In2012, a total of12,783healthy life years were lost in malignant tumors in Wendeng district, Weihai city. The DALYs rate was21.94per1000person, and the age-standardized rates to the China’s population and the world population were15.96per1000and13.61per1000person, respectively. The top3ranks of DALYs from malignant tumors were lung cancer, stomach cancer and liver cancer. Burden of malignant tumors was focused on30-79age group, accounting for93.72%with the highest in45-59age group. Losses caused by the premature death of life years (YLLs) were10,202DALYs, accounting for79.81%of the total DALYs. The top3ranks of YLLs from malignant tumors were lung cancer, liver cancer and stomach cancer. The Years lived with disability (YLDs) caused by loss of life were2581DALYs, accounting for20.19%of the total DALYs. The top3ranks of YLDs from malignant tumors were colorectal cancer, breast cancer and lung cancer.6. The indirect economic burden caused by morbidity and mortality of malignant tumors was512million Yuan in Wendeng district, Weihai city in2012, which in males and females were281million Chinese Yuan and231million Chinese Yuan, respectively. Indirect economic burden was mainly concentrated in30-69years old, with the highest burden in45-59years old. The highest indirect economic burden caused by malignant tumors was liver cancer, followed lung cancer, gastric cancer, breast cancer and colorectal cancer. Indirect economic burden caused by the top5 malignant tumors accounted for64.25%of the total malignant tumors.[Conclusions]The mortality of malignant tumors accounted for23.93%of all deaths in Wendeng district, Weihai city from2007to2012. The rank of death causes was the2nd for the whole population. The mortality of malignant tumors in our study area was lower than the average mortality of tumors in Shandong province and whole nation. Although the change of standardized mortality rate of malignant tumors from1970to2012was not obvious, the crude death rate and standardized mortality of malignant tumors were on the rise with aging population, the bad living habits and economic development. According to the burden and components of malignant tumors estimated by the disability adjusted life years (DALYs), the losses caused by the premature death of life year (YLLs) is much higher than that by disability (YLDs). The heavy economic burdens of tumors were liver cancer, lung cancer, gastric cancer, breast cancer and colorectal cancer. Malignant tumors should be strengthened the prevention and control work in future, especially lung cancer, liver cancer and other major malignant tumors. |
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