2005-2016年中国老年人恶性肿瘤疾病负担分析

Cancer burden among the elderly in China from 2005 to 2016

目的:量化评估我国60岁及以上老年人恶性肿瘤的疾病负担,为我国恶性肿瘤的防控提供流行病学证据。方法:本研究收集了2008-2019年《中国肿瘤登记年报》中60岁及以上老年人恶性肿瘤患者的发病和死亡数据,计算伤残调整生命年(disability adjusted of life years,DALY)分析其疾病负担,使用Joinpoint模型对其进行时间趋势分析。结果:2005-2016年,我国老年人恶性肿瘤所致DALY共计25921678人年,DALY率波动范围为73.43‰~84.07‰,并以年均1.2%(95%CI:0.8%~1.5%)的速率下降。2005-2016年我国老年人寿命损失最多的恶性肿瘤是肺癌,年均寿命损失为28454人年,其次为胃癌、肝癌、食管癌和结直肠癌,以上五种肿瘤造成的寿命损失约占全部恶性肿瘤所致寿命损失的74.3%。85岁以上年龄组女性肺癌的DALY率随时间呈上升趋势(AAPC=1.8%,95%CI:0.7%~2.9%)。乳腺癌仅在女性60~64岁年龄组中排名前五,DALY率也呈上升趋势(AAPC=2.2%,95%CI:1.3%~3.0%)。随着年龄的增长,肝癌造成的疾病负担减轻,结直肠癌造成的疾病负担增加。结论:2005-2016年,我国老年人恶性肿瘤疾病负担有所下降,且存在年龄、性别、地区和恶性肿瘤类型差异。因此,相关部门应继续针对不同恶性肿瘤的分布特征,采取更加精准的防控措施,合理分配卫生资源,达到更加有效降低恶性肿瘤疾病负担的目标。

Objective:Cancer burden in the aged 60 years and above was evaluated quantitatively,to provide epidemiological evidence for the prevention and control of cancer in China.Methods:In this study,the morbidity and mortality data of cancer patients aged 60 years and above were collected from the China Annual Report of Cancer Registration in 2008-2019.Disability adjusted of life years(DALY)were calculated to analyze the disease burden.The Joinpoint model was used to analyze its time trends.Results:From 2005 to 2016,there were 25921678 person-years of DALY caused by cancer in the elderly in China,and the DALY rate fluctuated between 73.43‰and 84.07‰,decreasing at an average annual rate of 1.2%(95%CI:0.8%~1.5%).The cancer with the largest life loss among the elderly was lung cancer,with an average annual life loss of 28454 person-years,followed by gastric,liver,esophageal and colorectal cancer in 2005-2016.The life loss caused by the above five cancers accounted for 74.3%of all cancers.The DALY rate of lung cancer in females aged≥85 years increased with time(AAPC=1.8%,95%CI:0.7%~2.9%).Breast cancer ranked in the top five only in females aged 60~64 years,and the DALY rate also showed an increasing trend(AAPC=2.2%,95%CI:1.3%~3.0%).As people age,the burden from liver cancer decreased and that from colorectal cancer increased.Conclusion:From 2005 to 2016,the cancer disease burden among the elderly in China was decreased,and there were differences in age,gender,region and type of cancer.Therefore,the relevant departments should continue to target the distribution characteristics of different cancer,take more precise preventive and control measures,and rationally allocate health resources to achieve the goal of more effectively reducing the disease burden of cancer.