1990—2021年中国食管癌疾病负担趋势分析及2022—2050年数据预测

范雅捷; 姚亚轩; 孙士玲; 关徐涛; 蒋立峰

doi:10.3971/j.issn.1000-8578.2026.26.0035

1990—2021年中国食管癌疾病负担趋势分析及2022—2050年数据预测

Trends Analysis of Esophageal Cancer Burden in China from 1990 to 2021 and Projections from 2022 to 2050

摘要

摘要:
目的分析1990—2021年中国食管癌疾病负担趋势，并预测2022—2050年数据。
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），结合敏感性分析与模型校正，对2022—2050年中国食管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17.637/10⁵增至2021年的22.548/10⁵（EAPC=0.55，95%CI: 0.38~0.71）；标化死亡率由1990年的17.920/10⁵增至2021年的20.836/10⁵（EAPC=0.21，95%CI: 0.02~0.39）；标化DALYs率由1990年的497.437/10⁵降至2021年的484.884/10⁵（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、标化发病率、标化死亡率以及标化DALYs率将分别降至 25.1/10⁵，6.4/10⁵，14.2/10⁵和12.0/10⁵。
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。20岁及以上各年龄段食管癌发病率虽均呈下降态势，但受人口老龄化等因素影响，总体标化率呈上升特征。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，45 岁及以上人群为食管癌疾病负担的核心人群，需作为防控重点。

Abstract:
Objective To analyze esophageal cancer burden trends in China from 1990 to 2021, further project the burden from 2022 to 2050.
Methods The time trends of standardized incidence, standardized mortality, and standardized disability-adjusted life years (DALYs) rate of esophageal cancer in China from 1990 to 2021 using data from the Global Burden of Disease 2021 were analyzed using the estimated annual percentage change (EAPC). The disease burden of esophageal cancer in China from 2022 to 2050 was predicted using the Bayesian age–period–cohort model combined with sensitivity analysis and model calibration.
Results In China, the ASIR of esophageal cancer increased from 17.637 per 10⁵ in 1990 to 22.548 per 10⁵ in 2021 (EAPC=0.55, 95%CI: 0.38–0.71). The ASMR rose from 17.920 per 10⁵ in 1990 to 20.836 per 10⁵ in 2021 (EAPC=0.21, 95%CI: 0.02–0.39). The age-standardized DALYs decreased from 497.437 per 10⁵ in 1990 to 484.884 per 10⁵ in 2021 (EAPC=−0.39, 95%CI: from −0.59 to −0.2). Among individuals aged 45 years and above, the proportion of esophageal cancer cases increased from 93.32% in 1990 to 97.56% in 2021, and 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. In particular, the 35–39 year age group exhibited the most significant decline (EAPC=−3.74, 95%CI: from −4.22 to −3.25). Among individuals aged 20 years and above, the 70+ year age group had the smallest decrease in ASMR and age-standardized DALYs. By 2050, the standardized prevalence, standardized incidence, standardized mortality, and standardized DALY rate of esophageal cancer in China were predicted to decrease to 25.1/10⁵, 6.4/10⁵, 14.2/10⁵, and 12.0/10⁵, respectively.
Conclusion From 1990 to 2021, the ASIR and ASMR of esophageal cancer in China showed an upward trend, whereas the age-standardized DALY rate exhibited a slow downward trend. Although the incidence of esophageal cancer showed a downward trend across all the age groups from 20 years and above, the overall standardized rate exhibited an upward trend due to factors such as population aging. By 2050, the burden of esophageal cancer in China, including prevalence, incidence, mortality, and DALYs, will decline. The population aged 45 years and above is the core group affected by esophageal cancer and should be prioritized for prevention and control.

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