Disease burden of gastric cancer in Chinese population: a comparison between 1990 and 2017
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摘要:
目的 比较中国居民1990年与2017年胃癌的疾病负担,为胃癌的预防控制、健康管理以及制定相关卫生决策提供参考依据。 方法 收集2017年全球疾病负担研究(GBD 2017)中1990年和2017年中国居民胃癌疾病负担相关数据,采用过早死亡损失寿命年(YLL)、伤残损失健康寿命年(YLD)和伤残调整寿命年(DALY)等指标对1990年和2017年中国居民胃癌疾病负担的变化情况进行描述。 结果 中国居民2017年胃癌的YLL、YLD、标化YLD率和DALY分别为764.8万人年、16.7万人年、8.5/10万和781.5万人年,较1990年的734.0万人年、7.4万人年、8.4/10万和741.5万人年升高了4.2 %、125.7 %、1.2 %和5.4 %;胃癌的标化YLL率和标化DALY率分别由1990年的779.0/10万和787.3/10万下降至2017年的383.2/10万和391.7/10万,分别下降了50.8 %和50.3 %。与1990年相比,男性居民2017年胃癌的YLD升高了152.1 %,高于女性居民的76.9 %;标化YLL率和标化DALY率下降了46.4 %和45.8 %,均低于女性的58.5 %和58.0 %;YLL、标化YLD率和DALY分别升高了13.7 %、11.6 %和15.1 %,而女性则分别下降了12.7 %、19.0 %和11.9 %。与1990年相比,2017年 < 50岁各年龄组和55~59岁年龄组居民胃癌的DALY均有下降,其他年龄组居民胃癌的DALY均有升高,其中 ≥ 80岁年龄组居民的升幅最大(133.5 %);而各年龄组居民胃癌的标化DALY率则均有下降,其中20~24岁年龄组居民的降幅最大(75.7 %)。与1990年相比,2017年陕西地区居民胃癌的DALY升幅最大(86.2 %),西藏地区居民胃癌的DALY降幅最大(25.1 %);33个地区居民胃癌的标化DALY率均有下降,其中降幅最大的地区为北京(66.7 %),降幅最小的地区为陕西(14.7 %)。 结论 中国2017年全国及各省级行政区居民的胃癌疾病负担均较1990年有所下降,但仍处于较高水平,且存在明显的性别和地区差异,针对相关危险因素实施精准的防控措施十分重要。 Abstract:Objective To compare the disease burden of gastric cancer among Chinese residents in 1990 and 2017 for providing references to decision making on gastric cancer prevention and health management. Methods Using the data of 1990 and 2017 from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we analyzed the changes in years of life lost (YLL), years living with disability (YLD) and disability-adjusted life years (DALY) due to gastric cancer in Chinese population between 1990 and 2017. Results In contrast with those in 1990, higher gastric cancer-related YLL (7 648 000 person-years [PYs] vs. 7 340 000 PYs), YLD ( 167 000 PYs vs. 74 000 PYs), standardized YLD rate (8.5/100 000 vs. 8.4/100 000) and DALY (7 815 000 PYs vs. 7 415000 PYs) were observed in 2017 in Chinese population, with the increasing percentage of 4.2%, 125.7%, 1.2%, and 5.4%; but the standardized YLL rate declined from 779/100 000 to 383.2/100 000 and the standardized DALY rate declined from 787.3/100 000 to 391.7/100 000. There were gender, age, and region differences in the changes between 1990 and 2017 for disease burden due to gastric cancer in the population; in the males, the YLD increased by 152.1%, higher than 76.9% in the females; while the standardized YLL and DALY rate decreased by 46.4% and 45.8% in the males, both lower than in female population (58.5% and 58.0%); the YLL, standardized YLD rate, and DALY of the males increased by 13.7%, 11.6%, and 15.1% but those of the females decreased by 12.7%, 19.0%, and 11.9%, respectively; the DALY decreased in people aged < 50 and 55 – 59 years but increased in the people of other age groups, with the highest increase of 133.5% in the people ≥ 80 years; the standardized DALY rate decreased among all age groups and the decrease percentage (75.7%) was the highest for the people aged 20 – 24 years; the highest increase of DALY (86.2%) was observed in the population of Shaanxi province whereas the greatest decrease of DALY (25.1%) was in the population of Tibet Autonomous Region; the standardized DALY rate decreased in all 33 provincial-level administrative divisions, with the greatest decrease (66.7%) in Beijing and the least decrease (14.7%) in Shaanxi province. Conclusion The disease burden of gastric cancer in Chinese population decreased in 2017 compared to that in 1990 but the decrease differed by gender and region and the disease burden is still at a relatively high level. -
