1992一2021年中美两国结直肠癌死亡趋势的年龄-时期-队列模型及分解分析

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AbstractObjective：Tocomparethelong-termtrendsincolorectalcancer（CRC）mortalityratesinChinaandtheUnited States（U.S.） from1992to2O21andtoprovidescientificevidenceforCRCpreventionandcontrolinChina.Methods：Basedondatafromthe GBD2021database，CRCmortalityburdendataforChinaandtheU.Sfrom1992to202lwereextracted.TheAge-Period-Cohort（APC） modelwasusedtoaluatetedependenteetsofagerd，andohort，hiledcompositionalysisuantifdteontiosf aging，populatiogrowthndeidemilgicalchangstoCRCmortalityResutsFro992toOolorectalanerdathsicasd inbothChinaandtheUnited States.However，theage-standardized mortalityrate（ASMR）declinedinbothcountries，withmales consistentlyearingaighermortlityburdenthanfemales.Acordingtoteage-periodohort（PC）model，colorectalcancerrtality rosesharplywithageinbothcountries，particularlyamong individualsaged5Oyearsandolder.InChina，theoverallmortalityrate increasedfrom0.53per1000to236.50per1000，whileintheUnitedStatesitrosefrom0.11per0000to71.02per000. Theperiodefectdemonstratedadowwardtrendinbothcountries，withtheperiodrateratiodecreasingfrom1.10toO.91inChinaand from1.07toO.85intheUnitedStates.Thecohortefectalsoshowedacontinuousdecline，ithChina'scohortateatiodecreasingfrom 1.34to0.46andtheU.S.decliingfrom2.54toO.74.AlthoughtheU.S.exhitedhighercohortrisks，itseductionwasmoreproonced. Decompositionanalysisfurtherindicatedthat theriseincolorectalcancerdeaths inChinawasprimailydrivenbypopulationagingand populationgrowthhereasthemortalityhangesinteUnitedStateserepredominantlyatributabletoimprovementsindeiological factors.Conclusions：Froml992to2O21，theASMRforCRCdeclinedinbothChinaandtheU.S.owever，CRCmortalitychanges in Chinawereprimarilydrivenbyagingandpopulationgrowth，highlightingtheneedforenhancedscreeingandinterventionforolder males.EpidemiologicalimprovementshadmorepronouncedefectintheU.S.，emphasizingtheneedforChinatostrengthenCRC preventionand screening eforts fortheaging population and furtherto improve the impactofepidemiological changes.

Keywords colorectal cancer;mortality rate;age;aging;epidemiolog：

结直肠癌（colorectalcancer，CRC）是全球最常见的恶性肿瘤之一，近年来其发病率和死亡率持续升高，给公共卫生带来沉重负担[，根据全球癌症统计报告，2020年有近190万例结直肠癌新发病例和93.5万例死亡病例，约占癌症病例和死亡病例的 1/10[2] 。（剩余11458字）