1990至2019年海南省肝癌疾病负担变化趋势及其危险因素分析

Trend of disease burden and analysis of its risk factors of liver cancer in Hainan Province from 1990 to 2019

目的:分析海南省1990至2019年肝癌疾病负担的变化趋势及其危险因素归因情况。方法:根据2019年全球疾病负担(Global Burden of Disease,GBD)研究的海南省数据,利用Joinpoint回归模型分析1990至2019年海南省肝癌发病、死亡、伤残调整寿命年(disability-adjusted life year,DALY)的变化趋势,平均年度变化百分比(average annual percentage change,AAPC)用于描述年平均变化趋势,年度变化百分比(annual percentage change,APC)用于描述不同阶段时间变化趋势,归因DALY率用于描述危险因素归因情况。结果:1990至2019年海南省肝癌年龄标化发病率、年龄标化死亡率及年龄标化DALY率均呈下降趋势,分别下降了59.30%、61.21%和64.03%(P<0.001)。1990至2019年海南省40岁以下人群肝癌的年龄标化DALY率均较低,1990年的年龄标化DALY率的峰值出现在55~59岁年龄组,2019年后移至75~79岁年龄组。在1990至2019年期间,吸烟一直是海南省肝癌归因DALY率的主要危险因素,而在2019年,高BMI已经超越了药物使用因素,成为肝癌疾病负担的第三大危险因素。结论:海南省肝癌疾病负担总体呈下降趋势,峰值年龄段后移,吸烟、饮酒和高BMI仍是主要危险因素,应继续加强肝癌的早诊早治及危险因素干预等防控工作。

Objective:To analyze the trend of liver cancer disease burden and its risk factor attribution in Hainan Province from 1990 to 2019.Methods:Based on the data of Hainan Province from the Global Burden of Disease(GBD)2019 study,the trend of hepatocellular carcinoma incidence,death,and disability-adjusted life year(DALY)in Hainan Province from 1990-2019 was analyzed by using the Joinpoint regression model,and the average annual percentage change(AAPC)was used to describe the average annual trend,the annual percentage change(APC)was used to describe the trend of time change at different stages,and attributed DALY rate was used to describe risk factor attribution.Results:The age-standardized incidence rate,age-standardized mortality rate and age-standardized DALY rate of liver cancer in Hainan Province showed a decreasing trend from 1990 to 2019,which decreased by 59.30%,61.21%and 64.03%,respectively(P<0.001).The age-standardized DALY rates of hepatocellular carcinoma for people younger than 40 years old in Hainan Province from 1990 to 2019 were all lower,with the peak of age-standardized DALY rates occurring in the 55~59 age group in 1990 and moving back to the 75~79 age group in 2019.Smoking has been the main risk factor for attributed DALY rates of liver cancer in Hainan Province during 1990-2019,while high BMI has surpassed drug use factors as the third risk factor for liver cancer disease burden in 2019.Conclusion:The disease burden of liver cancer carcinoma in Hainan Province showed an overall decreasing trend,with the peak age group shifted backward,and smoking,alcohol consumption,and high BMI were still the main risk factors,and prevention and control efforts such as early diagnosis and treatment of liver cancer carcinoma as well as risk factor interventions should be continued to be strengthened.