1990-2019年中国结直肠癌发病与死亡趋势的APC模型分析

APC Model Analysis of Trends in Incidence and Mortality of Colorectal Cancer in China,1990-2019

目的评估1990-2019年中国结直肠癌发病与死亡趋势,为降低结直肠癌疾病负担提供科学依据。方法本研究采用年龄-时期-队列(age-period-cohort,APC)模型,分析2019年全球疾病负担(global burden of disease study,GBD2019)数据库中1990-2019年中国结直肠癌发病率和死亡率的数据。结果1990-2019年中国结直肠癌发病/死亡率总体呈现上升趋势。APC模型分析结果显示:我国结直肠癌的发病与死亡风险的年龄效应随着年龄的增长而增加。结直肠癌发病风险的队列效应总体呈上升趋势,死亡风险队列效应呈现先上升后下降趋势。结直肠癌发病风险的时期效应总体呈上升趋势,死亡风险的时期效应呈先下降后上升再下降趋势。结论由于年龄、时期和队列效应的影响,中国居民1990-2019年结直肠癌发病率和死亡率均呈上升趋势,且结直肠癌发病的风险在60~70年龄段增长速度最快。这提示我们,有必要加强结直肠癌相关健康教育,尤其是中老年群体的健康干预,进而预防结直肠癌的发生,减轻疾病给个人、家庭和社会带来的负担。

Objective To evaluate the incidence and mortality trends of colorectal cancer in China from 1990 to 2019,and to provide scientific evidence to reduce the disease burden of colorectal cancer.Methods We used an APC model to analyze the incidence and mortality of colorectal cancer in China from 1990 to 2019 in the Global Burden of Disease(GBD2019)database.Results From 1990 to 2019,the incidence and mortality of colorectal cancer in China showed an increasing trend.The results of APC model analysis showed that the age effect on the risk of morbidity and mortality of colorectal cancer increased with the increase of age.The cohort effect of colorectal cancer incidence was generally increasing,while the cohort effect of death risk was first increasing and then decreasing.The period effect of colorectal cancer incidence risk was generally increased,while the period effect of death risk was first decreased,then increased and then decreased.Conclusion Due to age,period and cohort effects,the incidence and mortality of colorectal cancer among Chinese residents increased from 1990 to 2019,and the risk of colorectal cancer increased fastest in the 60~70 age group.This suggests that it is necessary to strengthen health education related to colorectal cancer,especially health intervention for middle-aged and elderly groups,so as to prevent the occurrence of colorectal cancer and reduce the burden of the disease on individuals,families and society.