2010—2020年河北承德地区胰腺癌疾病负担现状及其变化趋势

Current status changing trend and influencing factors of pancreatic cancer disease burden in Chengde of Hebei Province in 2010-2020

目的 分析河北承德地区2010—2020年胰腺癌疾病负担现状、趋势变化以及可能的影响因素,以期为胰腺癌防控提供理论依据。方法 利用全球疾病负担(global burden of disease)开放数据库,获得该地区胰腺癌的发病率、患病率、死亡率、早逝损失寿命年(years of life lost, YLL)、伤残损失寿命年(years lived with disability, YLD)及伤残调整寿命年(disability adjusted life year, DALY)等疾病负担指标,使用Joinpoint模型计算平均年度变化率(average annual percent change, AAPC)以此进行胰腺癌患者2010—2020年疾病负担变化的趋势检验;同时,将患者特征如高血压、糖尿病等分类变量设置哑变量,线性回归分析影响胰腺癌患者死亡率变化的风险因素。结果 2010年河北承德地区胰腺癌的新发病例数为15人,死亡数为13人,因胰腺癌所致YLLs为DALY的70.67%。2020年,河北承德地区胰腺癌的新发病例数为160人,死亡数为147人,因胰腺癌所致YLLs为DALY的96.02%。2010—2020年河北承德地区胰腺癌发病人数增长9.79%,发病率增长7.81%,呈现明显的上升趋势(APCC=2.20%,P<0.05);死亡人数增长11.38%,死亡率增长8.39%,也呈现上升趋势(APCC=2.81%,P<0.05)。此外,2010—2020年由于胰腺癌引起DALY增长20.10%,DALY率增长309.41%(APCC=4.83);YLL增长了7.94%,YLL率增长了210.42%(APCC=2.20);同时,YLD增长了5.71%,YLD率增长了11.03%(APCC=2.32),均表现为上升趋势(P<0.05)。线性回归结果显示,患有糖尿病(OR=1.430,95%CI:1.192~2.016)、BMI>28.0及患有胰腺炎(OR=1.574,95%CI:1.328~3.045)均为引起胰腺癌患者死亡的风险因素(OR>1)。结论 2010—2020年河北承德地区本地户籍居民胰腺癌发病率、死亡率呈上升趋势,胰腺癌造成的疾病负担也在逐年增加,患有糖尿病、慢性胰腺炎基础病增加该类疾病的死亡风险,应重点防护。

Objective To analyze the disease burden status,trends and possible influencing factors of pancreatic cancer in Chengde of Hebei from 2010 to 2020,in order to provide theoretical basis for the preventionof pancreatic cancer.Methods Using the global burden of disease open database,the incidence rate,mortality,years of life lost(YLL),years of life lost with disability(YLD)and disability adjusted life year(DALY)of pancreatic cancer in the region are obtained,average annual percent change(AAPC)was calculated using joinpoint model to test the trend of disease burden change of pancreatic cancer patients from 2010 to 2020.At the same time,the patient characteristics such as hypertension,diabetes and other categorical variables were set as dummy variables,and the risk factors affecting the mortality of patients with pancreatic cancer were analyzed by linear regression.Results In 2010,there were 15 new cases of pancreatic cancer and 13 deaths in Chengde District,Hebei Province.The YLLs caused by pancreatic cancer accounted for 70.67%of DALY.In 2020,there were 160 new cases of pancreatic cancer and 147 deaths in Chengde,Hebei Province.The YLLs caused by pancreatic cancer accounted for 96.02%of DALY.From^(2)010 to 2020,the incidence of pancreatic cancer increased by 9.79%,and the incidence rate increased by 7.81%,showing an obvious upward trend(APCC=2.20%,P<0.05);The number of deaths increased by 11.38%,and the mortality rate increased by 8.39%,showing an upward trend(APCC=2.81%,P<0.05).In addition,from 2010 to 2020,the DALY caused by pancreatic cancer increased by 20.10%,and the DALY rate increased by 309.41%(APCC=4.83);YLL increased by 7.94%and YLL rate increased by 210.42%(APCC=2.20);At the same time,YLD increased by 5.71%and YLD rate increased by 11.03%(APCC=2.32),showing an upward trend(P<0.05).The results of linear regression showed that diabetes(OR=1.430,95%CI:1.192-2.016),BMI>28.0 and pancreatitis(OR=1.574,95%CI:1.328-3.045)were all risk factors for death of patients with pancreatic cancer(OR>1).Conclusion From^(2)010 to 2020,the incidence and mortality of pancreatic cancer among local residents in Chengde of Hebei showed an upward trend,and the disease burden was also increasing year by year.The basic diseases of diabetes and chronic pancreatitis increase the death risk and should be protected.