To explore the mortality and probability of premature mortality caused by four major NCDs (cardiovascular and cerebrovascular diseases, cancer, diabetes and chronic respiratory disease) in Pudong New Area of Shanghai from 2002 to 2020, providing a reference for the development of measures to the target of reducing the probability of premature mortality due to these four major NCDs in the Health China 2030 plan.

This analysis was conducted in May 2021 based on data collected from Pudong New Area's Residents Death Surveillance Database, involving registered residents of Pudong New Area who died of cardiovascular and cerebrovascular diseases, cancer, diabetes and chronic respiratory disease between 2002-01-01 and 2020-12-31. Crude mortality, age-standardized mortality and probability of premature mortality were used for analyzing deaths due to the four above-mentioned NCDs. The annual percent change (APC) was adopted to analyze the temporal trend of mortality and probability of premature mortality.

The crude mortality of four major NCDs ascended from 526.82/100 000 in 2002 to 678.84/100 000 in 2020 (APC=1.56%, Z=13.715, P<0.001) . The age-standardized mortality of four major NCDs decreased from 404.05/100 000 in 2002 to 260.87/100 000 in 2020 (APC=-2.09%, Z=-12.428, P<0.001) . The probability of premature mortality caused by four major NCDs decreased from 13.09% in 2002 to 8.45% in 2020 (APC=-2.31%, Z=-15.847, P<0.001) . The probability of premature mortality caused by cardiovascular and cerebrovascular diseases was declined from 3.57% in 2002 to 2.38% in 2020 (APC=-2.21%, Z=-9.739, P<0.001) , and that caused by cancer decreased from 8.36% to 5.49% (APC=-2.24%, Z=-19.476, P<0.001) , and that by chronic respiratory disease reduced from 1.08% to 0.24% (APC=-7.23%, Z=-13.326, P<0.001) . No significant temporal trend for the probability of premature mortality caused by diabetes was found (Z=-0.395, P=0.698) . The probability of premature mortality caused by four major NCDs in males was higher than that in females. According to the annual increase rates during 2015 to 2020, it is estimated that the probability of premature mortality caused by these four major NCDs would be 6.67%.

The crude mortality of the four major NCDs in Pudong New Area ascended during 2002—2020, and both the age-standardized mortality and the probability of premature mortality showed a downward tendency in the same period. Pudong New Area had achieved the goal in the Health China 2020 plan of reducing the probability of premature mortality of four NCDs in 2020. However, according to the present annual increase rates, the task of achieving the Health China 2030 target of the decent of the probability of premature mortality caused by four major NCDs would be daunting. Thus, more measures should be taken to strengthen the containment of such NCDs. Moreover, males should be treated as the key group, and more attention should be paid to the premature death caused by diabetes in males.

了解2002—2020年上海市浦东新区居民4类主要慢性病死亡率与早死概率情况，为制定进一步的干预措施实现"健康中国2030"下降目标提供参考。

2021年5月，将浦东新区户籍居民作为研究对象，从浦东新区户籍居民死因数据库中筛选死亡日期在2002-01-01至2020-12-31因4类主要慢性病（包括心脑血管疾病、恶性肿瘤、糖尿病及慢性呼吸系统疾病）死亡的数据进行分析。采用粗死亡率、标化死亡率与早死概率分析上海市浦东新区居民4类主要慢性病死亡情况。利用年均变化百分比（APC）分析死亡率与早死概率的变化趋势。

2002—2020年上海市浦东新区居民4类主要慢性病粗死亡率由526.82/10万上升至678.84/10万（APC=1.56%，Z=13.715，P<0.001），标化死亡率由404.05/10万下降至260.87/10万（APC=-2.09%，Z=-12.428，P<0.001），4类主要慢性病早死概率由13.09%下降至8.45%（APC=-2.31%，Z=-15.847，P<0.001）。2002—2020年上海市浦东新区居民心脑血管疾病、恶性肿瘤及慢性呼吸系疾病早死概率分别由3.57%、8.36%、1.08%下降至2.38%、5.49%、0.24%（APC_{心脑血管疾病}=-2.21%，Z=-9.739，P<0.001；APC_恶性肿瘤=-2.24%，Z=-19.476，P<0.001；APC_{慢性呼吸系统疾病}=-7.23%，Z=-13.326，P<0.001）。糖尿病早死概率保持稳定（Z=-0.395，P=0.698）。2002—2020年上海市浦东新区男性居民4类主要慢性病早死概率均大于女性。根据2015—2020年上海市浦东新区居民4类主要慢性病年均增长率，2030年浦东新区居民4类主要慢性病早死概率为6.67%。

2002—2020年上海市浦东新区居民4类主要慢性病粗死亡率逐年上升，标化死亡率与早死概率呈下降趋势。浦东新区已实现4类主要慢性病早死概率2020年的下降目标，按照现有年均增长率，预计2030年浦东新区居民4类主要慢性病早死概率与"健康中国2030"目标尚有差距，应进一步强化针对慢性病的防控工作。男性人群应作为重点关注人群，男性人群糖尿病过早死亡尤其值得关注。