基于全球视角下的口腔癌疾病负担公平性分析  

Analysis of the inequalities of oral cancer burden from a global perspective

作　　者：罗丽莎 栾航航 邬兰[3] 黄娇 LUO Lisha;LUAN Hanghang;WU Lan;HUANG Jiao(Center for Evidence-Based and Translational Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Forensic Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Stomatology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院循证与转化医学中心,武汉430071 [2]武汉大学中南医院法医司法鉴定所,武汉430071 [3]武汉大学中南医院口腔科,武汉430071

出　　处：《医学新知》2024年第6期603-610,共8页New Medicine

基　　金：武汉大学中南医院优秀博士(后)项目(ZNYB2021044)。

摘　　要：目的研究1990—2019年由社会经济发展水平差异所致的全球口腔癌疾病负担不平等情况,为制定有效的预防和控制政策提供科学依据。方法本研究的疾病负担数据来源于2019年全球疾病负担研究,人类发展指数(human development index,HDI)来自于《2020年人类发展报告》,采用线性回归分析年龄标化的伤残调整寿命年(disability-adjusted life yeas,DALY)率与HDI的相关性,使用不平等斜率指数(slope index of inequality,SII)和集中指数(concentration index,CI)评价1990—2019年全球口腔癌疾病负担的不公平情况及发展趋势。结果本研究共纳入189个国家和地区,2019年口腔癌DALY率为46.61[IQR(30.70,64.97)],线性回归结果显示口腔癌DALY率与HDI水平呈显著负相关(ρ=-0.06,P<0.001)。口腔癌DALY负担在189个国家和地区间表现出显著的不平等性,2019年SII值为-107.16[95%CI(-127.60,-90.69)],1990—2019年SII值<0且绝对值呈上升趋势;2019年口腔癌CI值为-1.35[95%CI(-2.88,-1.01)],1990—2015年CI值>0且呈下降趋势,而2016—2019年CI值<0且绝对值呈上升趋势。结论1990—2019年全球口腔癌疾病负担存在明显的社会不公平现象,口腔癌疾病负担更集中在低社会经济发展水平国家,且随着时间变化呈现出加重趋势。因此,未来应注重发展中国家的医疗资源分配问题,采取更有针对性的措施,有效控制口腔癌疾病负担的不平等现状。Objective To investigate the inequalities of oral cancer burden caused by socioeconomic development differences in worldwide from 1990 to 2019,to provide scientific evidence for the development of effective prevention and control policies.Methods The burden of disease data for this study was derived from the 2019 Global Burden of Disease Study,and the human development index(HDI)were from the Human Development Report 2020.Linear regression analysis was used to assess the correlation between age-standardized disability-adjusted life year(DALY)rates and HDI.The slope index of inequality(SII)and concentration index(CI)were used to evaluate the inequalities and their trends of oral cancer burden from 1990 to 2019.Results A total of 189 countries and territories were included in this study.The DALY rate for oral cancer in 2019 was 46.61[IQR(30.70,64.97)].The linear regression results showed a significant negative correlation between DALY rate and HDI level(ρ=-0.06,P<0.001).The burden of oral cancer exhibited significant inequalities among the 189 countries and territories,with an SII value of-107.16[95%CI(-127.60,-90.69)]in 2019.From 1990 to 2019,the SII value was below 0 and showed an increasing trend.The CI of oral cancer in 2019 was-1.35[95%CI(-2.88,-1.01)],and from 1990 to 2015,the CI was above 0 and showed a decreasing trend,while from 2016 to 2019,the CI was below 0 and showed an increasing trend.Conclusion From 1990 to 2019,there is a strong socioeconomic inequality in the oral cancer burden globally,which is more concentrated in countries with low levels of socioeconomic development,and shows a trend of exacerbation over time.In the future,it is necessary to focus on the allocation of medical resources in developing countries and implement more targeted measures to effectively address the inequality of oral cancer burden.

关 键 词：口腔癌 伤残调整寿命年 人类发展指数 不平等斜率指数 集中指数 

分 类 号：R73[医药卫生—肿瘤]