1990-2021年东亚五国归因于吸烟和高空腹血糖的膀胱癌疾病负担分析  

Analysis of the disease burden of bladder cancer attributed to smoking and high fasting blood glucose in five East Asian countries from 1990 to 2021

作　　者：张洁[1] 路孟鑫 文峻 栾航航 何韶华 訾豪 覃丽虹 罗丽莎 ZHANG Jie;LU Mengxin;WEN Jun;LUAN Hanghang;HE Shaohua;ZI Hao;QIN Lihong;LUO Lisha(Department of Retirement Affairs,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Urology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Academic Discipline and Research Platform Development Office,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Forensic Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Precision Medicine Center,The Second People's Hospital of Huaihua,Huaihua 418000,Hunan Province,China;Evidence-Based Medicine Center,Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine,Xiangyang 441000,Hubei Province,China;Wound&Stoma Diagnosis and Treatment Center,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Center for Evidence-Based and Translational Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院离退休工作处,武汉430071 [2]武汉大学中南医院泌尿外科,武汉430071 [3]武汉大学中南医院学科与平台建设办公室,武汉430071 [4]武汉大学中南医院法医司法鉴定所,武汉430071 [5]湖南怀化市第二人民医院精准医学中心,湖南怀化418000 [6]湖北医药学院附属襄阳市第一人民医院循证医学中心,湖北襄阳441000 [7]武汉大学中南医院创面造口诊疗中心,武汉430071 [8]武汉大学中南医院循证与转化医学中心,武汉430071

出　　处：《医学新知》2024年第11期1199-1209,共11页New Medicine

基　　金：国家自然科学基金青年科学基金项目(82103609)。

摘　　要：目的研究1990—2021年东亚五个国家归因于吸烟和高空腹血糖的膀胱癌疾病负担,为制定膀胱癌防控政策提供科学依据。方法数据来源于2021年全球疾病负担研究,基于死亡和伤残调整寿命年(disability-adjusted life years,DALYs)指标采用Joinpoint回归模型评估归因负担的时间变化趋势,年龄-时期-队列(age-period-cohort,APC)模型评估归因负担年龄、时期和出生队列的独立效应。结果2021年中国归因于吸烟的膀胱癌疾病负担最高,日本归因于高空腹血糖的疾病负担最高。1990—2021年东亚五国的吸烟归因负担均呈现下降趋势(AAPC<0),其中韩国下降幅度最大(死亡率AAPC=-1.87%,DALY率AAPC为-2.29%);中国因高空腹血糖所致的膀胱癌疾病负担呈下降趋势(AAPC<0),而朝鲜仍在上升(AAPC>0)。APC结果显示吸烟和高空腹血糖归因率的年龄效应均呈上升趋势,80岁以上年龄组最高;东亚五国吸烟归因率的出生队列效应均呈下降趋势,高空腹血糖归因率除朝鲜外也呈下降趋势。结论吸烟和高空腹血糖是东亚五国膀胱癌疾病负担重要的独立危险因素,尤其在中国和日本。年龄是导致膀胱癌归因负担上升的主要原因,老年群体是其高风险人群,未来应针对高危人群制定相应的防控措施,提高居民对吸烟相关膀胱癌的认知度,有效降低糖尿病发生率,从而减少膀胱癌疾病负担。Objective To study the disease burden of bladder cancer attributed to smoking and high fasting blood glucose(HFBG)among five East Asian countries from 1990 to 2021,providing a scientific basis for formulating bladder cancer prevention and control policies.Methods Data were sourced from the 2021 Global Burden of Disease study.The Joinpoint regression model was used to assess the temporal trends,and the age-period-cohort(APC)model was employed to evaluate the independent effects of age,period,and birth cohort on attributable burden.Results In 2021,China had the highest burden of bladder cancer attributed to smoking,while Japan had the highest burden attributed to HFBG.From 1990 to 2021,the smoking-attributed burden in the five East Asian countries showed declining trends(AAPC<0),with the largest decrease in South Korea(mortality rate-AAPC=-1.87%,DALY rate-AAPC=-2.29%).HFBG-attributed burden in China showed a declining trend(AAPC<0),whereas it exhibited increasing trends in North Korea(AAPC>0).APC results indicated that the age effects of both smoking and HFBG showed upward trends,peaking in the age group of 80 and above;the birth cohort effects for smoking-attributed rates in the five East Asian countries showed declining trends,while HFBG-attributed rates showed declining trends in all countries except North Korea.Conclusion Smoking and HFBG are significant independent risk factors for bladder cancer in the five East Asian countries,especially in China and Japan.Age is the main reason for the rising bladder cancer attributed burden,with the elderly being a high-risk population.Future prevention and control measures should target high-risk groups,improve residents’awareness of smoking-related bladder cancer,and effectively reduce the incidence of diabetes to decrease the disease burden of bladder cancer.

关 键 词：膀胱癌 吸烟 高空腹血糖 趋势 疾病负担 

分 类 号：R737.14[医药卫生—肿瘤]