1990-2019年中国宫颈癌和卵巢癌疾病负担趋势及预测研究

Trend and prediction of disease burden of cervical cancer and ovarian cancer in China from 1990 to 2019

目的分析1990-2019年我国宫颈癌和卵巢癌的疾病负担及变化趋势,并预测2020-2030年宫颈癌和卵巢癌的发病率和死亡率。方法采用2019年全球疾病负担数据库(GBD)提取宫颈癌和卵巢癌发病率、标化发病率、死亡率、标化死亡率、伤残调整寿命年(DALY)、伤残损失寿命年(YLD)和过早死亡损失寿命年(YLL)等指标,通过Joinpoint回归分析1990-2019年宫颈癌和卵巢癌的平均年度变化百分比(AAPC)变化趋势。采用灰色预测模型预测2020-2030年中国宫颈癌和卵巢癌发病率和死亡率。结果1990-2019年,中国宫颈癌发病人数从4.07万人增至10.98万人,相对增长了168.78%;死亡人数从2.64万人增至5.34万人,相对增长了102.27%。卵巢癌发病人数从1.27万人增至4.55万人,相对增长了258.27%;死亡人数从0.8万人增至2.91万人,相对增长了263.75%。中国宫颈癌标化发病率(AAPC=0.95%,P<0.001)、卵巢癌标化发病率(AAPC=2.03%,P<0.001)和标化死亡率(AAPC=1.58%,P<0.001)均呈上升趋势,宫颈癌标化死亡率(AAPC=-0.45%,P<0.001)呈下降趋势。2019年宫颈癌和卵巢癌的DALY、YLL都随着年龄增加而升高,均在50~54岁时达到顶峰,YLL和YLD都有不同程度增长,2019年宫颈癌和卵巢癌的标化YLD率也分别增长了61.51%和89.31%。灰色预测模型结果显示,预计到2030年,中国宫颈癌发病率和死亡率将分别为20.58/10万和9.69/10万,卵巢癌发病率和死亡率将分别为9.47/10万和6.29/10万。结论1990-2019年我国宫颈癌和卵巢癌的疾病负担仍然较重,预计2020-2030年中国宫颈癌和卵巢癌的发病率和死亡率仍呈上升趋势。应加强对高危人群(尤其是50岁以上妇女)的筛查工作,早发现、早诊断、早治疗,加强对中老年女性的健康宣教,提高女性自我预防意识和主动筛查意识。

Objective To analyze the disease burden and trends of cervical cancer and ovarian cancer in China from 1990 to2019,and to predict the incidence and mortality rates of cervical cancer and ovarian cancer from 2020 to 2030.Methods The incidence,age-standardized incidence rate,mortality,age-standardized mortality rate,disability adjusted life year(DALY),years of life lost(YLL)and years lived with disability(YLD)of cervical cancer and ovarian cancer were extracted from the 2019 global burden of disease(GBD)database.The trend of the average annual percentage change(AAPC)for cervical cancer and ovarian cancer from 1990 to 2019 was analyzed by Joinpoint regression.The grey prediction model was used to predict the incidence and mortality of cervical cancer and ovarian cancer in China from 2020 to 2030.Results From1990 to 2019,the number of incidence of cervical cancer in China increased from 40700 to 109800,a relative increase of168.78%;the number of mortality increased from 26400 to 53400,a relative increase of 102.27%;the number of incidence of ovarian cancer increased from 12700 to 45500,a relative increase of 258.27%;the number of mortality increased from 8000 to 29100,a relative increase of 263.75%.The number of ovarian cancer cases increased from 12700 to45500,a relative increase of 258.27%;the number of deaths increased from 8000 to 29100,a relative increase of263.75%.In China,the age-standardized incidence rate of cervical cancer(AAPC=0.95%,P<0.001),the age-standardized incidence rate of ovarian cancer(AAPC=2.03%,P<0.001)and age-standardized mortality rate of ovarian cancer(AAPC=1.58%,P<0.001)showed an increasing trend,while the standardized mortality of cervical cancer(AAPC=-0.45%,P<0.001)showed a decreasing trend.In 2019,the DALY and YLL of cervical cancer and ovarian cancer increased with age,and reached the peak at 50-54 years old.YLL and YLD both increased to some degree,and the agestandardized YLD rate increased by 61.51%and 89.31%respectively in 2019.The results of grey prediction model show that by 2030,the incidence and mortality of cervical cancer in China will be 20.58/100000 and 9.69/100000 respectively,and the incidence and mortality of ovarian cancer will be 9.47/100000 and 6.29/100000,respectively.Conclusion The disease burden of cervical cancer and ovarian cancer in China remained heavy from 1990 to 2019,and it is expected that the incidence and mortality of cervical cancer and ovarian cancer in China will continue to rise from 2020 to 2030.Screening of high-risk groups(especially women over 50 years old)should be strengthened,early detection,early diagnosis and early treatment,health education for middle-aged and elderly women should be strengthened,and women's awareness of self-prevention and proactive screening should be enhanced.