1990-2021年中国居民结直肠癌疾病负担变化趋势及预测  

Variation Tendency and Prediction of Colorectal Cancer Burden Among Chinese Population from 1990 to 2021

作　　者：王㠉州 朱娟芳[2] 周瑾[2] 张盼 唐琴 WANG Tongzhou;ZHU Juanfang;ZHOU Jin;ZHANG Pan;TANG Qin(Hospital Quality Management Office,Jiangsu Cancer Hospital(Cancer Hospital Affiliated to Nanjing Medical University/Jiangsu Cancer Center),Nanjing 210000,China;Department of Public Health,Jiangsu Cancer Hospital(Cancer Hospital Affiliated to Nanjing Medical University/Jiangsu Cancer Center),Nanjing 210000,China;Sichuan Center for Disease Control and Prevention,National Institute of Health Education,Chengdu 610041,China)

机构地区：[1]江苏省肿瘤医院(南京医科大学附属肿瘤医院/江苏省癌症中心)医院质量管理办公室,南京210000 [2]江苏省肿瘤医院(南京医科大学附属肿瘤医院/江苏省癌症中心)公共卫生科,南京210000 [3]四川省疾病预防控制中心,健康教育所,成都610041

出　　处：《肿瘤防治研究》2025年第4期319-323,共5页Cancer Research on Prevention and Treatment

基　　金：江苏省老年健康科研项目(LKM2023009);江苏省肿瘤医院卓越管理计划(ZG202008)。

摘　　要：目的分析中国居民1990—2021年结直肠癌(CRC)疾病负担现状与趋势。方法收集1990—2021年全球疾病负担数据库中国、亚洲和全球居民结直肠癌疾病负担的相关数据进行描述性分析,利用年龄-时期-队列模型估算年龄、时期和队列对结直肠癌死亡所产生的影响,并预测疾病负担变化趋势。结果2021年中国CRC年龄标化死亡率、患病率和DALY率均高于全球和亚洲地区,1990—2021年年估计变化百分比分别为−0.49%(95%CI:−0.55%~−0.43%)、3.17%(95%CI:3.03%~3.31%)和−0.62%(95%CI:−0.71%~−0.54%)。高社会人口学指数(SDI)和中高SDI地区CRC标化死亡率、标化DALY率降幅明显,但仍高于全球其他地区。中国人群、男性和女性人群CRC死亡率随年龄增长呈上升趋势,且男性结直肠癌死亡率增长逐渐大于女性。以2002—2006年时期组为对照组(RR=1),女性CRC死亡风险的时期效应在2004年前高于男性和总人群,此后呈明显下降趋势。以1957年出生队列组为对照组(RR=1),中国人群、男性和女性CRC死亡风险的队列效应随出生队列的推移总体均呈下降趋势。预测结果显示,2035年中国居民CRC标化患病率为267.21/10万,标化死亡率为12.29/10万。结论1990—2021年中国CRC年龄标化死亡率和DALY率整体均呈下降趋势,标化患病率呈增长趋势,提示政府需构建全方位、多层次的CRC防控网络。Objective To examine the current status and trends of colorectal cancer(CRC)burden among Chinese residents from 1990 to 2021.Methods Data on CRC burden in China,Asia,and the global population from 1990 to 2021 were retrieved from the Global Burden of Disease database for descriptive analysis.An age-period-cohort model was employed to estimate the effects of age,period,and cohort on CRC mortality and to forecast changes in disease burden.Results In 2021,China’s age-standardized mortality rate,prevalence rate,and DALY rate for CRC were higher than global and Asian averages.The estimated annual percentage changes(EAPC)from 1990 to 2021 were−0.49%(95%CI:−0.55%to−0.43%)for mortality,3.17%(95%CI:3.03%−3.31%)for prevalence,and−0.62%(95%CI:−0.71%to−0.54%)for DALYs.Areas with high and medium-high sociodemographic indexes(SDIs)showed significant decreases in standardized mortality and DALY rates,but these rates remained higher compared with other regions.CRC mortality increased with age in the Chinese population,more prominently in males than in females.Using the 2002–2006 period as a reference(RR=1),the period effect on CRC mortality risk for women was higher than that for men until 2004,after which it declined considerably.With the 1957 birth cohort as a reference(RR=1),CRC mortality risk generally decreased across subsequent birth cohorts.Predictions indicate that by 2035,the standardized prevalence rate will be 267.21 per 100000,and the standardized mortality rate will be 12.29 per 100000.Conclusion From 1990 to 2021,China’s age-standardized CRC mortality and DALY rates have decreased,while the standardized prevalence rate has increased.These findings suggest the government to establish a comprehensive multi-level CRC prevention network.

关 键 词：结直肠癌 中国居民 疾病负担 预测 

分 类 号：R735.34[医药卫生—肿瘤]