1990―2019年中国归因于饮酒的肝癌疾病负担变化趋势分析

Analysis of the trend of changes in the liver cancer burden attributed to drinking in China from 1990 to 2019

目的分析1990—2019年中国归因于饮酒的肝癌疾病负担变化趋势。方法从2019年全球疾病负担数据库获取1990—2019年中国归因于饮酒的肝癌疾病负担数据,运用Joinpoint回归模型分析其疾病负担的时间变化趋势,并使用年龄-时期-队列模型评估年龄、时期和队列效应。结果1990—2019年中国总人口、男性和女性归因于饮酒的肝癌标化发病率均呈下降趋势,AAPC分别为−2.52%[95%CI(−2.83%,−2.21%)]、−3.26%[95%CI(−3.62%,−2.89%)]和−2.24%[95%CI(−2.61%,−1.86%)];标化死亡率均呈下降趋势,AAPC分别为−2.86%[95%CI(−3.46%,−2.26%)]、−3.48%[95%CI(−4.20%,−2.76%)]和−2.67%[95%CI(−2.99%,−2.34%)];标化DALY率均呈下降趋势,AAPC分别为−3.09%[95%CI(−3.65%,−2.53%)]、−2.92%[95%CI(−3.25%,−2.58%)]和−3.77%[95%CI(−4.21%,−3.31%)],趋势变化均有统计学意义(P<0.05)。1990—2019年中国总体、男性和女性归因于饮酒的肝癌发病和死亡风险随年龄增加均呈现先上升后下降趋势;随时期增加先均呈下降趋势,后总体和男性人群均呈上升趋势,而女性人群保持相对稳定;随队列的推移归因于饮酒的肝癌发病和死亡风险越低。结论中国归因于饮酒的肝癌标化发病率、死亡率和DALY率总体均呈下降趋势,应对男性和老年人群加强健康教育和早诊早治,降低肝癌疾病负担。

Objective To analyze the trend of changes in the burden of liver cancer diseases attributed to alcohol consumption in China from 1990 to 2019.Methods Data on liver cancer burden attributed to drinking in China from 1990 to 2019 were obtained from the global burden of disease 2019.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age-period-cohort model was used to evaluate age,period,and cohort effects.Results From 1990 to 2019,the standardized incidence rate of liver cancer attributable to drinking among the total population,men and women showed a downward trend.The AAPC was−2.52%(95%CI−2.83%to−2.21%),3.26%(95%CI−3.62%to−2.89%)and−2.24%(95%CI−2.61%to−1.86%),respectively;The standardized mortality rates showed a decreasing trend,with AAPC values of−2.86%(95%CI−3.46%to−2.26%),−3.48%(95%CI−4.20%to−2.76%),and−2.67%(95%CI−2.99%to−2.34%),respectively;The standardized DALY rates showed a downward trend,with AAPC values of−3.09%(95%CI−3.65%to−2.53%),−2.92%(95%CI−3.25%to−2.58%),and−3.77(95%CI−4.21%to−3.31%),respectively.The trend changes were statistically significant(P<0.05).From 1990 to 2019,the overall risk of liver cancer incidence and death attributed to drinking in China,both in males and females,showed a trend of first increasing and then decreasing with age;As the period increased,both the overall population and the male population showed a downward trend,followed by an upward trend,while the female population remained relatively stable;The lower the risk of liver cancer incidence and death attributed to drinking as the queue progressed.Conclusion The standardized incidence rate,mortality and DALY rates of liver cancer attributable to drinking in China are generally declining,we should strengthen health education and early diagnosis and treatment for both male and elderly people to reduce the burden of liver cancer.