Evaluation Of The Incidence,Mortality,Hospitalization,and Risk Factors Of Lung Cancer In Shanxi Province

Objective:Cancer are the second disease only behind cerebrovascular disease in affecting the health of our citizens.As the "king of cancer",lung cancer is difficult to prevent and treat.In order to understand the occurrence and development of lung cancer in Shanxi Province,this paper studied the incidence,mortality,hospitalization and change trend of lung cancer in Shanxi Province in recent years,and investigated the risk factors of lung cancer,so as to provide reference for effective prevention and control of lung cancer in Shanxi Province in the next step.Method:The age-adjusted incidence(death)rate,cumulative incidence(death)rate,and reduced incidence(death)rate were calculated by using the Joinpoint model to analyze the trend of biding incidence(death)rate in different regions and different genders,according to the data published in Shanxi Province’s Annual Cancer Registration Report from 2013 to 2017.Multi-stage stratified random sampling was used to extract various types of medical institutions from Shanxi Province,and the information of the first page of medical records and hospitalization expenses of patients discharged from hospital diagnosed as pulmonary malignant tumor(ICD-10 disease code: C34)during2015-2019 was derived from the medical management system of each institution.Descriptive statistics were used to analyze the number,gender and age of inpatients with lung cancer.t test and F test were used to compare the mean value between groups,and grey correlation method and structural variation degree were used to analyze the structure of lung cancer hospitalization costs.The questionnaire was prepared according to the "High Risk Group Self-examination Rating Table" and "Chinese Guidelines for Screening and Early Diagnosis and Treatment of Lung Cancer(2021)".A multi-stage stratified random sampling method was used to investigate the high risk groups and risk factors of lung cancer among permanent residents aged 45 years and above in Shanxi Province.Results:1.Analysis of incidence,mortality and change trend of lung cancer in Shanxi Province:From 2013 to 2017,the crude incidence of lung cancer was 43.13 per 100,000,and the mortality rate was 34.91 per 100,000.The winning morbidity was 30.43 per 100,000,and the winning mortality was 24.24 per 100,000.During the five-year period,the winning incidence of lung cancer showed a decreasing trend(APC=-1.5%,95%CI:-7.7%-5.2%),while the winning mortality showed an increasing trend(APC=1.3%,95%CI:-3.9%-6.9%),but the trend difference was not statistically significant.In Shanxi Province,the bid-winning incidence rate of male lung cancer(4279/100,000)was 2.35 times that of female(18.23/100,000),the mortality rate of male lung cancer(3477/100,000)was 2.50 times that of female(1391/100,000),and the morbidity and mortality rate of urban lung cancer(3345/100,000)was 2.50 times that of female.28.15/100,000)were higher than those in rural areas(27.50/ 100,000,21.17/ 100,000).Morbidity increases rapidly after the age of 40 and mortality increases rapidly after the age of 45.2.Analysis of hospitalized situation and change trend of residents with lung cancer in Shanxi Province:From 2015 to 2019,the number of inpatients with lung cancer showed an overall fluctuating trend.From 2017 to 2019,the number of lung cancer patients increased year by year,but the proportion of cancer inpatients decreased year by year,and the male to female ratio decreased from 2.89:1 to 2.66:1.From the age of hospitalization,the proportion of the age group with the highest number of inpatients with lung cancer showed an increasing trend during 2015-2019,and the peak age of inpatients was delayed from 60-64 years old to 65-79 years old.From 2015 to 2019,drug costs had the greatest influence on total inpatient costs,and the grey correlation degree was 0.922.The influence degree of other single costs on total inpatient costs was ranked as other fees,treatment fees,examination fees,laboratory fees,operation fees,bed fees,nursing fees and examination fees.The overall structural variation degree of hospitalization costs for each cost pair was 39.10%,and the structural variation degree was larger during 2016-2017(DSV: 16.03%)and 2017-2018(DSV: 15.86%).During the five-year period,the expenses of medical products(-18.65 percent),examinations(5.37 percent),and treatment(5.03 percent)changed greatly.In the past five years,the highest contribution rate to the change of the overall structure of hospitalization costs was drug costs(47.70%),examination costs(13.74%),treatment costs(12.86%),and the cumulative contribution rate was 74.3%.3.Investigation and analysis of risk factors of lung cancer in residents aged 45 years and above in Shanxi Province:The proportion of people at high risk of lung cancer was 22.83%(122 people)according to the "rating table" and 34.58%(162 people)according to the "Guidelines".The main risk factors for lung cancer were passive smoking in women(62.06%),lampblack exposure(48.41%),active smoking in men(43.87%),chronic lung disease(21.68%),and exposure to occupational harmful substances(11.59%).Conclusion:The overall incidence and mortality of lung cancer in Shanxi Province were lower than the national level.Compared with the female population,the incidence and death of lung cancer in the male population was more severe.Compared with rural population,the incidence and death of lung cancer in urban population is more severe.The control effect of drug cost was significant,but there was no obvious downward trend in hospitalization cost.In Shanxi Province,the proportion of residents aged 45 and above at high risk of lung cancer ranges from 23% to 35%.The main risk factors include female passive smoking,oil smoke exposure,male active smoking,chronic lung diseases and exposure to occupational harmful substances.