摘要
目的:分析1990~2021年我国胰腺癌的疾病负担及变化趋势,并预测2022~2036年的胰腺癌发病率和死亡率趋势。方法:利用全球疾病负担2021年研究数据,评估1990~2021年我国胰腺癌的年龄标准化发病率(ASIR)、年龄标准化死亡率(ASMR)和伤残调整生命年率(ASDR)。伤残调整生命年(DALY)通过胰腺癌所致的生命损失年数和伤残损失寿命年相加得出。采用Joinpoint模型计算年均变化百分比(AAPC),应用年龄-时期-队列模型控制年龄、时期和出生队列的影响,并采用贝叶斯年龄-时期-队列模型预测2022~2036年的我国胰腺癌发病和死亡趋势。结果:与1990年相比,2021年我国胰腺癌ASIR、ASMR和年龄标准化DALY率数据均较前增长,且男性较女性增长明显。1990年和2021年发病与死亡高峰均集中于老年人群。各年龄段男性发病率、死亡率和变化均高于女性。年龄标准化DALY率变化主要体现于男性人群,1990年和2021年第一个年龄标准化DALY率高峰均出现于70~74岁,2021年年龄标准化DALY率的第二个高峰后移至85~89岁。女性年龄标准化DALY率高峰较男性靠前。1990~2021年我国胰腺癌全性别ASIR和ASMR的AAPC分别为0.72(95%CI:0.50~0.94,P<0.001)和0.56(95%CI:0.31~0.82,P<0.001),差异具有统计学意义。我国男性胰腺癌ASIR(AAPC=0.89,95%CI:0.68~1.10,P<0.001)和ASMR(AAPC=0.71,95%CI:0.49~0.93,P<0.001)较女性ASIR(AAPC=0.48,95%CI:0.22~0.73,P<0.001)和ASMR(AAPC=0.33,95%CI:0.08~0.58,P=0.010)增长快,差异具有统计学意义。全性别ASDR呈上升趋势(AAPC=0.36,95%CI:0.18~0.54,P<0.001),差异具有统计学意义。全性别别发病率和别死亡率均呈上升趋势。当人群年龄>60岁时,别发病率和别死亡率随出生队列的推迟呈现上升趋势。预期从2022年至2036年,男性和女性的ASIR和ASMR逐年增长并最终增长1倍。结论:1990~2021年我国胰腺癌负担整体呈增长趋势,并预计未来疾病负担将进一步加重。
Objective To analyze the disease burden and changing trend of pancreatic cancer in our country from 1990 to 2021,and predict the incidence and mortality trends of pancreatic cancer from 2022 to 2036.MethodsUtilizing the data from the Global Burden of Disease 2021 Study,the age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and disability-adjusted life rate(DALY)of pancreatic cancer in our country from 1990 to 2021 were evaluated.DALY is calculated by adding the number of years of life lost due to pancreatic cancer to the years of life lost due to disability.The Joinpoint model was used to calculate the average annual percentage change(AAPC),the age-period-cohort model was applied to control the influence of age,period and birth cohort,and the Bayesian age-period-cohort model was used to predict the incidence and mortality trends of pancreatic cancer in our country from 2022 to 2036.ResultsCompared with 1990,the data of ASIR,ASMR and age-standardized disability-adjusted life years(DALY)rates of pancreatic cancer in our country in 2021 all increased,and the increase in men was more significant than that in women.The peaks of morbidity and mortality in 1990 and 2021 were both occurred in the elderly.The incidence rate,mortality rate and changes of men in all age groups were higher than those of women.The changes in the age-standardized DALY rate were mainly reflected in the male population.The first peaks of the age-standardized DALY rate in 1990 and 2021 both occurred at the age of 70-74,and the second peak of the age-standardized DALY rate in 2021 shifted to the age of 85-89.The peak rate of age-standardized DALY in females is earlier than that in males.The AAPC of ASIR and ASMR for all genders of pancreatic cancer in our country from 1990 to 2021 was 0.72(95%CI:0.50-0.94,P<0.001)and 0.56(95%CI:0.31-0.82,P<0.001),respectively,and the difference was statistically significant.In our country men with pancreatic cancer,ASIR(AAPC=0.89,95%CI:0.68-1.10,P<0.001)and ASMR(AAPC=0.71,95%CI:0.49-0.93,P<0.001)were compared with ASIR(AAPC=0.48,95%CI:)in women.(0.22-0.73,P<0.001)and ASMR(AAPC=0.33,95%CI:0.08-0.58,P=0.010)increased rapidly,and the difference was statistically significant.The ASDR of all genders showed an upward trend(AAPC=0.36,95%CI:0.18-0.54,P<0.001),and the difference was statistically significant.The incidence rate and mortality rate of all genders are on the rise.When the age of the population is over 60 years old,the incidence and mortality of specific diseases show an upward trend with the delay of the birth cohort.It is expected that from 2022 to 2036,the ASIR and ASMR of both men and women will increase annuallyand eventually double.ConclusionFrom 1990 to 2021,the burden of pancreatic cancer in our country has generally shown an increasing trend,and it is expected that the disease burden will further increase in the future.
作者
李童
刘美兰
王晴
孙天罕
曹健夫
韦军民
崔红元
Li Tong;Liu Meilan;Wang Qing;Sun Tianhan;Cao Jianfu;Wei Junmin;Cui Hongyuan(Department of General Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)
出处
《中华肝胆外科杂志》
北大核心
2025年第9期671-677,共7页
Chinese Journal of Hepatobiliary Surgery
基金
中央高水平医院临床科研业务费(BJ-2025-129)。
关键词
胰腺肿瘤
发病率
死亡率
全球疾病负担
伤残调整生命年
Pancreatic neoplasms
Incidence
Mortality
Global burden of disease
Disability adjusted life years
