摘要
目的探讨1990—2021年中国人群5种常见消化系统恶性肿瘤(食管癌、胃癌、结直肠癌、胰腺癌、肝癌)疾病负担变化趋势。方法采用描述性流行病学方法。收集全球疾病负担数据库1990—2021年中国人群5种常见消化系统恶性肿瘤的新发病例数、粗发病率、年龄标化发病率、死亡例数、粗死亡率、年龄标化死亡率。根据全球疾病负担数据库2021年全世界标准化人口结构计算年龄标化率。观察指标:(1)1990—2021年中国人群5种常见消化系统恶性肿瘤发病情况。(2)1990—2021年中国人群5种常见消化系统恶性肿瘤死亡情况。(3)1990—2021年中国人群5种常见消化系统恶性肿瘤年龄标化发病率变化趋势。(4)1990—2021年中国人群5种常见消化系统恶性肿瘤年龄标化死亡率变化趋势。构建Joinpoint回归模型进行趋势分析,计算不同时期各癌种年龄标化发病率和年龄标化死亡率的年变化率、年平均变化率(AAPC)及其95%可信区间(CI)。结果(1)1990—2021年中国人群5种常见消化系统恶性肿瘤发病情况。中国人群食管癌、胃癌、结直肠癌、胰腺癌、肝癌的新发病例数从1990年的207495、407471、158389、37818、96434例变化为2021年的320805、611799、658321、118665、196637例。上述各癌种的粗发病率从1990年的17.64/10万、34.64/10万、13.46/10万、3.21/10万、8.20/10万变化为2021年的22.55/10万、43.00/10万、46.27/10万、8.34/10万、13.82/10万。食管癌、胃癌、结直肠癌、胰腺癌、肝癌新发病例数均呈现增加趋势,绝对数变化率分别为54.61%、50.15%、315.64%、213.78%、103.91%。(2)1990—2021年中国人群5种常见消化系统恶性肿瘤死亡情况。中国人群食管癌、胃癌、结直肠癌、胰腺癌、肝癌的死亡例数从1990年的210821、374066、119303、38883、94937例变化为2021年的296443、445013、275129、119602、172068例。上述各癌种的粗死亡率从1990年的17.92/10万、31.80/10万、10.14/10万、3.31/10万、8.07/10万变化为2021年的20.84/10万、31.28/10万、19.34/10万、8.41/10万、12.09/10万。食管癌、胃癌、结直肠癌、胰腺癌、肝癌死亡例数均呈现增加趋势,绝对数变化率分别为40.61%、18.97%、130.61%、207.59%、81.24%。(3)1990—2021年中国人群5种常见消化系统恶性肿瘤年龄标化发病率变化趋势。中国人群食管癌、胃癌、结直肠癌、胰腺癌、肝癌年龄标化发病率变化趋势分别分为5、5、4、5、5个时期。上述各癌种的年龄标化发病率的AAPC分别为-1.60%(95%CI为-1.78%~-1.42%)、-1.60%(95%CI为-1.78%~-1.43%)、1.66%(95%CI为1.39%~1.94%)、0.72%(95%CI为0.36%~1.08%)、-0.31%(95%CI为-0.39%~-0.23%)。(4)1990—2021年中国人群5种常见消化系统恶性肿瘤年龄标化死亡率变化趋势。中国人群食管癌、胃癌、结直肠癌、胰腺癌、肝癌年龄标化死亡率变化趋势分别分为5、5、4、5、4个时期。上述各癌种的年龄标化死亡率的AAPC分别为-1.96%(95%CI为-2.03%~-1.90%)、-2.44%(95%CI为-2.50%~-2.38%)、-0.49%(95%CI为-0.58%~-0.41%)、0.56%(95%CI为0.48%~0.63%)、-0.68%(95%CI为-0.89%~-0.52%)。结论1990—2021年中国人群食管癌、胃癌、肝癌疾病负担均呈下降趋势;结直肠癌年龄标化发病率呈上升趋势,年龄标化死亡率呈下降趋势;胰腺癌疾病负担呈上升趋势。
Objective To investigate the change trend in the burden of 5 common malignant tumors of digestive system(esophageal cancer,gastric cancer,colorectal cancer,pancreatic cancer and liver cancer)in the Chinese population from 1990 to 2021.Methods The descriptive epidemiologic method was conducted.The number of new cases,crude incidence rate,age‐standardized incidence rate,the number of deaths,crude mortality rate and age‐standardized mortality rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021 of the Global Burden of Disease were collected.The age-standardized rate was calculated based on the standardized demographics of the whole world in the Global Burden of Disease for the year 2021.Observation indicators:(1)The incidence of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021;(2)the mortality of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021;(3)the change trend of age‐standardized incidence rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021;(4)the change trend of age-standardized mortality rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021.The Joinpoint regression model was constructed for trend analysis,specifically to calculate the annual percentage change,average annual percentage change(AAPC),and their 95%confidence interval(CI)for age‐standardized incidence and mortality rates for each cancer type at different time periods.Results(1)The incidence of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021.The number of new cases of esophageal cancer,gastric cancer,colorectal cancer,pancreatic cancer and liver cancer in the Chinese population changed from 207495,407471,158389,37818 and 96434 in 1990 to 320805,611799,658321,118665 and 196637 in 2021.The crude incidence rates of the above cancer types changed from 17.64/100000,34.64/100000,13.46/100000,3.21/100000,8.20/100000 in 1990 to 22.55/100000,43.00/100000,46.27/100000,8.34/100000,13.82/100000 in 2021.The new cases of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,and liver cancer all showed an increasing trend,with absolute changes of 54.61%,50.15%,315.64%,213.78%,and 103.91%,respectively.