1990—2021年吸烟对中国≥55岁居民胃癌疾病负担的影响及趋势分析  

Impact of smoking on gastric cancer burden and trends among Chinese adults aged 55 and above from 1990 to 2021:A GBD analysis

作　　者：牛省利 刘博伟 NIU Shengli;LIU Bowei(The First People's Hospital,Pingdings han,Henan 467000,China;Henan Provincial People's Hospital,People's Hospital of Zhengzhou University)

机构地区：[1]河南省平顶山市第一人民医院消化内科,河南平顶山467000 [2]河南省人民医院,郑州大学人民医院消化内科

出　　处：《现代疾病预防控制》2025年第2期110-115,119,共7页MODERN DISEASE CONTROL AND PREVENTION

基　　金：河南省医学科技攻关计划省部共建重点项目(SBGJ202102042)。

摘　　要：目的 分析1990—2021年中国≥55岁居民吸烟所致胃癌疾病负担及其趋势,探讨胃癌高危人群控烟策略。方法使用2021年全球疾病负担研究(GBD 2021)数据,采用Joinpoint回归模型,估算平均年度变化百分比(AAPC)和年度变化百分比(APC),分析我国1990—2021年≥55岁居民吸烟所致胃癌死亡和伤残调整寿命年数(DALYs)及其率值。结果 我国≥55岁胃癌归因于吸烟的死亡数和DALYs自1990年的40 654人(占同期同年龄段胃癌总死亡数的14.22%)和979 840人年(占同期同年龄段胃癌总DALYs的14.45%)增加至2021年的58 386人(占同期总死亡数的15.10%)和1 244 823人年(占同年我国≥55岁胃癌总DALYs的15.41%)。死亡率和DALYs率自1990年的28.33/10万和682.73/10万下降至2021年的15.41/10万和328.49/10万。趋势分析发现,我国≥55岁居民吸烟所致胃癌DALYs率平均每年下降2.26%(Z=-43.20,P<0.05),男性平均每年下降2.09%(Z=-40.37,P<0.05)。≥55岁老年人DALYs率均呈下降趋势(P均<0.05),70~<75岁组老人疾病负担水平最高(AAPC=-1.87%,P<0.05),≥85岁老人下降速度较慢(AAPC=-0.70%,P<0.05);我国≥55岁居民吸烟所致胃癌疾病负担高于全球、高、中高、中等、中低、低社会人口指数(SDI)国家或地区水平,且下降速度仅高于中等和中低SDI国家或地区(下降速度分别为中国2.26%,全球2.69%,高SDI 4.11%,中高SDI 2.35%,中等SDI 1.77%,中低SDI 1.78%,低SDI 2.58%)。结论 1990—2021年中国居民吸烟所致胃癌疾病负担水平较高,且有年龄与性别差异,对70~<75岁老年男性开展控烟干预,有助于实现健康老龄化和降低胃癌疾病负担。Objective To analyze the burden and trends of gastric cancer attributed to smoking among individuals aged 55 and above in China, with the aim of informing smoking control strategies for high-risk gastric cancer populations.Methods Utilizing data from the Global Burden of Disease 2021(GBD 2021), Joinpoint regression model was applied to assess the average annual percentage changes(AAPC) and annual percentage changes(APC) in smoking-attributed gastric cancer deaths and disability-adjusted life years(DALYs) among individuals aged 55 and above in China from 1990 to 2021. Results The number of gastric cancer deaths and DALYs attributed to smoking in individuals aged 55 and above increased from 40 654(14.22% of total gastric cancer deaths in the same age group) and 979 840 person-years(14.45% of total gastric cancer DALYs) in 1990 to 58 386(15.10%) and 1 244 823 person-years(15.41%) in 2021. The mortality and DALYs rates have decreased from 28.33/100 000 and682.73/100 000 in 1990 to 15.41/100 000 and 328.49/100 000 in 2021, respectively. Trend analysis revealed a 2.26%(Z=-43.20,P <0.05)annual decrease in the DALY rate for smoking-attributed gastric cancer among individuals aged 55 and above, with a2.09%(Z=-40.37,P<0.05)in males. While the DALY rate showed a downward trend across all age groups(all P<0.05), the70-<75 age group had the highest disease burden(AAPC=-1.87%, P<0.05), and the decline was slower in those aged 85 and above(AAPC=-0.70%, P<0.05). Compared to global and other SDI countries or regions, China′s burden was higher, with a decline rate only exceeding that of mediumand low SDI countries or regions(China 2.26% vs global 2.69%, high SDI 4.11%, medium high SDI 2.35%, medium SDI 1.77%, medium low SDI 1.78%, and low SDI 2.58%). Conclusions The burden of gastric cancer due to smoking among Chinese individuals is relatively high, with significant age and gender differences. Targeted smoking control interventions for elderly males aged 70 to <75 could attribute healthy aging and reduce the gastric cancer burd

关 键 词：胃癌 疾病负担 伤残调整生命年 吸烟 生活方式 

分 类 号：R735.2[医药卫生—肿瘤]