1990—2019年中国归因于烟草的食管癌疾病负担趋势和死亡预测分析  

Analysis of the Disease Burden Trends and Death Projections for Esophageal Cancer Attributable to Tobacco in China from 1990 to 2019

作　　者：刘爱玲 周静静 李成程 贺凯玥 梁珊珊 周尚成 LIU Ailing;ZHOU Jingjing;LI Chengcheng;HE Kaiyue;LIANG Shanshan;ZHOU Shangcheng(School of Public Health and Management,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]广州中医药大学公共卫生与管理学院,广东省广州市510006

出　　处：《中国全科医学》2023年第36期4587-4594,4601,共9页Chinese General Practice

基　　金：国家自然科学基金资助项目(71774049,81973979);广东省社科基金项目(GD19CSH04);广东省自然科学基金项目(2019A1515011496)。

摘　　要：背景我国食管癌疾病负担较重,越来越多的研究显示,烟草对食管癌的发病有较大的不利影响。目的了解1990—2019年我国归因于烟草的食管癌死亡情况和疾病负担趋势,为公共卫生政策和干预措施的制定提供数据参考。方法本研究使用全球疾病负担(GBD)2019数据,提取其中中国1990—2019年由烟草引起的食管癌死亡的分年龄段、性别的数据。采用死亡率、伤残调整寿命年(DALYs)、早死寿命损失年(YLLs)、伤残寿命损失年(YLDs)指标评估中国归因于烟草的食管癌的疾病负担情况。应用Joinpoint回归软件和年龄-时期-队列模型方法分析疾病负担趋势和死亡率随年龄、时期和队列的时间变化趋势,最后运用贝叶斯年龄-时期-队列分析(BAPC)对2020—2030年中国归因于烟草的食管癌的死亡率进行预测。结果1990—2019年,中国居民归因于烟草的食管癌所导致的死亡人数由7.64万例上升为12.39万例,增长了62.17%,标化死亡率由9.30/10万逐年下降至6.20/10万,下降了33.33%;DALYs由197.25万人年上升至282.26万人年,增长了43.10%,DALYs率由220.50/10万下降至134.47/10万,下降了39.02%。从性别上看,归因于烟草的食管癌的疾病负担主要由男性造成,2019年因为烟草所致的食管癌导致男性的死亡人数为11.77万例,标化死亡率为12.82/10万,女性的死亡人数为0.62万例,标化死亡率为0.63/10万。2019年,中国居民归因于烟草的食管癌死亡人数在>69~74岁年龄组达到顶峰,而DALYs在>64~69岁年龄组达到顶峰,分别是2.30万例和51.03万例。死亡率随着年龄的增加不断增加,尤其是50岁以后增长迅速。Joinpoint回归分析结果显示,1990—2019年中国归因于烟草的食管癌死亡率的平均年度变化百分比(AAPC)值为-1.4%[95%CI(-1.6%,-1.2%)],其中女性为-3.3%[95%CI(-3.6%,-2.9%)],男性为-1.3%[95%CI(-1.4%,-1.1%)];DALYs率的AAPC为-1.7%[95%CI(-1.9%,-1.5%)],其中女性为-3.7%[95%CI(-4.0%,-3.4%)],男�Background The disease burden of esophageal cancer is high in China,more and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer.Objective To understand trends in esophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019,and provide data to inform the development of public health policies and interventions.Methods Global burden of disease 2019(GBD 2019)data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019.Mortality,disability adjusted life years(DALYs),years of life lost(YLLs),and disability adjusted life years(YLDs)were used to assess the disease burden of esophageal cancer attributable to tobacco in China.Joinpoint regression software and age-period-cohort modeling methods were applied to analyze the trends of disease burden and mortality with age,period and cohort.the Bayesian-period-cohort analysis(BAPC)was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030.Results From 1990 to 2019,the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76400 to 123900,with an increase of 62.17%,and the standardized mortality rate declined from 9.30/100000 to 6.20/100000,with a decrease of 33.33%;the DALYs rose from 1972500 person-years to 2822600 person-years,with an increase of 43.10%,and the DALYs rate decreased from 220.50/100000 to 134.47/100000,with a decrease of 39.02%.In terms of gender,the disease burden of esophageal cancer attributable to tobacco was mainly caused by males,with 117700 deaths and a standardized mortality rate of 12.82/100000 in 2019 due to tobacco-attributable esophageal cancer in males,compared to 0.62 million deaths number and a standardized mortality rate of 0.63/100000 in females.In 2019,the number of esophageal cancer deaths attributable to tobacco among Chinese residents peaked in the age group of>69-74

关 键 词：食管癌 吸烟 死亡率 伤残调整寿命年 疾病负担 贝叶斯年龄-时期-队列分析 

分 类 号：R735.1[医药卫生—肿瘤]