1990-2019年中国鼻咽癌发病和死亡年龄-时期-队列分析及预测

Age period cohort analysis and prediction of nasopharyngeal carcinoma incidence and mortality in China from 1990 to 2019

目的分析1990-2019年中国鼻咽癌的发病和死亡变化,为制定相关防治策略提供数据支持。方法从全球疾病负担数据库(GBD2019)获取中国鼻咽癌发病和死亡数据,利用Joinpoint回归分析1990-2019年中国发病和死亡的趋势变化,采用年龄-时期-队列模型和内生因子法估计鼻咽癌发病和死亡风险的年龄、时期和队列效应,并使用贝叶斯年龄时期队列模型分析2020-2035年中国鼻咽癌的标化发病率和标化死亡率。结果2019年中国鼻咽癌发病率和标化发病率较1990年分别升高186.35%和70.69%,2019年死亡率和标化死亡率较1990年分别降低10.27%和50.69%,其中男性发病的相关指标均高于女性。1990-2019年鼻咽癌标化发病率呈现上升趋势,平均年度变化百分比(AAPC)为1.9%,其中男性AAPC为2.5%,女性AAPC为0.7%;鼻咽癌标化死亡率呈现下降趋势,AAPC为-2.5%,其中男性AAPC为-2.0%,女性AAPC为-3.7%。发病率的年龄-时期-队列模型结果显示,55~59岁年龄组发病风险最高,RR值为3.00,1990-2019年发病效应系数逐年升高,但随出生年份的后移逐渐降低。死亡率的年龄-时期-队列模型结果显示,死亡效应系数在5~89岁呈升高趋势,在85~89岁年龄组达到最高,死亡风险RR值为3.49,1990-2019年死亡效应呈下降趋势并随出生队列的推移逐渐下降。2020-2035年中国鼻咽癌的标化发病率呈现上升趋势,标化死亡率呈下降趋势。中国鼻咽癌归因于行为危险因素占比最高,其次为酒精和吸烟。结论1990-2019年中国鼻咽癌的标化发病率呈上升趋势,标化死亡率呈下降趋势,预测未来15年发病率仍将持续上升,根据我国人群鼻咽癌发病和死亡的相关特点,制定有针对性的措施,以期降低我国鼻咽癌造成的重大疾病负担。

Objective To analyzes the incidence and mortality changes of nasopharynx cancer in China from 1990 to 2019and provide data support for the formulation of related prevention and treatment strategies.Methods Data on the incidence and mortality of nasopharynx cancer in China were collected from the global burden of disease database(GBD2019).Joinpoint regression was used to analyze the trend changes of incidence and mortality in China from 1990 to 2019,age-period-cohort model and risk factor method were used to estimate the age,period and cohort effect of the risk of incidence and mortality of nasopharynx cancer,and Bayesian age period cohort model was used to analyze the standardized incidence and mortality of nasopharyngeal carcinoma in China from 2020 to 2035.Results Compared with 1990,the incidence and standardized incidence of nasopharynx cancer in China in 2019 increased by 186.35%and 70.69%,respectively,and the mortality rate and standardized mortality rate in 2019 decreased by 10.27%and 50.69%compared with 1990,respectively.Among which the relevant indicators of male incidence were higher than that of female.From 1990 to 2019,the standardized incidence of nasopharynx cancer showed an increasing trend,AAPC was 1.9%,of which AAPC was2.5%in men and 0.7%in women.The standardized mortality rate showed a downward trend,with AAPC being-2.5%:-2.0%for men and-3.7%for women.The age-period-cohort model of incidence showed that the risk of incidence was highest in the age group 55-59 years old,with an RR value of 3.00,and the effect coefficient of incidence increased year by year from 1990 to 2019,but gradually decreased with the backward shift of birth year.The results of the age-periodcohort model showed that the mortality effect coefficient increased in the 5-89 years and reached the highest in the 85-89 age group,and the RR value of mortality risk was 3.49,and the mortality effect decreased from 1990 to 2019 and gradually decreased with the passage of the birth cohort.From 2020 to 2035,the standardized incidence rate of nasopharynx cancer in China showed an upward trend,and the standardized mortality rate showed a downward trend.The proportion of nasopharynx cancer in China was attributed to behavioral risk,followed by alcohol and smoking.Conclusions From 1990to 2019,the standardized incidence rate of nasopharynx cancer in China shows an upward trend,while the standardized mortality rate shows a downward trend.It is predicted that the incidence rate will continue to increase in the next15 years,to formulate targeted measures to reduce the burden of nasopharynx cancer in our country.