Key words:
- stomach cancer /
- disease burden /
- comparison /
- Chinese residents
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表 1 中国居民1990年与2017年胃癌疾病负担情况比较
性别 年份 YLL
(万人年)标化YLL率
(1/10万)YLD
(万人年)标化YLD率(1/10万) DALY
(万人年)标化DALY率
(1/10万)男性 1990 470.3 1010.0 4.8 11.2 475.1 1021.2 2017 534.6 541.3 12.1 12.5 546.7 553.7 变化率(%) 13.7 – 46.4 152.1 11.6 15.1 – 45.8 女性 1990 263.8 555.5 2.6 5.8 266.4 561.3 2017 230.2 230.8 4.6 4.7 234.8 235.5 变化率(%) – 12.7 – 58.5 76.9 – 19.0 – 11.9 – 58.0 合计 1990 734.0 779.0 7.4 8.4 741.5 787.3 2017 764.8 383.2 16.7 8.5 781.5 391.7 变化率(%) 4.2 – 50.8 125.7 1.2 5.4 – 50.3 表 2 中国不同年龄组居民1990年与2017年胃癌疾病负担情况比较
年龄(岁) DALY(万人年) 标化DALY率(1/10万) 1990年 2017年 变化率(%) 1990年 2017年 变化率(%) 15~19 3.0 0.6 – 81.0 23.9 7.5 – 68.6 20~24 8.3 1.4 – 83.2 63.1 15.3 – 75.7 25~29 15.0 6.2 – 59.0 136.5 50.1 – 63.3 30~34 25.6 10.8 – 57.9 289.2 90.1 – 68.8 35~39 37.0 11.0 – 70.1 403.7 113.5 – 71.9 40~44 50.0 21.6 – 56.9 744.1 194.5 – 73.9 45~49 58.7 53.2 – 9.5 1135.4 425.8 – 62.5 50~54 77.4 87.0 12.4 1619.8 728.3 – 55.0 55~59 93.5 70.5 – 24.6 2152.3 875.6 – 59.3 60~64 111.7 136.4 22.0 3152.0 1647.2 – 47.7 65~69 104.4 145.7 39.6 3813.1 2379.6 – 37.6 70~74 84.3 102.1 21.2 4467.0 2506.0 – 43.9 75~79 45.5 71.9 58.3 3979.4 2547.4 – 36.0 ≥ 80 27.1 63.2 133.5 3229.9 2142.4 – 33.7 表 3 中国不同地区居民1990年与2017年胃癌疾病负担情况比较
区域 地区 DALY(万人年) 标化DALY率(1/10万) 1990年 2017年 变化率(%) 1990年 2017年 变化率(%) 华北 北京市 4.1 4.2 3.1 393.4 130.9 – 66.7 天津市 3.7 4.3 16.3 443.1 199.7 – 54.9 河北省 41.5 52.9 27.4 810.3 500.5 – 38.2 山西省 28.5 26.9 – 5.8 1219.3 528.4 – 56.7 内蒙古自治区 11.1 11.6 4.4 744.5 317.2 – 57.4 东北 黑龙江省 16.2 18.4 14.0 665.7 291.4 – 56.2 吉林省 12.2 11.0 – 9.9 657.5 245.4 – 62.7 辽宁省 21.1 25.4 20.5 629.2 325.7 – 48.2 华东 上海市 10.2 9.4 – 7.5 632.0 224.5 – 64.5 江苏省 62.1 66.1 6.5 1001.2 500.1 – 50.1 浙江省 31.4 28.1 – 10.4 810.4 324.9 – 59.9 安徽省 55.9 51.7 – 7.5 1246.8 553.8 – 55.6 山东省 70.3 72.8 3.5 975.7 476.2 – 51.2 江西省 28.2 23.0 – 18.6 1017.8 391.5 – 61.5 福建省 20.6 24.0 16.2 924.7 476.6 – 48.5 华中 河南省 70.3 67.9 – 3.4 1027.1 537.2 – 47.7 湖北省 28.0 35.8 27.9 657.7 406.7 – 38.2 湖南省 26.3 28.8 9.7 525.6 291.3 – 44.6 华南 广东省 23.1 26.6 15.1 455.7 206.1 – 54.8 广西壮族自治区 17.3 19.0 9.6 534.9 305.2 – 43.0 海南省 3.8 3.5 – 7.6 763.6 303.6 – 60.2 香港特别行政区 2.4 2.4 0.6 408.1 184.5 – 54.8 澳门特别行政区 0.1 0.1 23.0 367.5 141.9 – 61.4 西南 四川省 62.1 56.9 – 8.4 665.1 420.3 – 36.8 云南省 12.2 15.3 25.5 435.2 260.3 – 40.2 贵州省 13.9 14.5 4.2 575.2 319.3 – 44.5 重庆市 7.2 10.5 45.9 510.4 232.6 – 54.4 西藏自治区 2.0 1.5 – 25.1 1210.2 513.7 – 57.5 西北 新疆维吾尔自治区 7.1 12.1 71.2 701.3 452.7 – 35.5 宁夏回族自治区 3.4 4.7 35.7 1194.7 597.8 – 50.0 青海省 4.2 5.8 37.4 1437.2 832.9 – 42.0 陕西省 11.5 21.4 86.2 448.1 382.0 – 14.7 甘肃省 29.4 24.8 – 15.6 1817.4 696.1 – 61.7 -
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