1990—2019年福建省结直肠癌疾病负担变化及未来趋势预测

Trends and prediction of disease burden of colorectal cancer in Fujian Province from 1990 to 2019

目的 了解1990—2019年福建省结直肠癌(CRC)疾病负担变化情况,并预测CRC疾病负担的未来趋势,为制定福建省CRC的防控策略提供参考依据。方法 收集2019年全球疾病负担研究(GBD)福建省CRC数据。使用SAS 9.4和R 4.1.2软件计算发病率、死亡率、伤残调整寿命年(DALY)及其标化率和年估计百分比变化(EAPC),描述1990—2019年福建省CRC的疾病负担变化趋势,运用Joinpoint回归模型预测2020—2030年福建省CRC疾病负担变化。结果 2019年,福建省CRC的标化发病率为39.71/10万(95%UI:31.71/10万~48.79/10万),标化死亡率为17.66/10万(95%UI:14.48/10万~21.18/10万),标化DALY率为417.23/10万(95%UI:338.81/10万~504.63/10万),以上3个率男性均高于女性;CRC的发病率、DALY率在80~84岁达到高峰,死亡率则随年龄增长而增高,尤其50岁以上年龄组增长明显。1990—2019年CRC标化发病率、标化死亡率和标化DALY率均呈上升趋势,EAPC分别为4.19%(95%CI:3.85%~4.52%)、1.64%(95%CI:1.41%~1.86%)和1.65%(95%CI:1.40%~1.90%)。其中,男性CRC各标化率的上升趋势均较女性显著,而女性CRC标化DALY率处于平稳状态。从年龄分组来看,各年龄组CRC的发病率均呈上升趋势。不同年龄组的CRC死亡率、DALY率呈现不同的变化趋势,5~9、10~14和15~19岁年龄组呈下降趋势,20~24岁组处于平稳状态,其余各年龄组呈上升趋势。Joinpoint回归模型预测结果显示,2020—2030年福建省CRC标化发病率、标化死亡率和标化DALY率均呈上升趋势,其中男性增长趋势较女性显著,女性标化死亡率和标化DALY率的上升幅度小。结论 1990—2019年福建省CRC标化发病率、标化死亡率、标化DALY率均呈明显上升趋势,预测到2030年福建省CRC疾病负担仍将不断增长,且男性明显高于女性,应重点加强男性及50岁以上人群CRC的监测和早期筛查。

Objective To understand the changes of disease burden of colorectal cancer(CRC) in Fujian Province from 1990 to2019,predict the disease burden of CRC in Fujian Province in the future,and provide the basis for the prevention and control of CRC in Fujian Province. Methods The CRC data of Fujian from Global Burden of Disease Study(GBD) were collected. SAS 9.4and R 4.1.2 software were used to calculate the incidence,mortality,disability adjusted life years(DALY),standardized rates and estimated annual percentage change(EAPC),and to describe the trend of CRC disease burden from 1990 to 2019 in Fujian Province. Joinpoint regression model was used to predict the change of CRC disease burden from 2020 to 2030 in Fujian Province.Results In 2019,the standardized incidence rate of CRC in Fujian Province was 39.71/105(95%UI:31.71/105-48.79/105),the standardized mortality was 17.66/105(95%UI:14.48/105-21.18/105),and the standardized DALY rate was 417.23/105(95%UI:338.81/105-504.63/105). The above three indicators in males were higher than those in females. The rate of CRC incidence and DALY showed the peak in 80-84 years old group. The mortality gradually increased with age,especially in ≥50 years old group.From 1990 to 2019,the standardized incidence rate,mortality rate and DALY rate of CRC showed an upward trend,and the EAPCs were 4.19%(95%CI:3.85%-4.52%),1.64%(95%CI:1.41%-1.86%),and 1.65%(95%CI:1.40%-1.90%),respectively.The upward trend of the all CRC standardized rates in males were more significant than that in females,but the CRC standardized DALY rate in females showed stable. According to age subgroups,the CRC incidences in all age subgroups showed the upward trend. The mortality rate,DALY rate of CRC in different age groups showed different trends,the CRC mortality rate,DALY rate in5-9 years old,10-14 years old and 15-19 years old groups showed downward trends,the CRC mortality rate,DALY rate in 20-24years old group showed stable,the CRC mortality rate,DALY rate in other age groups showed upward trends. Joinpoint regression model showed that the standardized rates of CRC incidence,mortality and DALY showed upward trend from 2020 to 2030,the increase trend in males was more significant than that in females,the increase values of standardized mortality and standardized DALY rate in females would be smaller. Conclusion The standardized incidence rate,standardized mortality rate and standardized DALY rate of CRC in Fujian Province from 1990 to 2019 show significant increasing trends. It is predicted that the disease burden of CRC will continue to increase in Fujian Province by 2030. The disease burden of CRC is significantly higher in males than that in females. The males and people ≥50 years old should be monitored and early screened for CRC.