基于GBD数据分析2000—2021年中国人群胃癌所致伤残调整寿命年负担趋势

Trend Analysis of Disability-Adjusted Life Years for Gastric Cancer in China Based on GBD Data from 2000 to 2021

[目的]分析2000—2021年中国人群胃癌所致伤残调整寿命年(disability-adjusted life years,DALY)的现况与趋势,并开展国际比较分析。[方法]基于2021年全球疾病负担研究(GBD 2021)数据库提取胃癌DALY数据,描述2021年中国胃癌所致DALY数和标化率及其2000—2021年趋势变化,并采用年龄-时期-队列(age-period-cohort,APC)模型评估并比较中国、全球、日本、韩国、美国2000—2021年DALY率的平均年度变化百分比(average annual percentage change,AAPC)。以2000年中国胃癌DALY为基准参照,采用因素分解法计算中国2001—2021年归因于人口老龄化、人口数量增长和年龄别率的胃癌DALY数和比例。[结果]2021年中国胃癌所致DALY总数为1064.21万人年,占全球胃癌DALY负担的46.70%,占我国全部癌种DALY负担的14.94%,其中65岁及以上人群占49.97%。2000—2021年,我国胃癌所致DALY总数降低4.59%,标化率从959.29/10万降低至501.26/10万,降幅与日本相近、大于全球和美国,但小于韩国,我国、日本、全球、美国和韩国标化DALY率AAPC分别为-3.58%、-3.72%、-2.79%、-1.48%和-5.04%。2000—2021年间,中国胃癌年龄别DALY率下降和人口老龄化的归因占比快速上升,所致胃癌DALY归因数分别为-760.41万人年和494.56万人年,归因比例分别为-14.84%和9.65%。[结论]20年来我国胃癌所致DALY负担整体呈现下降趋势。我国人口老龄化所致胃癌DALY负担持续加重,且已经成为我国胃癌DALY增长的首位驱动因素。应稳步扩大胃癌筛查的人群覆盖率,并强化人口老龄化的干预措施。

[Purpose]To estimate the trends in disability-adjusted life years(DALY)caused by gastric cancer(GC)in China from 2000 to 2021.[Methods]Using data from Global Burden of Disease 2021,the DALY and age-standardized DALY rates of gastric cancer from 2000 to 2021in the Chinese population were analyzed.An age-period-cohort model was used to evaluate the average annual percentage change(AAPC)in DALY rates from 2000 to 2021 in China,and to compare with those in the world,Japan,Korea,and the United States of America.We analyzed the changes in GC DALYs associated with population aging,population growth,and age-specific DALY rates from 2001 to 2021 using a decomposition method,by taking data in 2000 as a reference.[Results]In 2021,GC DALY in the Chinese population were 1064.21×104person-years,accounting for 46.70%of the global GC DALY and 14.94%of all cancers DALY in China.The DALY in those aged≥65 years old accounted for 49.97%.From 2000 to 2021,the total GC DALY in the Chinese population decreased by 4.59%,and the age-standardized rate decreased from 959.29/105to 501.26/105.From 2000 to 2021,similar decreased trends were observed in China and Japan,with AAPC being-3.58%and-3.72%,respectively.A higher decreased trend was observed in Korea,whereas relatively modest decreased trends were observed in the global levels and in the United States of America,with AAPC being-5.04%,-2.79%,and-1.48%,respectively.From 2000 to 2021,age-specific DALY rates and population aging accounted for the largest decrease and increase in GC DALY.The changes in GC DALY attributed to these two factors were-14.84%(-760.41×104person-years)and 9.65%(494.56×104person-years),respectively.[Conclusion]The disease burden of GC in China decreased in the past 20 years.GC DALYs attributed to rapidly increased population aging,and population aging has become the first driving factor for the DALY increase in China.The coverage of GC screening population and the intervention measures of population aging should be strengthened.