摘要
目的 分析1990-2021年中国继发于乙型肝炎病毒(HBV)感染的肝癌疾病负担变化趋势及其危险因素变化情况。方法 基于全球疾病负担(GBD)2021研究数据,分析1990-2021年中国继发于HBV感染的肝癌发病、死亡和伤残调整生命年(DALY)水平,采用平均年度变化百分比(AAPC)评估整体趋势,年度变化百分比(APC)分析阶段趋势。结果 2021年中国继发于HBV感染的肝癌发病人数、死亡人数和DALY数分别增长至11.87万例、10.02万例和314.86万人年,较1990年绝对数值上升。标化发病率、标化死亡率和标化DALY率整体均呈下降趋势,AAPC分别为-0.44%、-0.97%和-0.99%,均P<0.001。男性继发于HBV感染的肝癌疾病负担高于女性,2021年男性标化死亡率(8.48/10万)约为女性(1.40/10万)的6倍。1990-2021年中国全人群继发于HBV感染的肝癌标化发病率呈现波动趋势,标化死亡率和标化DALY率呈先上升后下降的变化趋势。1995-2000年标化发病率(APC=2.11%,P<0.001)、1994-2001年标化死亡率(APC=1.34%,P=0.001)和1990-2001年标化DALY率(APC=0.60%,P<0.001)均呈上升趋势;2001年后中国继发于HBV感染的肝癌各疾病负担指标开始下降,但2005-2017年标化发病率出现上升趋势(APC=0.43%,P<0.001),2012-2015年标化DALY率和2018-2021年标化死亡率变化均较为稳定,其余时期均呈下降趋势。1990和2021年吸烟都是继发于HBV感染肝癌的首位危险因素,2021年高身体质量指数跃升为第2位危险因素。结论 中国继发于HBV感染的肝癌疾病负担整体呈下降趋势,但发病人数、死亡人数和DALY数均有所增加,疾病负担仍然较重;应重点关注男性继发于HBV感染的肝癌防治,重视吸烟与高身体质量指数对继发于HBV感染肝癌的危害。
Objective To analyze trends in the disease burden of hepatitis B virus(HBV)infection-related liver cancer in China from 1990 to 2021 and changes in associated risk factors.Methods Using data from the Global Burden of Disease Study 2021(GBD 2021),we assessed the incidence,mortality,and disability-adjusted life years(DALYs)of HBV infection-related liver cancer in China from 1990 to 2021.Average annual percentage change(AAPC)was used to describe overall trends,and annual percentage change(APC)was applied to evaluate trends in specific periods.Results Compared with 1990,the number of incident cases,deaths,and DALYs for HBV infection-related liver cancer in China increased to 118700 cases,100200 cases and 3148600 person-years,respectively,by 2021.However,age-standardized incidence,mortality,and DALY rates exhibited overall declining trends,with AAPCs of-0.44%,-0.97%,and-0.99%,respectively(all P<0.001).Disease burden indicators forHBVinfection-related liver cancer were consistently higher in males than females.In 2021,the age-standardized mortality rate in males(8.48 per 100000)was six times higher than that in females(1.40 per 100000).Over the 32-year period,the age-standardized incidence rate of HBV infection-related liver cancer fluctuated,while age-standardized mortality and DALY rates initially rose and then declined.The standardized incidence rate rate in 1995-2000(APC=2.11%,P<0.001),the standardized mortality rate in1994-2001(APC=1.34%,P=0.001)and the standardized DALYrate in 1990-2001(APC=0.60%,P<0.001)all showed an upward trend.After 2001,the disease burden indicators of liver cancer secondary to HBV infection in China began to decline,but the standardized incidence rate in 2005-2017 showed an upward trend(APC=0.43%,P<0.001),the standardized DALY rate in 2012-2015and the standardized mortality rate in 2018-2021 were relatively stable,and the rest of the period showed a downward trend.Smoking remained the leading risk factor for HBV infection-related liver cancer in both 1990 and 2021.By 2021,high body mass index(BMI)emerged as the second-ranked risk factor.Conclusions Although the overall disease burden of HBV infection-related liver cancer in China has declined,the absolute number of cases,deaths,and DALYs continues to rise,indicating a persistent public health challenge.Future efforts should prioritize prevention and control of HBV infection-related liver cancer in males,while addressing the growing impact of smoking and high BMI.
作者
冯雪
付振涛
鹿子龙
姜帆
徐晓慧
楚洁
郭晓雷
FENG Xue;FU Zhentao;LU Zilong;JIANG Fan;XU Xiaohui;CHU Jie;GUO Xiaolei(School of Public Health,Shandong University,Jinan,Shandong 250012,China;Institute of Chronic Non-communicable Diseases,Shandong Center for Disease Control and Prevention,Jinan,Shandong 250014,China)
出处
《中华肿瘤防治杂志》
北大核心
2025年第11期653-659,共7页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省医药卫生科技发展计划(202012051127,202412051228)
山东省重点研发计划(2016GSF201231)
国家重点研发计划精准医学重点研究专项(2016YFC0901300)
泰山学者工程专项(ts201511105)
关键词
乙型肝炎病毒
肝癌
疾病负担
中国
hepatitis B virus(HBV)
liver cancer
disease burden
China
