1990-2019年亚洲主要国家胰腺癌疾病负担和归因风险因素及相关预测分析

Analysis and forecast of burden of pancreatic cancer along with attributable risk factors in Asia countries between 1990 and 2019

目的分析亚洲主要国家胰腺癌的疾病负担,预测中国胰腺癌流行趋势,为胰腺癌防控提供参考依据。方法收集全球疾病负担研究(GBD)2019版数据库中全球及亚洲主要国家的胰腺癌疾病负担数据,对年份、性别、社会人口指数对发病、死亡、伤残调整寿命年(DALY)的绝对数或标化率的分布情况进行描述,采用估计年百分比变化(EAPC)描述标化率的趋势。比较2019年不同年龄、性别和地区胰腺癌风险因素的死亡归因占比。运用R语言建立ARIMA模型预测2020—2029年中国胰腺癌标化发病率和死亡率。结果1990—2019年,中国胰腺癌的标化发病率从3.17/10万增加到5.78/10万,标化死亡率从3.34/10万增加到5.99/10万,增幅超过亚洲高收入国家;全球胰腺癌标化发病率、死亡率和DALY率均呈逐年上升趋势。在亚洲主要国家中,中国疾病负担增速最高(标化发病率EAPC=2.32%,95%CI:2.10%~2.48%;标化死亡率EAPC=2.25%,95%CI:2.03%~2.42%)。ARIMA模型预测结果显示,中国胰腺癌发病率和死亡率在2020—2029年继续呈上升趋势,发病率预计增长15.92%,死亡率预计增长15.86%。结论中国胰腺癌的标化发病率和死亡率逐年增加,疾病负担呈上升趋势。随着人口老龄化,胰腺癌疾病负担还将进一步增长,应采取积极防控措施。

Objective To analyze the disease burden of pancreatic cancer in major Asian countries and forecast the burden of that in China,which helps to provide reference for the prevention and control of pancreatic cancer.Methods Data on disease burden of pancreatic cancer among global and major Asian countries from on the Global Burden of Disease(GBD)2019 were collected to describe burden distribution through the absolute numbers or standardized rates of incidence,death and disability adjusted life years(DALY)by year,sex and socio-demographic index.Estimated annual percentage changes(EAPC)was used to assess the trend of standardized rate.The proportion of deaths attributable to risk factors for pancreatic cancer in 2019 was used to compare by age,sex and region.ARIMA model was performed with R language to predict change of age-standardized incidence and death rates of pancreatic cancer from 2020 to 2029.Results From 1990 to 2019,the standardized incidence rates of pancreatic cancer in China increased from 3.17/100000 to 5.78/100000,and the standardized death rate increased from 3.34/100000 to 5.99/100000.The increases exceeded other high-income Asia countries.In the past three decades,the standardized incidence,death and DALY rates of pancreatic cancer in global have increased year by year.Among the major countries in Asia,China has the highest growth rate of disease burden(EAPC of standardized incidence rates=2.32%,95%CI:2.10%-2.48%and EAPC of standardized death rate=2.25%,95%CI:2.03%-2.42%).In addition,incidence and death rates of pancreatic cancer in China are expected to continue on the rise between 2000 and 2029 by ARIMA model.Incidence rate is expected to increase 15.92%and death rate is expected to increase 15.86%.Conclusions The standardized incidence and death rates of pancreatic cancer in China increase year by year with an increasing trend for the burden of disease.The disease burden of pancreatic cancer is expected to rise due to the increase and aging of the population.Preventive measures should be adopted to decrease the burden of the pancreatic cancer.