摘要
目的汇总并分析中国人群食管癌疾病负担及危险因素的变化趋势。方法从全球癌症统计数据(GLOBOCAN)、全球疾病负担(GBD)、五大洲癌症发病率数据库(CI5)、《中国肿瘤登记年报》《中国死因监测数据集》和《中国卫生健康统计年鉴》6个数据源中摘录我国食管癌的发病率(数)、死亡率(数)和伤残调整寿命年(DALY),对中国人群食管癌疾病负担的现况、变化趋势以及未来预测进行分析。结果GLOBOCAN估计2020年中国食管癌发病率和死亡率分别为18.2/10万和17.2/10万;《2020中国肿瘤登记年报》报告的2017年全国肿瘤登记地区的发病率为11.3/10万,死亡率为8.6/10万;发病率和死亡率均随年龄的增加而升高。GBD显示2019年中国食管癌所致DALY达576.0万人年,占全球的49.4%。《中国肿瘤登记年报》数据显示2004-2017年中国食管癌发病率和死亡率分别下降了22.4%和23.6%,平均年度变化百分比(AAPC)分别为-2.1和-2.4;农村人群的食管癌发病率(AAPC:-7.2)和死亡率(AAPC:-7.2)整体下降幅度较大,P<0.05;男性死亡率呈下降趋势(AAPC:-1.5,95%CI:-2.7~-0.2);女性发病率(AAPC:-3.5)和死亡率(AAPC:-4.2)整体均呈下降趋势,均P<0.05。GBD数据显示1990-2019年中国人群食管癌发病例数和死亡例数整体呈上升趋势。CI5和《中国肿瘤登记年报》数据均显示,鳞状细胞癌是中国食管癌的主要病理类型。GBD数据显示,1990-2019年,吸烟和饮酒导致的中国食管癌DALY占比一直较高,高身体质量指数占比逐渐升高,水果和蔬菜摄入量低占比逐渐下降,咀嚼烟草占比一直较低。GLOBOCAN 2020预测,到2040年,预计我国食管癌发病和死亡例数将达到529621例和525362例,相比于2020年分别增加了63.3%和74.5%,其中≥75岁人群增幅远高于45~74岁人群和0~44岁人群。结论中国食管癌的发病率和死亡率在过去几十年间呈现下降趋势,但新发病例和死亡数在逐渐增加,食管癌疾病负担仍然较重,应进一步加强一级及二级预防工作,从而减轻中国人群食管癌疾病负担。
Objective To summarize and analyze the disease burden of patients with esophageal cancer in China and tendancy of the risk factors.Methods Based on six data sources,including GLOBOCAN,disability-adjusted life year(GBD),Cancer Incidence in Five Continents(CI5),Chinese Cancer Registry Annual Report,China Death Cause Surveillance Datasets and China Health Statistical Yearbook,the incidence(number),mortality(number),and disability-adjusted life year(DALY)of esophageal cancer in China were extracted to analyze the current status,time trend and prediction of esophageal cancer burden.Results GLOBOCAN estimated that the incidence and mortality rate of esophageal cancer in China in 2020 were 18.2/100000and 17.2/100000,respectively.According to latest Chinese Cancer Registry Annual Report,in 2017,the incidence rate was 11.3/100000,and the mortality rate was 8.6/100000.Both incidence and mortality increased with age.GBD 2019showed that the DALY caused by esophageal cancer in China reached 5.76million person-years,accounting for 49.4%of the global burden of esophageal cancer.Chinese Cancer Registry Annual Report showed that,from 2004 to 2017,the incidence and mortality rate of esophageal cancer in China decreased by 22.4%and 23.6%,and the average annual percent change(AAPC)was-2.1and-2.4,respectively;the incidence rate(AAPC:-7.2)and mortality rate(AAPC:-7.2)decreased significantly in rural areas(P<0.05);mortality of men showed a downward trend(AAPC:-1.5,95%CI:-2.7to-0.2);both incidence(AAPC:-3.5)and mortality(AAPC:-4.2)rates of women showed a downward trend(P<0.05).GBD showed that the number of incidents and deaths as a whole showed an upward trend.Both CI5and Chinese Cancer Registry Annual Report showed that squamous cell carcinoma was the main type of esophageal cancer in China.GBD showed that,from 1990 to 2019,the proportion of esophageal cancer DALY attributed to smoking and alcohol consumption in China was high;the proportion of high BMI gradually increased;the proportion of low fruit and vegetable intake gradually declined;the proportion of chewing tobacco was low.GLOBOCAN 2020 predicted that,by 2040,the number of esophageal cancer cases and deaths in China would reach 529621and 525362,with an increase of 63.3%and 74.5%respectively,compared with the number in 2020.Population over 75years old would have a more significant increase than that of population of 45-74years old and 0-44 years old.Conclusion The incidence and mortality rate of esophageal cancer in China have shown a downward trend in the past few decades,but the number of new cases and deaths is still gradually increasing.The burden of esophageal cancer remains high.The primary and secondary prevention should be further strengthened to reduce the disease burden of esophageal cancer in China.
作者
宋颂
雷林
刘涵
张瑞
李贺
彭绩
李霓
陈万青
任建松
SONG Song;LEI Lin;LIU Han;ZHANG Rui;LI He;PENG Ji;LI Ni;CHEN Wanqing;REN Jiansong(Office of Cancer Screening,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Cancer Control and Prevention,Shenzhen Centre for Chronic Disease Control,Shenzhen 518000,China;Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement,Beijing 100021,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第15期887-896,共10页
Chinese Journal of Cancer Prevention and Treatment
基金
国家科技基础资源调查专项(2019FY101105)
中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2019PT320027)
深圳市医疗卫生三名工程(SZSM 201911015)
关键词
食管癌
疾病负担
预测
发病率
死亡率
esophageal cancer
disease burden
prediction
incidence
mortality
