摘要
目的系统评估1990—2021年我国食管癌与胃癌的疾病负担演变特征,分析不同性别间的发病差异。构建预测模型,对2022—2031年的疾病发展趋势进行科学预测,为优化相关疾病的防控措施提供数据支撑和决策依据。方法依托全球疾病负担(Global Burden of Disease,GBD)2021数据库,收集并整理1990—2021年中国食管癌与胃癌的流行病学数据,并利用Jointpoint(版本4.9.1.0)软件对其变化趋势进行分析,运用灰色系统理论中的GM(1,1)模型预测2022—2031年的疾病发展趋势。结果1990—2021年中国归因于烟草和饮酒的食管癌疾病负担上升,归因于烟草和饮食风险的胃癌疾病负担无显著变化。1990—2021年中国食管癌的死亡数和伤残调整生命年(disability-adjusted life years,DALY)数分别增加了40.61%和17.89%,胃癌死亡数上升了18.95%,DALY数下降了1.22%;食管癌年龄标准化死亡率和年龄标准化DALY率分别下降了45.78%和51.45%,胃癌年龄标准化死亡率和年龄标准化DALY率分别下降了53.29%和57.58%。1990—2021年,我国食管癌与胃癌的疾病负担均呈显著下降趋势。其中,胃癌的整体疾病负担水平持续高于食管癌。此外,1990—2021年,中国食管癌与胃癌的年龄标准化死亡率及DALY率持续高于全球平均水平。人口学分析显示,男性疾病负担显著高于女性。预测模型显示,2022—2031年中国食管癌和胃癌疾病负担均呈下降趋势,但下降速度趋缓。结论近30年来,中国食管癌和胃癌疾病负担有所减轻,胃癌疾病负担高于食管癌,男性疾病负担显著高于女性,中国食管癌和胃癌的疾病负担仍高于全球平均水平。针对男性和老年人口的重点防治是两种癌症未来10年防治工作的关键挑战。
Objective To assess the evolving disease burden of esophageal and gastric cancers in China from 1990 to 2021,with a focus on gender disparities,and construct a predictive model to forecast disease trends from 2022 to 2031,aiming to optimize targeted prevention strategies.Methods Epidemiological data for esophageal and gastric cancers in China(1990-2021)were extracted from the Global Burden of Disease(GBD)2021 database.Temporal trends were analyzed using Joinpoint regression(version 4.9.1.0),and future trends were predicted via the GM(1,1)model under grey system theory.Results From 1990 to 2021,tobacco-and alcohol-attributable burdens of esophageal cancer increased,while tobacco-and diet-related burdens of gastric cancer showed no significant change.Deaths and disabilityadjusted life years(DALY)for esophageal cancer rose by 40.61%and 17.89%,respectively;gastric cancer deaths increased by 18.95%,though DALY decreased by 1.22%.Both cancers exhibited significant declines in age-standardized mortality rates(−45.78%for esophageal cancer,−53.29%for gastric cancer)and age-standardized DALY rates(−51.45%for esophageal cancer,−57.58%for gastric cancer).China’s age-standardized mortality and DALY rates for both cancers remained consistently higher than global averages.Males exhibited disproportionately higher burdens than females.Predictive modeling projected continued but decelerating declines in disease burdens for both cancers by 2031.Conclusion Over three decades,China achieves measurable reductions in esophageal and gastric cancer burdens,though gastric cancer burdens remain higher than esophageal cancer.Persistent disparities relative to global levels,elevated male burdens,and aging demographics highlight the urgency for prioritized interventions targeting high-risk populations.
作者
李崇瑞
胡守财
李斌
林明治
惠一鸣
李海天
LI Chongrui;HU Shoucai;LI Bin;LIN Mingzhi;HUI Yiming;LI Haitian(Department of Thoracic Surgery,The Second Hospital&Clinical Medical School,Lanzhou University/Gansu Province Key Laboratory of Environmental Oncology/Cuiying Biomedical Research Center,The Second Hospital&Clinical Medical School,Lanzhou University,Lanzhou,730030,P.R.China;Department of Thoracic Surgery,The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army,Lanzhou,730030,P.R.China)
出处
《中国胸心血管外科临床杂志》
北大核心
2025年第10期1438-1446,共9页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家自然科学基金项目(82060428)
甘肃省自然科学基金项目(24JRRA335)
甘肃省卫生行业科研计划项目(GSWSQN2021-003)。
关键词
食管癌
胃癌
疾病负担
变化趋势
中国
性别差异
Esophageal cancer
gastric cancer
disease burden
trend of change
China
gender differences
