1990—2019年中国前列腺癌疾病负担分析及趋势预测

Analysis of Disease Burden of Prostate Cancer in China from 1990 to 2019 and Trend Prediction

[目的]分析1990—2019年中国前列腺癌流行特征及变化趋势,预测2020—2030年前列腺癌发病率和死亡率。[方法]利用2019年全球疾病负担(GBD)研究成果,选取中国前列腺癌发病、死亡与疾病负担资料,通过Joinpoint回归分析1990—2019年前列腺癌疾病负担变化趋势和不同年龄别流行趋势。采用灰色预测模型预测2020—2030年中国前列腺癌粗发病率和粗死亡率。[结果] 1990—2019年,中国前列腺癌粗发病率[平均年度变化百分比(AAPC)=5.6%,P<0.01]、标化发病率(AAPC=2.3%,P<0.01)均呈显著上升趋势,粗死亡率(AAPC=2.8%,P<0.01)呈显著上升趋势,标化死亡率(AAPC=-0.2%,P<0.01)呈缓慢下降趋势;因前列腺癌造成的伤残调整寿命年(DALY)率(AAPC=2.5%,P<0.01)、过早死亡损失寿命年(YLL)率(AAPC=2.3%,P<0.01)、伤残损失寿命年(YLD)率(AAPC=6.4%,P<0.01)均呈显著上升趋势,标化DALY率(AAPC=-0.2%,P<0.01)、YLL率(AAPC=-0.4%,P<0.01)均呈缓慢下降趋势,标化YLD率(AAPC=3.4%,P<0.01)呈显著上升趋势。30年来中国前列腺癌发病率在各个年龄段均呈显著上升趋势,死亡率与DALY率均在20~79岁呈下降趋势,均在50~59岁年龄段(AAPC=-1.1%,P<0.05;AAPC=-0.8%,P<0.05)下降速度最快。灰色模型预测结果显示,2020—2030年中国前列腺癌发病率和死亡率均呈上升趋势。[结论]我国前列腺癌发病率正迅速上升,年轻患者比例增加,严重威胁男性健康。应通过加强前列腺癌高危人群的早期筛查,控制危险因素,倡导健康生活方式等干预措施以改善我国男性的健康水平。

[Purpose] To analyze the disease burden of prostate cancer in China from 1990 to2019, and forecast the incidence and mortality of prostate cancer from 2020 to 2030. [Methods]The data of incidence, mortality and disease burden of prostate cancer in China were obtained from the Global Burden of Disease(GBD) study in 2019, and the trend of prostate cancer disease burden in different age groups from 1990 to 2019 was analyzed by Joinpoint regression. A grey prediction model was used to predict the crude incidence and mortality of prostate cancer in China from 2020 to 2030. [Results] From 1990 to 2019, the crude incidence of prostate cancer[average annual percentage change(AAPC)=5.6%, P<0.01] and standardized incidence(AAPC=2.3%, P<0.01) significantly increased. The crude mortality rate(AAPC =2.8%, P <0.01) significantly increased, while the standardized mortality rate(AAPC=-0.2%, P<0.01) slowly decreased. The disability-adjusted life year(DALY)(AAPC=2.5%, P<0.01), years of life lost(YLL)(AAPC=2.3%, P<0.01) and years lived with disability(YLD)(AAPC=6.4%, P<0.01) significantly increased due to prostate cancer. The standard DALY rate(AAPC=-0.2%, P<0.01) and YLL rate(AAPC=-0.4%,P<0.01) showed a slowly decreasing trend, while the standard YLD rate(AAPC=3.4%, P<0.01)showed a significant increasing trend. In the past 30 years, the incidence of prostate cancer in China has increased significantly in all age groups, and the mortality and DALY rates decreased in age 20 to 79 years old, with the fastest decreasing rate during 50 to 59 years old(AAPC=-1.1%,P <0.05;AAPC =-0.8%, P <0.05). The grey model predicted that the incidence and mortality of prostate cancer in China would increase from 2020 to 2030. [Conclusion] The incidence of prostate cancer in China has been increasing and the proportion of young patients is rising. Interventions should be strengthened by early screening, controlling risk factors, and promoting healthy lifestyles in targeted population.