1990-2019年中国早发胃癌发病与死亡及其时间变化趋势分析

Time trend analysis of incidence and mortality of early-onset gastric cancer in China from 1990 to 2019

目的 分析1990-2019年中国早发胃癌发病与死亡及其时间变化趋势。方法 利用全球疾病负担2019(global burden of disease 2019,GBD 2019)数据库获取我国15~49岁人群1990-2019年间胃癌发病、死亡及伤残调整寿命年(disability-adjusted life years,DALYs)的数量及率,以死亡人数与新发例数之比计算死亡发病比(mortality-to-incidence ratio,MIR)。以GBD 2019标准人口计算年龄标化发病率(age-standardized incidence rate,ASIR)及死亡率(agestandardized mortality rate,ASMR),并使用Joinpoint软件对国早发胃癌的发病率及死亡率进行时间变化趋势分析。结果 2019年我国早发胃癌的新发病例及死亡人数为66 759及31 114,相比1990年分别增加39.84%及减少21.13%,其MIR则从1990年的0.83降至2019年的0.47。我国早发胃癌ASIR及ASMR为7.77/10万及3.57/10万,较1990年分别下降了13.85%及52.59%。时间变化趋势分析显示,我国早发胃癌ASIR及ASMR均呈显著下降趋势,其平均年变化百分比(average annual percentage change,AAPC)分别为-0.6 (-1.0~-0.3)及-2.7(-3.1~-2.3)。我国早发胃癌DALYs为1 479 545人年,占胃癌总体DALYs的15.06%及全球早发胃癌DALYs的35.17%。结论 我国早发胃癌发病率及死亡率均明显降低,但其导致的疾病负担仍较严峻。

Objective To analyze the disease burden and time trends of early-onset gastric cancer in China from 1990 to 2019. Methods The number,incidence,deaths and disability-adjusted life years(DALYs) of gastric cancer diagnosed between 15 and 49 years in China from 1990 to 2019 were obtained from the Global Burden of Disease 2019(GBD 2019) database. The mortality-to-incidence ratio(MIR) was calculated as the ratio of deaths to new cases. Age-standardized incidence(ASI)and age-standardized mortality(ASM) were calculated using the GBD 2019 as standard population.Joinpoint software was used to analyze the time trends of ASI and ASM for early-onset gastric cancer in China. Results In 2019,the new cases and deaths of early-onset gastric cancer in China were 66 759 and 31 114,showing an increase of 39.84% and a decrease of 21.13% compared with the data from 1990. The MIR decreased from 0.83 in 1990 to 0.47 in 2019. The ASI and ASM of early-onset gastric cancer in China were 7.77/105and 3.57/105,decreased by 13.85% and 52.59%respectively compared with the data in 1990. The time trend analysis showed that the ASI and ASM of early-onset gastric cancer in China have a significant downward trend,the AAPC were-0.6(-1.0--0.3) and-2.7(-3.1--2.3) for ASI and ASM,respectively. The DALYs caused by early-onset gastric cancer in China were 1 479 545 in 2019,accounting for 15.06% of the total DALYs caused by gastric cancer and 35.17% of the worldwide DALYs caused by early-onset gastric cancer. Conclusions The incidence and mortality of early-onset gastric cancer have been decreasing significantly in China,but the disease burden caused by this disease is still heavy.