1990—2021年中国归因于饮酒的肝癌疾病负担变化趋势及预测  

Trends and forecasts of changes in burden of liver cancer attributable to alcohol consumption in China from 1990 to 2021

作　　者：徐慧慧 戴敏 Xu Huihui;Dai Min(International Center for Health Care,Shanghai First People's Hospital,Shanghai 200080,China;Department of Gynecology,Shanghai First People's Hospital,Shanghai 200080,China)

机构地区：[1]上海市第一人民医院国际医疗保健中心,上海200080 [2]上海市第一人民医院妇科,上海200080

出　　处：《实用肿瘤杂志》2025年第2期105-113,共9页Journal of Practical Oncology

摘　　要：目的分析1990—2021年中国归因于饮酒的肝癌疾病负担变化趋势,以及年龄、时期和队列因素对其的影响,并对2022—2030年的疾病负担进行预测。方法基于全球疾病负担(Global Burden of Disease,GBD)2021数据库中1990—2021年间中国成年人群归因于饮酒的肝癌疾病负担数据,运用Joinpoint回归方法分析发展趋势的转折点,并计算年龄标化(简称标化)发病率和标化死亡率的年变化百分比(annual percentage change,APC)、估计APC(estimated APC,EAPC)和平均APC(average APC,AAPC)。通过年龄-时期-队列(age-period-cohort,APC)模型估算中国归因于饮酒的肝癌发生率和死亡率的年龄、时期和队列效应。采用整合移动平均自回归(Autoregressive Integrated Moving Average,ARIMA)模型预测2022—2030年的疾病负担。结果在1990—2021年间,中国因饮酒导致的肝癌发病和死亡负担呈显著增长趋势。发病例数从0.75万例增至2.05万例,发病率从0.64/10万增至1.44/10万,标化发病率从0.84/10万升至0.94/10万(AAPC=0.36%,P<0.01)。死亡例数从0.76万例增至1.83万例,死亡率从0.64/10万增至1.29/10万,标化死亡率从0.87/10万降至0.85/10万(AAPC=-0.02%,P=0.931)。Joinpoint回归结果显示,男性标化发病率和标化死亡率均高于女性。APC模型分析显示,肝癌发病和死亡风险随年龄增长呈现先升后降的单峰分布趋势,随时期发展呈递增趋势,随出生队列推移总体呈现下降趋势。ARIMA预测分析表明,2022—2030年间,肝癌发病例数、死亡例数、发病率和死亡率将继续增加,而标化发病率和标化死亡率将趋于稳定。结论1990—2021年,中国归因于饮酒的肝癌的疾病负担呈增长趋势,男性疾病负担重于女性。发病和死亡风险随年龄增长先升后降,随时期发展而升高,随出生队列发展呈下降趋势。未来中国归因于饮酒的肝癌疾病负担将持续沉重。Objective To analyse the trends in the burden of liver cancer attributable to alcohol consumption and the effects of age,period,and cohort factors on it in China from 1990 to 2021,and to project the burden of disease from 2022 to 2030.Methods The data of the burden of liver cancer attributable to alcohol consumption in Chinese adult population during the period 1990-2021 were extracted from the Global Burden of Disease(GBD)2021 database,and Joinpoint regression was used to analyse the turning points of the development trend,and calculate age-standardised incidence rates(ASIRs),age-standardised death rates(ASDRs),and their annual percentage changes(APCs),estimated APCs(EAPCs),and average APCs(AAPCs).Age,period,and cohort effects on the incidence and mortality of liver cancer attributable to alcohol consumption in China were estimated by the age-period-cohort(APC)model.Autoregressive Integrated Moving Average(ARIMA)model was used to predict the burden of disease in 2022-2030.Results Between 1990 and 2021,the incidence and mortality burden of liver cancer due to alcohol consumption in China showed a significantly increasing trend.The number of incident cases increased from 7500 to 20500,the incidence rate increased from 0.64/10^(5) to 1.44/10^(5),the ASIR increased from 0.84/10^(5) to 0.94/10^(5)(AAPC=0.36%,P<0.01),the number of deaths increased from 7600 to 18300,the mortality rate increased from 0.64/10^(5) to 1.29/10^(5),and the ASDR decreased from 0.87/10^(5) to 0.85/10^(5)(AAPC=-0.02%,P=0.931).Joinpoint regression analysis showed that the ASIR and ASDR of males were significantly higher than those of females.The APC model showed that the risk of the incidence and mortality of liver cancer showed a trend of single-peak distribution that firstly rose and then declined with the age,an increasing trend with the development of period,and an overall decreasing trend with birth cohort progression.ARIMA projection analysis showed that the number of incident cases,deaths,incidence rate,and mortality rate of liver cancer

关 键 词：肝癌 饮酒 疾病负担 全球疾病负担 

分 类 号：R73[医药卫生—肿瘤]