1990—2019年中国居民胃癌疾病负担变化趋势分析

Trend analysis of disease burden of gastric cancer in Chinese residents from 1990 to 2019

目的分析1990—2019年中国居民胃癌疾病负担变化趋势,为中国胃癌的防控政策提供参考依据。方法利用2019年全球疾病负担(global burden of disease study,GBD)数据库中1990—2019年中国居民的胃癌粗发病率、粗死亡率并计算标化发病率及标化死亡率,运用伤残调整寿命年(DALY)、伤残所致的健康寿命损失年(YLD)、早死所致的寿命损失年(YLL)等指标分析中国居民胃癌的疾病负担的年龄和性别分布情况,并运用Joinpoint回归模型分析胃癌疾病负担变化趋势。结果1990—2019年中国居民胃癌发病人数与粗发病率均上升,标化发病率下降;死亡人数呈上升趋势,粗死亡率及标化死亡率均下降,男性发病及死亡各指标值均大于女性;中国总体标化DALY率及标化YLL率均年均下降2.30%(均有AAPC=-2.30%,P<0.001),标化YLD率的变化趋势则无统计学意义(P=1.000);男性的标化DALY率、标化YLD率和标化率YLL率的年均下降幅度均小于女性;2019年各疾病负担指标的标化率峰值主要分布在55~74岁年龄组。结论1990—2019年中国胃癌疾病负担整体呈现下降趋势,男性以及中老年群体是重点防治人群。

Objective To analyze the trend of disease burden of gastric cancer in Chinese residents from 1990 to 2019 and to provide reference for the prevention and control of gastric cancer in China.Methods The crude incidence and crude mortality rates of gastric cancer in Chinese residents of different genders from 1990 to 2019 were calculated from the Global Burden of Disease Study(GBD)database,and the standardized incidence and mortality rates were calculated to describe the trend of incidence and mortality of gastric cancer in Chinese residents.Disability Adjusted Life year(DALY)and years lived with Disability(DALY)were used.YLD,years of life lost(YLL)and other indicators were used to analyze the age and gender distribution of the disease burden of gastric cancer in Chinese residents.Joinpoint regression model was used to analyze the trend of the disease burden of gastric cancer.Results From 1990 to 2019,the incidence and crude incidence of gastric cancer increased,while the standard incidence decreased.The number of deaths was on the rise,the crude mortality rate and the standard mortality rate were both decreased,the morbidity and mortality index values of male were higher than that of female.The average annual average of the standardized DALY rate and the standardized YLL rate in China decreased by 2.30%(AAPC=-2.30%,P<0.001),while the trend of the standardized YLD rate was not statistically significant(P=1.000).The average annual decrease rate of standardized DALY rate,standardized YLD rate and standardized YLL rate for males was smaller than that for females.In 2019,the peak rates of normalization of disease burden indicators were mainly distributed in the 55-74 age group.Conclusion From 1990 to 2019,the disease burden of gastric cancer in China showed a downward trend,and males and middle-aged and elderly people were the key prevention and treatment groups.