摘要目的:分析2021年浙江省肿瘤登记地区劳动力人口恶性肿瘤的发病和死亡情况及2000—2021年趋势，预测2031年负担，为精准防控提供依据。方法:收集2000—2021年浙江省肿瘤登记地区15～64岁人群恶性肿瘤数据，分析不同性别、年龄组、城乡地区及主要癌种发病和死亡情况，中标率采用中国2000年标准人口构成标化，世标率采用Segi's世界人口构成标化。采用Joinpoint回归模型估计时间变化趋势并计算平均年度变化百分比（AAPC），使用自回归移动平均模型（ARIMA）预测2031年负担。结果:2021年，浙江省肿瘤登记地区劳动力人口新发恶性肿瘤60 152例，占全年龄组新发恶性肿瘤的51.6%；死亡10 285例，占全年龄组的25.4%。中标发病率为283.4/10万，中标死亡率为39.5/10万。城市地区发病率高于农村地区，死亡率低于农村地区。世标发病率男女比为0.64∶1，世标死亡率男女比为1.76∶1。发病率前3位的癌种是甲状腺癌、肺癌、女性乳腺癌，死亡率前3位的癌种是肺癌、肝癌和女性乳腺癌。2000—2021年，浙江省肿瘤登记地区劳动力人口恶性肿瘤发病率总体呈上升趋势（AAPC=3.61%， P＜0.001），尤其是2013年起快速上升；死亡率总体呈下降趋势（AAPC=-1.60%， P＜0.001）。男性甲状腺癌和前列腺癌上升趋势显著，AAPC分别为15.62%和15.30%；女性甲状腺癌增长最为突出，AAPC为15.59%（均 P＜0.05）。发病和死亡双增长的癌种，男性为前列腺癌和结直肠癌，女性为宫颈癌和淋巴瘤。ARIMA模型预测结果显示，到2031年，浙江省肿瘤登记地区劳动力人口恶性肿瘤世标发病率将升至438/10万，世标死亡率将降至39/10万。 结论:2000—2021年浙江省劳动力人口恶性肿瘤呈现发病率上升、死亡率下降的趋势，应继续推进肿瘤早诊早治、疫苗接种、体重管理、健康生活方式等工作。

abstractsObjective:To analyze the incidence and mortality of malignant tumors among the labor force in cancer registration areas of Zhejiang Province in 2021, as well as the trend from 2000 to 2021, and predict the burden in 2031, in order to provide reference for precise prevention and control.Methods:The data of malignant tumors among the population aged 15-64 in Zhejiang cancer registration areas from 2000 to 2021 were collected. The incidence and mortality rates by gender, age group, urban-rural region, and major cancer types were analyzed. The age-standardized incidence (mortality) rates were calculated using the 2000 China standard population composition and Segi's world population composition, respectively. The Joinpoint regression model was used to estimate the temporal trends and to calculate the average annual percentage change (AAPC), and the auto-regressive integrated moving average model (ARIMA) was applied to predict the burden in 2031.Results:In 2021, 60 152 new cases of malignant tumors were reported among the labor force in the cancer registration areas of Zhejiang Province, accounting for 51.6% of all newly diagnosed malignant tumors across all age groups, while 10 285 deaths were recorded, representing 25.4% of the total. The age-standardized incidence rates of China was 283.4/10 5, and the age-standardized mortality rates of China was 39.5/10 5. The incidence rate in urban areas was higher than that in rural areas, while the mortality rate was lower in urban areas. The male-to-female ratio of the age-standardized incidence rate of world was 0.64:1, and the ratio of the age-standardized mortality rate of world was 1.76∶1. The top three cancers by incidence rate were thyroid cancer, lung cancer and breast cancer in females, while the top three by mortality rate were lung cancer, liver cancer and breast cancer in females. From 2000 to 2021, the incidence rate of malignant tumors in this population showed a significant upward trend (AAPC=3.61%, P＜0.001), particularly accelerating after 2013; while the mortality rate exhibited a general downward trend (AAPC=-1.60%, P＜0.001). The upward trends were most pronounced for thyroid cancer and prostate cancer in males, with AAPCs of 15.62% and 15.30%, respectively, while thyroid cancer in females showed the most significant growth, with an AAPC of 15.59% (all P＜0.05). Cancers with concurrent increases in both incidence and mortality included prostate cancer and colorectal cancer in males, and cervical cancer and lymphoma in females. ARIMA model projections indicated that by 2031, the age-standardized incidence rate of world would rise to 438/10 5, while the mortality rate would decline to 39/10 5. Conclusions:From 2000 to 2021, malignant tumors among the labor force in cancer registration areas of Zhejiang Province exhibits an upward trend in incidence and a downward trend in mortality. Efforts should continue to advance early detection and treatment of tumors, vaccination, weight management, and healthy lifestyle practices.