摘要
目的 描述分析1990-2019年中国早发食管癌疾病负担及变化趋势,并与全球水平进行对比分析.方法 采用2019年全球疾病负担(GBD 2019)研究数据,基于GBD世界标准人口的年龄结构,对1990-2019年中国早发食管癌(20～49岁)的发病率、死亡率、患病率和伤残调整生命年(DALY)率进行年龄标准化计算,按年份、性别描述年龄标化率分布情况,并与全球水平进行对比分析.使用标化死亡率与标化发病率计算[1-死亡发病比(MIR)],作为5年相对生存率替代指标.计算1990-2019年中国与全球早发食管癌新发与死亡病例数分别占全部食管癌新发与死亡病例数的比例,按年份与性别描述早发食管癌占比情况.采用Joinpoint回归模型分别计算1990-2019年中国与全球的早发食管癌标化发病率、标化死亡率、标化患病率、标化DALY率的平均年度变化百分比(AAPC).结果1990-2019年,中国早发食管癌的标化发病率、标化死亡率、标化患病率和标化DALY率均高于全球整体水平.2019年中国早发食管癌的标化发病率、标化死亡率、标化患病率和标化DALY率分别为1.96/10万、1.46/10万、5.31/10万和66.95/10万,对应的全球整体水平分别为1.19/10万、0.96/10万、2.81/10万和44.23/10万.2019年中国与全球的男性早发食管癌标化率均高于对应的女性标化率,其中中国女性早发食管癌的标化死亡率与标化DALY率低于全球水平(分别为0.31/10万vs0.47/10万与14.80/10万vs22.34/10万),其余中国早发食管癌的男性、女性各项标化率均高于全球水平.中国早发食管癌的(1-MIR)从1990年的0.10上升至2019年的0.26,全球水平从0.12上升至0.19.1990-2019年中国早发食管癌占比低于全球水平,2019年中国早发食管癌的新发与死亡病例占比分别为5.59％与4.50％,对应的全球水平分别为7.64％和6.62％.1990-2019年,中国早发食管癌的标化发病率、标化死亡率、标化患病率和标化DALY率均呈下降趋势,且下降幅度大于全球水平,APCC分别为-2.03％、-2.77％、-0.88％和-2.74％,对应的全球水平分别为-1.31％、-1.63％、-0.68％和-1.61％.结论 中国早发食管癌的疾病负担整体呈下降趋势,但仍高于全球整体水平,相关肿瘤综合防控工作仍需给予重视.
Abstract
Objective To describe and investigate the temporal trend of early-onset esophageal cancer burden in China from 1990 to 2019,and compare it with the global burden.Methods The 2019 Global Burden of Disease(GBD 2019)study da-ta were used to analyze the incidence,mortality,prevalence and disability adjusted life years(DALY)rate of early-onset esophageal cancer(20-49 years)in China from 1990 to 2019 based on age structure of GBD world standard population,and age-standardized rates were calculated by year and sex and were compared with the global rates.Age-standardized mortality and incidence were used for calculation[1-mortality-to-incidence ratio(MIR)],which was a proxy of 5-year relative survival rate.The proportions of new cases and deaths of early-onset esophageal cancer from 1990 to 2019 to those in total were calculated and stratified by year and sex.The Joinpoint regression model was used to calculate average annual percentage change(AAPC)of the four indexes mentioned above from 1990 to 2019.Results From 1990 to 2019,the age-standardized incidence,mortality,prevalence and DALY rates of early-onset esophageal cancer in China were higher than the global overall level.In 2019,the age-standardized incidence,mortality,prevalence and DALY rates of early-onset e-sophageal cancer in China were 1.96 per 100 000,1.46 per 100 000,5.31 per 100 000 and 66.95 per 100 000,respective-ly,the corresponding global indexes were 1.19 per 100 000,0.96 per 100 000,2.81 per 100 000 and 44.23 per 100 000,respectively.In 2019,the standardized rates of early onset esophageal cancer in males in China and globally were higher than those counterparts in females.Except for the standardized mortality rate and standardized DALY rate of early onset esophageal cancer in Chinese women were lower than the global level(0.31 per 100 000 vs 0.47 per 100 000 and 14.80 per 100 000 vs 22.34 per 100 000,respectively),the standardized rates of early onset esophageal cancer in both males and fe-males in China were higher than global levels.[1-MIR]of early-onset esophageal cancer in China increased from 0.10 to 0.26,and the global[1-MIR]increased from 0.12 to 0.19.From 1990 to 2019,the proportions of early onset esopha-geal cancer in China were lower than the global levels.In 2019,the proportions of new cases and deaths in China were 5.59％and 4.50％,respectively,and the corresponding global levels were 7.64％and 6.62％.From 1990 to 2019,the age-standardized incidence,mortality,prevalence and DALY rates of early-onset esophageal cancer in China showed a sta-tistically significant decline trend,the magnitude of trend was greater than the global with APCC being-2.03％,-2.77％,-0.88％and-2.74％,respectively,and the corresponding global indexes were-1.31％,-1.63％,-0.68％and-1.61％,respectively.Conclusions The disease burden of early-onset esophageal cancer in China showed a decline trend but was still higher than the global overall level.More attention should be paid for the comprehensive pre-vention and control of early-onset esophageal cancer.
NETL
NSTL
万方数据