(2)The mortality of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021.The number of deaths of esophageal cancer,gastric cancer,colorectal cancer,pancreatic cancer and liver cancer in the Chinese population changed from 210821,374066,119303,38883 and 94937 in 1990 to 296443,445013,275129,119602 and 172068 in 2021.The crude death rates of the above cancer types changed from 17.92/100000,31.80/100000,10.14/100000,3.31/100000,8.07/100000 in 1990 to 20.84/100000,31.28/100000,19.34/100000,8.41/100000,12.09/100000 in 2021.Death cases of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,and liver cancer all showed an increasing trend,with absolute changes of 40.61%,18.97%,130.61%,207.59%,and 81.24%,respectively.(3)The change trend of age‐standardized incidence rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021.The change trends of age‐standardized incidence rates of esophageal cancer,gastric cancer,colorectal cancer,pancreatic cancer,and liver cancer in the Chinese population were divided into 5,5,4,5,and 5 periods,respectively,and the AAPCs of agestandardized incidence rates of the above cancer types were−1.60%(95%CI as−1.78%to−1.42%),−1.60%(95%CI as−1.78%to−1.43%),1.66%(95%CI as 1.39%to 1.94%),0.72%(95%CI as 0.36%to 1.08%),and−0.31%(95%CI as−0.39%to−0.23%).(4)The change trend of age‐standardized mortality rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021.The change trend of age‐standardized mortality rates of esophageal cancer,gastric cancer,colorectal cancer,pancreatic cancer,and liver cancer in the Chinese population were divided into 5,5,4,5,and 4 periods,respectively,and the AAPC of age‐standardized mortality rates for each of the above mentioned cancer types were−1.96%(95%CI as−2.03%to−1.90%),−2.44%(95%CI as−2.50%to−2.38%),−0.49%(95%CI as−0.58%to−0.41%),0.56%(95%CI as 0.48%to 0.63%),and−0.68%(95%CI as−0.89%to−0.52%).Conclusions From 1990 to 2021,the disease burden of esophageal cancer,gastric cancer and liver cancer in the Chinese population show a downward trend.The standardized incidence of colorectal cancer shows an upward trend,and the standardized mortality rate shows a downward trend.The disease burden of pancreatic cancer shows an upward trend.
作者
王嘉琛
何思怡
曹梦迪
滕熠
李倩茹
谭诺培
吴宇洁
左婷婷
李天一
郑渊杰
陈万青
Wang Jiachen;He Siyi;Cao Mengdi;Teng Yi;Li Qianru;Tan Nuopei;Wu Yujie;Zuo Tingting;Li Tianyi;Zheng Yuanjie;Chen Wanqing(National Cancer Center,National Cancer Clinical Medical Research Center,Cancer Hospital of Peking Union Medical College,Chinese Academy of Medical Sciences,Office of Early Detection and Treatment of Cancer,Beijing 100021,China)
出处
《中华消化外科杂志》
北大核心
2025年第2期213-222,共10页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金(82273721)
首都卫生发展科研专项项目(2024‑1G‑4023)。
关键词
食管肿瘤
胃肿瘤
结直肠肿瘤
胰腺肿瘤
肝肿瘤
疾病负担
发病
死亡
变化趋势
Esophageal neoplasms
Stomach neoplasms
Colorectal neoplasms
Pancreatic neoplasms
Liver neoplasms
Disease burden
Incidence
Death
Change trend
