1990-2019年中美两国归因于高BMI的食管癌疾病负担和死亡预测分析

Disease Burden of Esophageal Cancer Attributable to High BMI and Death Prediction in China and the United States,1990-2019

目的分析1990—2019年中国和美国人群归因于高体重指数(BMI)的食管癌疾病负担变化趋势,并进行未来10年的死亡预测。方法使用2019年全球疾病负担(GBD 2019)数据,获取1990—2019年期间中国和美国归因于高BMI的食管癌疾病负担的不同年份、性别和年龄的死亡率、伤残调整生命年(DALYs)数据。Joinpoint回归分析用于分析长期变化趋势,贝叶斯年龄-时期-队列分析(BAPC)用于预测2020—2030年归因于食管癌的年龄标准化死亡率。结果1990—2019年,中国归因于高BMI的食管癌年龄标准化死亡率由1.44/10^(5)增长至1.80/105,年龄标准化DALYs率从34.17/10^(5)增长至40.79/10^(5)。从性别角度看,1990—2019年中国和美国男性的死亡人数、DALYs及相应的年龄标准化率均呈上升趋势;中国女性的年龄标准化死亡率及DALYs率呈下降趋势,降幅分别为21.36/10^(5)、29.71/10^(5)。Joinpoint分析结果显示,1990-2019年中国总人口和男性归因于食管癌的死亡率平均年度百分比(AAPC)分别以0.78%(95%CI:0.71~0.84)和1.52%(95%CI:1.44~1.60)的速度上升,女性AAPC以0.88%(95%CI:-0.96~-0.80)的速度下降;而美国女性AAPC以0.07%(95%CI:0.02~0.09)的速度缓慢上升。预测在2020-2030年,中国和美国归因于高BMI的食管癌死亡负担呈持续上升趋势。结论1990-2019年中国归因于高BMI的食管癌疾病负担呈显著上升趋势,预计2020-2030年我国由高BMI导致的食管癌疾病负担将会继续增高。

Objective To analyze trends in the disease burden of esophageal cancer attributable to high body mass index(BMI)in the Chinese and United States populations from 1990 to 2019 and predict deaths over the next 10 years.Methods This study used Global Burden of Disease 2019 data to obtain mortality and disability-adjusted life-year(DALY)data by year,gender,and age for the disease burden of esophageal cancer attributable to high BMI in China and the United States from 1990 to 2019.Joinpoint regression analysis was conducted to analyze long-term trends.Bayesian age–period–cohort analysis was used to predict age-standardized mortality attributable to esophageal cancer in 2020–2030.Results From 1990 to 2019,the age-standardized mortality rate for esophageal cancer attributable to high BMI in China increased from 1.44/10^(5) to 1.80/10^(5) and the age-standardized DALY rate increased from 34.17/10^(5) to 40.79/105.From the perspective of gender,the number of deaths,DALYs,and the corresponding age-standardized rate of males in China and the United States increased from 1990 to 2019.The age-standardized mortality and DALY rates of Chinese women showed a downward trend,decreasing by 21.36/105 and 29.71/10^(5),respectively.Joinpoint analysis results revealed that the average annual percentage changes(AAPCs)in mortality attributable to esophageal cancer in the total population and men in China from 1990 to 2019 increased by 0.78%(95%CI:0.71-0.84)and 1.52%(95%CI:1.44-1.60),respectively,and that in females decreased by 0.88%(95%CI:−0.96-−0.80).AAPC in women in the United States rose at a slow rate of 0.07%(95%CI:0.02-0.09).The burden of esophageal cancer deaths attributable to high BMI is predicted to continue to rise in China and the United States in 2020–2030.Conclusion The disease burden of esophageal cancer attributable to high BMI significantly increased in China from 1990 to 2019.The disease burden of esophageal cancer caused by high BMI in China is expected to increase from 2020 to 2030.