应用伤残调整寿命年测量山东省恶性肿瘤疾病负担的研究

Estimation of the Burden of Malignant Neoplasms by DALYs in Shandong Province

目的评价山东省恶性肿瘤疾病负担,为卫生决策提供科学依据。方法以2006年山东省第3次死因回顾抽样调查资料和2007年山东省恶性肿瘤现患状况抽样调查资料为基础,按照全球疾病负担(GBD)研究方法计算早死所致的寿命损失年(YLLs)、失能引起的寿命损失年(YLDs)、伤残调整寿命年(DALYs)和各种肿瘤的残疾权重,YLDs采用直接法进行测算,并对测算结果的不确定性进行分析。结果山东省人群因各种恶性肿瘤共导致138.3万个DALYs。肺癌、肝癌、胃癌和食管癌为山东省人群健康负担最重的4种主要恶性肿瘤,占全部恶性肿瘤负担的71.45%以上。95%的恶性肿瘤健康负担为早死所致,伤残负担仅占5.26%。DALYs不确定性范围约为±11%,YLDs的不确定性高于YLLs。结论恶性肿瘤对山东省人群造成的健康负担高于全国平均水平,肺癌、肝癌和胃癌应成为山东省恶性肿瘤预防控制工作的重点疾病。

Objective To evaluate the burden of malignant neoplasms in Shandong Province in order to provide scientific evidence for policy-making. Methods The main data for this study were from Shandong third cause of death sampling survey in 2006 and Shandong 2007 cancer prevalence survey. YLLs, YLDs, DALYs and disability weights of each type of cancers were calculated according to the global burdens of disease （GBD） methodology. The direct method was used to estimate YLDs. The uncertainty analysis was conducted following the methodology in GBD study. Results The total cancers burden in Shandong population was 1 383 thousands DALYs. Lung cancer, liver cancer, stomach cancer and esophagus cancer were the top four cancers with the highest health burden. The burden of the four major cancers together accounted for 71.45% of the total burden of all cancers. 95% of the total burden of malignant tumors was caused by premature death, and only 5.26% of the total cancer burden was due to disability. The uncertainty of total burden estimate was around＋l 1%, the uncertainty of YLDs was bigger than that of YLLs. Conclusion The health burden due to cancers in Shandong population is heavier than that of the national average level. Liver cancer, lung cancer and stomach cancer should be the major cancers for disease control and prevention in Shandong.