1990—2019年我国宫颈癌疾病负担变化趋势分析

Trend analysis of disease burden of cervical cancer in China from 1990 to 2019

目的 分析1990—2019年我国宫颈癌疾病负担现状与趋势,为宫颈癌防治提供理论基础。方法 使用2019年全球疾病负担研究的数据,分析宫颈癌粗发病率、标化发病率、粗死亡率、标化死亡率、伤残损失寿命年(YLD)、过早死亡损失寿命年(YLL)和伤残调整寿命年(DALY)。采用SAS 9.4软件进行趋势χ2检验。采用Joinpoint Regression Program 4.9.0.0软件计算恶性肿瘤发病及死亡年度变化百分比(APC)。结果 2019年我国女性宫颈癌发病人数为10.98万人,粗发病率和标化发病率分别由1990年的7.09/10万和8.41/10万上升至2019年15.74/10万和11.01/10万人,分别以每年3.55%和1.61%的速度上升,趋势均有统计学意义(P<0.01)。2019年我国女性宫颈癌死亡人数为5.34万人,粗死亡率由1990年的4.61/10万上升至2019年的7.66/10万,每年以2.40%的速度上升,趋势有统计学意义(P<0.01);标化死亡率由1990年的5.85/10万下降到2019年的5.13/10万,每年以0.09%的速度上升,趋势无统计学意义(P>0.05)。1990—2019年,宫颈癌的标化YLD率逐年上升,标化YLL率和标化DALY率均波动下降。50~69岁女性YLD率、YLL率及DALY率均最高。宫颈癌YLD、YLL、DALY的年龄构成中,15~49岁组占比较高。分年龄的DALY构成中,YLL构成比远大于YLD,YLD在15~49岁组所占比例呈缓慢上升趋势(P<0.05)。结论 我国女性宫颈癌疾病负担仍较重,有逐渐年轻化趋势,老年宫颈癌依旧是防控重点。

Objective To analyze the status and trends on the disease burden of cervical cancer from 1990 to 2019 in China,and provide the theoretical basis for cervical cancer prevention and treatment. Methods The rough incidence,standardized incidence,mortality,standardized mortality,years of life lost(YLL),years lived with disability(YLD) and disability-adjusted life year(DALY) of cervical cancer were collected and analyzed,on the basis of the Global Burden of Disease Study in 2019(GBD 2019).The trend χ2test was used to analyze the data,the used software was SAS 9.4. The Joinpoint Regression Program 4.9.0.0 software was used to calculate annual percent change(APC) of the morbidity,mortality of cervical cancer. Results The number of new cervical cancer was 109.8 thousand;the crude and standardized morbidity increased from 7.09/105and 8.41/105in 1990 to15.74/105and 11.01/105in 2019,which increased at an average annual rate of 3.55% and 1.61%(P<0.01),respectively. The number of deaths on cervical cancer was 53.4 thousand;the crude mortality increased from 4.61/105in 1990 to 7.66/105in 2019,but the standardized mortality decreased from 5.85/105in 1990 to 5.13/105in 2019. The crude and standardized mortality increased at average annual rate of 2.40% and 0.09%,respectively. Moreover,the changing trend in crude mortality was statistically significant(P<0.05) but standardized mortality was not statistically significant(P>0.05). From 1990 to 2019,the standardized YLD rates of cervical cancer showed an upward trend year by year,however,the standardized YLL rates and standardized DALY rates showed an undulatory trend. Rates regarding YLD、YLL and DALY on cervical cancer in the 50-69 age group were the highest. Disease burden in 15-49 age group was higher than that in other age groups. As for the composition in DALY,YLL appeare much larger than YLD and YLD slowly increased in 15-49 age group(P<0.05). Conclusion The burden of disease associated with cervical cancer retains heavy in China. Not only attention should be paid to the elderly,there is also a younger trend in cervical cancer.