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1990-2021年全球及中国食管癌疾病负担趋势分析及2022-2050年预测:基于GBD 2021数据

Analysis of the Global and Chinese Esophageal Cancer Burden Trends from 1990 to 2021 and Projections from 2022 to 2050: Based on GBD 2021 Data

  • 摘要: 背景:食管癌是全球常见癌症之一,给各国均造成了巨大的疾病负担,是全球尤其是发展中国家面临的一个重要的公共卫生问题。目的:分析1990-2021年中国食管癌疾病负担趋势,进一步预测2022-2040年食管癌疾病负担情况,为食管癌的预防提供科学的依据。方法:利用2021年全球疾病负担数据,采用年估计变化百分比(EAPC)对1990-2021年中国食管癌的标化发病率、标化死亡率及标化伤残调整寿命年(DALYs) 率的时间趋势进行分析。基于贝叶斯年龄-时期-队列模型(BAPC),对2022-2040年中国食道癌疾病负担进行预测。结果:中国食管癌标化发病率由1990年的17.637/10万增至2021年的22.548/10万(EAPC=0.55,95%CI=0.38~0.71);标化死亡率由1990年的17.920/10万增至2021年的20.836/10万(EAPC=0.21,95%CI=0.02~0.39); 标化DALYs率由1990年的497.437/10万降至2021年的484.884/10万(EAPC=-0.39,95%CI=-0.59~-0.2)。45岁及以上人群食管癌发病数占总病例数的比例从1990年的93.32%升至2021年的97.56%,死亡数占总死亡数的比例从1990年的90.44%升至2021年的98.22%;40岁及以上人群食管癌DALYs数占总DALYs数的比例从1990年的95.29%升至2021年的98.29%。20岁及以上年龄段食管癌发病率均呈下降趋势其中,35~39岁年龄组(EAPC=-3.74,95%CI=-4.22~-3.25)下降幅度最大;70岁以上年龄组食管癌死亡率和DALYs率在20岁以上人群中下降幅度最小。预测2050年,中国食管癌标化患病率、发病率、标化死亡率以及标化 DALYs 率将分别降至 25.1/10万,6.4/10万,14.2/10万和12.0/10万。结论:1990—2021年,中国食管癌标化发病率、标化死亡率均呈上升趋势,而标化DALYs率则呈缓慢下降趋势。预测至2050年,中国食管癌的患病、发病、死亡及DALYs负担将呈下降态势。

     

    Abstract: Background: Esophageal cancer is one of the common cancers worldwide, imposing a substantial disease burden on all countries. It constitutes a critical public health issue globally, particularly in developing nations.Objective: This study aims to analyze the trends of esophageal cancer burden in China from 1990 to 2021, further project the burden from 2022 to 2040, and provide scientific evidence for the prevention of esophageal cancer.Methods: Data from the 2021 Global Burden of Disease (GBD) study were utilized. The Annual Percentage Change (EAPC) was employed to analyze the temporal trends of age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (DALYs) rate of esophageal cancer in China from 1990 to 2021. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was used to project the esophageal cancer burden in China from 2022 to 2040.Results: In China, the ASIR of esophageal cancer increased from 17.637 per 100, 000 in 1990 to 22.548 per 100, 000 in 2021 (EAPC = 0.55, 95% Confidence Interval CI = 0.38–0.71). The ASMR rose from 17.920 per 100, 000 in 1990 to 20.836 per 100, 000 in 2021 (EAPC = 0.21, 95% CI = 0.02–0.39). In contrast, the age-standardized DALYs rate decreased from 497.437 per 100, 000 in 1990 to 484.884 per 100, 000 in 2021 (EAPC = -0.39, 95% CI = -0.59 to -0.2).The proportion of esophageal cancer cases among individuals aged 45 years and above increased from 93.32% in 1990 to 97.56% in 2021, while the proportion of deaths in this age group rose from 90.44% in 1990 to 98.22% in 2021. For individuals aged 40 years and above, the proportion of DALYs attributed to esophageal cancer increased from 95.29% in 1990 to 98.29% in 2021.Among people aged 20 years and above, the incidence rate of esophageal cancer showed a downward trend in all age groups. Specifically, the 35–39 years age group exhibited the most significant decline (EAPC = -3.74, 95% CI = -4.22 to -3.25). On the other hand, the 70+ years age group had the smallest decrease in ASMR and age-standardized DALYs rate among those aged 20 years and above.Projections indicate that by 2050, the age-standardized prevalence rate, ASIR, ASMR, and age-standardized DALYs rate of esophageal cancer in China will decrease to 25.1 per 100, 000, 6.4 per 100, 000, 14.2 per 100, 000, and 12.0 per 100, 000, respectively.Conclusion: From 1990 to 2021, the ASIR and ASMR of esophageal cancer in China showed an upward trend, while the age-standardized DALYs rate exhibited a slow downward trend. Projections suggest that by 2050, the burden of esophageal cancer in China (in terms of prevalence, incidence, mortality, and DALYs) will present a downward trajectory.

     

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