1990—2019年中国食管癌疾病负担及其变化趋势分析

Disease Burden and Trends of Esophageal Cancer in China During 1990—2019

[目的]描述和分析1990—2019年我国食管癌患病、发病、死亡及伤残调整生命年(disability adjusted life years,DALYs)状况的变化趋势。[方法]基于2019年全球疾病负担研究(GBD2019)公开数据库和可视化平台,按年份、性别和年龄对1990—2019年食管癌患病、发病、死亡及DALYs的分布情况进行描述。利用Joinpoint回归模型进行时间趋势分析,基于GBD世界标准人口的年龄结构,计算食管癌标化患病率、标化发病率、标化死亡率及标化DALYs率的年度变化百分比(annual percentage change,APC)和平均年度变化百分比(average annual percentage change,AAPC)。[结果]中国食管癌的患病人数从1990年的254169人增加至498410人,标化患病率从28.93/10万减少至24.10/10万。食管癌新发病人数从1990年的173687人增加至2019年278121人,标化发病率从20.97/10万减少至13.90/10万。食管癌死亡人数从1990年的176602人增加至2019年的257316人,标化死亡率从22.08/10万下降至13.15/10万。食管癌DALYs从1990年的4494070人年增加至2019年的5759997人年,标化DALYs率从506.98/10万减少至277.50/10万。从1990年到2019年,标化患病率,标化发病率、标化死亡率和标化DALY率整体呈现下降趋势(AAPC分别为-0.6%、-1.5%、-1.1%、-2.1%),差异均有统计学意义(P<0.05)。[结论]近30年来,我国食管癌的疾病负担得到了有效控制,但是人口老龄化的加重仍是食管癌防治需要面临的问题。

[Purpose]To analyze the changes of disease burden of esophageal cancer in China from 1990 to 2019.[Methods]Based on the 2019 Global Burden of Disease Study(GBD2019)database and visualization platform,the prevalence,incidence,mortality and disability adjusted life years(DALYs)of esophageal cancer in China from 1990 to 2019 were analyzed by year,gender and age.The Joinpoint regression model was used for time trend analysis,and the annual percentage change(APC)and average annual percentage change rate(AAPC)of the age-standardized prevalence,age-standardized incidence,age-standardized mortality,and age-standardized DALYs rate of esophageal cancer based on the GBD standard population were calculated.[Results]The number of esophageal cancer prevalence in China increased from 254169 in 1990 to 498410 in2019,while the standardized prevalence decreased from 28.93/105 to 24.10/105.The number of new cases of esophageal cancer increased from 173687 in 1990 to 278121 in 2019,while the standardized incidence rate decreased from 20.97/105 to 13.90/105.The number of deaths from esophageal cancer increased from 176602 in 1990 to 257316 in 2019,while the standardized mortality rate dropped from 22.08/105 to 13.15/105.DALYs for esophageal cancer increased from4494070 person-years in 1990 to 5759997 person-years in 2019,while the standardized DALYs rate decreased from 506.98/105 to 277.50/105.From 1990 to 2019,the standardized prevalence rate(AAPC:-0.6%),standardized incidence rate(AAPC:-1.5%),standardized mortality rate(AAPC:-1.1%)and standardized DALY rate(AAPC:-2.1%)showed a downward trend,and the differences were statistically significant(P<0.05).[Conclusion]In the past three decades,the incidence and mortality of esophageal cancer in China has been effectively controlled,but the acceleration of population aging and related disease burden is still a problem that needs to be faced,therefore the prevention and control of esophageal cancer still need to be strengthened.