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中国癌症防治杂志

中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (1): 68-73.doi: 10.3969/j.issn.1674-5671.2025.01.09

• 临床研究 • 上一篇    下一篇

2004—2021年中国胃癌死亡率的变化趋势及其疾病负担

  

  1. 南京中医药大学附属医院；南京中医药大学第一临床医学院
  • 出版日期:2025-02-25 发布日期:2025-03-06
  • 通讯作者: 江志伟 E?mail：surgery34@163.com
  • 基金资助:
    中国医药教育协会2022重大科学攻关课题（2022KTZ005）； 江苏省医学重点学科/实验室建设项目（ZDXK202251）

Trend of mortality and disease burden of gastric cancer in China,2004—2021

  • Online:2025-02-25 Published:2025-03-06

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摘要： 目的 分析1990—2021年中国归因于空腹高血糖的结直肠癌（colorectal cancer，CRC）的疾病负担情况，并预测2022—2036年的变化趋势，为中国CRC的预防提供依据。方法 从2021年全球疾病负担数据库提取相关数据，利用Joinpoint回归模型分析死亡数、年龄标化死亡率（age⁃standardized mortality rate，ASMR）、伤残调整寿命年（disability adjusted life years，DALYs）、年龄标化DALYs率（age⁃standardized DALYs rates，ASDR）的变化趋势。基于年龄⁃时期⁃队列模型探讨归因于空腹高血糖的CRC的年龄效应、时期效应和队列效应。采用自回归积分滑动平均（autoregressive integrated moving average，ARIMA）模型预测2022—2036年死亡例数、ASMR、ASDR的变化趋势。结果 与1990年相比，2021年中国归因于空腹高血糖的CRC死亡数、ASMR、DALYs、ASDR分别增长了192.88%、3.45%、162.27%、4.49%，ASMR平均每年上升0.25%，ASDR平均每年上升0.24%。男性疾病负担大于女性。年龄效应显示，中国归因于空腹高血糖的CRC死亡率在90~94岁年龄组达到峰值，DALYs率在85~89岁年龄组达到峰值；时期效应显示，死亡率的时期相对危险度（relative risk，RR）随着时间的增长呈先上升再小幅度波浪式变化趋势，DALYs率的时期RR随着时间的增长呈先上升后平稳再上升趋势；队列效应显示，死亡率和DALYs率的队列RR随着时间的增长均呈先下降再波动上升趋势。预测结果显示，2022—2036年中国归因于空腹高血糖的CRC死亡数从2021年的18 440例下降为2036年的5 144例，ASMR从2021年的0.90/10万下降为2036年的0.84/10万，ASDR从2021年的20.25/10万下降为2036年的18.85/10万。结论  1990—2021年中国归因于空腹高血糖的CRC死亡数、ASMR、DALYs、ASDR呈上升趋势，这一变化趋势一定程度上受到年龄、时期、队列效应的影响。未来需要加强对男性、老年等高危人群的血糖管理，注重对其进行CRC健康教育，以减轻疾病负担。

关键词: 结直肠癌, 空腹高血糖, 疾病负担, 年龄?时期?队列模型, 预测

Abstract: Objective To analyze the disease burden of colorectal cancer (CRC) attributed to fasting hyperglycemia in China from 1990 to 2021 and to project trends for the period 2022 to 2036, thereby providing a scientific basis for CRC prevention strategies in China. Methods Relevant data were extracted from the Global Burden of Disease 2021(GBD2021) database. The trend analysis of mortality, age⁃standardized mortality rate (ASMR), disability⁃adjusted life years (DALYs), and age⁃standardized DALYs rates (ASDR) were performed using the Joinpoint regression model. The age, period and cohort effects of CRC attributed to fasting hyperglycemia were examined using an age⁃period⁃cohort model. Additionally, the Autoregressive Integrated Moving Average (ARIMA) model was utilized to project trends in the disease cases, ASMR and ASDR from 2022 to 2036. Results Compared to 1990, the number of CRC deaths, ASMR, DALYs and ASDR attributable to fasting hyperglycemia in China in 2021 increased by 192.88%, 3.45%, 162.27%, and 4.49%, respectively, with an average annual increase of 0.25% for ASMR and 0.24% for ASDR. The disease burden was higher among males than females. The age effect revealed that the CRC mortality attributable to fasting hyperglycemia in China peaked in the 90-94 age group, while the DALYs rate peaked in the 85-89 age group. The period effect indicated that the period relative risk (RR) of mortality initially increased, followed by a slight wave⁃like trend over time, whereas the period RR of the DALYs rate initially increased, stabilized, and then rose again over time. The cohort effect demonstrated that the cohort RR for both mortality and DALYs rate initially decreased and then fluctuated upward over time. The predicted results indicated that the number of CRC deaths attributable to fasting hyperglycemia in China will decrease from 18,440 in 2021 to 5,144 in 2036. Similarly, the ASMR is projected to decline from 0.90/105 in 2021 to 0.84/105 in 2036. Additionally, the ASDR is expected to decrease from 20.25 /105 in 2021 to 18.85/105 in 2036. Conclusions The number of CRC deaths, ASMR, DALYs, and ASDR attributed to fasting hyperglycemia in China from 1990 to 2021 exhibited an increasing trend, partially influenced by age, period, and cohort effects. In the future, it is essential to strengthen glycemic control among high⁃risk groups, such as men and the elderly, and to prioritize CRC health education and awareness to reduce the disease burden.

Key words: Colorectal cancer, Fasting hyperglycemia, Disease burden, Age?period?cohort model, Prediction

中图分类号: 

  • R735.3