| 摘要: |
| 目的 分析1990-2021年我国食管癌疾病负担及变化趋势，并与日本、韩国进行对比。方法 基于2021年全球疾病负担数据库，分析1990-2021年我国食管癌的发病率、死亡率和伤残调整生命年（DALYs）及相应的年龄标化率，同时按不同年龄、性别进行描述性分析，并与日本、韩国进行对比。运用估计年度变化百分比和相对变化率评估食管癌疾病负担的变化趋势。纳入吸烟、饮酒、低蔬菜饮食、咀嚼烟草4个危险因素，分析食管癌DALYs和死亡负担归因于各危险因素的比例。运用因素分解方法分析人口增长、人口老龄化和流行病学变化对食管癌发病人数的贡献比例。利用年龄-时期-队列模型分析年龄、时期和出生队列对食管癌发病情况的效应趋势。使用Pearson相关分析评估年龄标化DALYs率与社会人口指数（SDI）的相关性。通过自回归移动平均模型预测未来20年中国的食管癌发病人数及年龄标化发病率（ASIR）。结果 2021年，中国食管癌发病人数、死亡人数和DALYs分别为32.08万、29.64万和689.87万，较1990年分别增加了54.61%、40.61%和17.88%。2021年，我国食管癌ASIR、年龄标化死亡率（ASMR）和年龄标化DALYs率分别为15.04/10万、14.13/10万和317.18/10万，高于日本（分别为6.22/10万、3.81/10万和84.34/10万）和韩国（分别为3.52/10万、2.29/10万和50.15/10万）；3个国家男性的食管癌疾病负担均高于女性。2021年，吸烟和饮酒是我国食管癌死亡的两大危险因素，发病人数的增长主要由人口增长及人口老龄化引起。此外，我国食管癌ASIR随年龄增长而上升，在85～89岁达到峰值。1990-2021年，中国、日本、韩国的SDI与食管癌年龄标化DALYs率呈负相关。预测到2041年，我国食管癌ASIR将持续降低至9.14/10万，但发病人数将增加至39.82万。结论 我国食管癌疾病负担沉重，未来应加强吸烟、饮酒等危险因素的防控，并促进重点人群的早筛、早诊、早治。 |
| 关键词: 食管肿瘤 疾病负担 中国 发病率 死亡率 危险因素 |
| DOI：10.16781/j.CN31-2187/R.20240617 |
| 投稿时间：2024-09-04修订日期：2024-10-14 |
| 基金项目:上海市科学技术委员会科技创新行动计划（21Y31900100）. |
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| Burden of esophageal cancer in China from 1990 to 2021: a comparative analysis with Japan and South Korea |
| FU Lin1△,WANG Tinglu2△,JIAO Yunfei2,WANG Luowei2* |
(1. Graduate School, Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou 014000, Inner Mongolia Autonomous Region, China;
2. Department of Gastroenterology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To analyze the burden and trends of esophageal cancer in China from 1990 to 2021, and compare them with Japan and South Korea. Methods Based on the global burden of disease 2021 database, the incidence, mortality, and disability-adjusted life years (DALYs) of esophageal cancer and the corresponding age-standardized rates in China from 1990 to 2021 were analyzed and descriptively studied according to different ages and genders, and compared with Japan and South Korea.The estimated annual percentage change and relative variation were used to evaluate the trend of the burden of esophageal cancer.Four risk factors, including smoking, alcohol consumption, low-vegetable diet, and chewing tobacco, were included and the proportions of esophageal cancer DALYs and death burden attributable to each risk factor were analyzed.Breakdown analysis method was used to analyze the contribution of population growth, population aging, and epidemiological changes to the incidence of esophageal cancer.The age-period-cohort model was used to analyze the effect trends of age, period, and birth cohort on the incidence of esophageal cancer.Pearson correlation analysis was used to evaluate the correlation between age-standardized DALYs rate and socio-demographic index (SDI).The number of incident cases and age-standardized incidence rate (ASIR) of esophageal cancer in China over the subsequent 20 years were predicted by autoregressive integrated moving average model. Results In 2021, the number of incident cases, number of deaths, and DALYs of esophageal cancer in China were 320 805, 296 443 and 6 898 666, respectively, with increases of 54.61%, 40.61%, and 17.88% over 1990.In 2021, the ASIR, age-standardized mortality (ASMR), and age-standardized DALYs rate of esophageal cancer in China were 15.04/100 000, 14.13/100 000, and 317.18/100 000, respectively, which were higher than those in Japan (6.22/100 000, 3.81/100 000, and 84.34/100 000, respectively) and South Korea (3.52/100 000, 2.29/100 000, and 50.15/100 000, respectively).The burden of esophageal cancer in males was higher than that in females in the 3 countries.In 2021, smoking and alcohol consumption were the 2 major risk factors for esophageal cancer death in China; the increase in the number of incident cases was mainly caused by population growth and population aging.In addition, the ASIR of esophageal cancer in China increased with age, peaking at 85-89 years old.From 1990 to 2021, SDI was negatively correlated with age-standardized DALYs rate of esophageal cancer in China, Japan, and South Korea.It was predicted that by 2041, the ASIR of esophageal cancer in China would continue to decrease to 9.14/100 000, but the number of incident cases would increase to 398 200. Conclusion The burden of esophageal cancer in China remains substantial.In the future, it will be crucial to strengthen the prevention and control of risk factors such as smoking and alcohol consumption.Additionally, efforts should be made to promote early screening, diagnosis, and treatment, particularly among high-risk populations. |
| Key words: esophageal neoplasms burden of disease China incidence mortality risk factors |
