1990-2023年亚洲5个区域唇和口腔癌疾病负担分析与预测OA
Prediction and analysis of disease burden of lip and oral cavity cancer in five Asian regions from 1990 to 2023
目的 分析1990-2023年亚洲5个区域(中亚、南亚、东南亚、东亚、高收入亚太地区)唇和口腔癌(LOC)的疾病负担情况并预测未来发展趋势.方法 基于2023年全球疾病负担数据库,选取LOC的死亡率、发病率、患病率及伤残调整生命年(DALY)等数据.采用Joinpoint回归分析趋势变化,利用年龄-时期-队列(A-P-C)模型评估年龄、时期和队列效应,并通过贝叶斯年龄-时期-队列(BAPC)模型,以2023年观测值为基线,预测2024-2035年的疾病负担趋势.结果 2023年南亚LOC疾病负担最重,其年龄标准化死亡率(ASMR)6.90/10万、年龄标准化发病率(ASIR)10.72/10万、年龄标准化患病率(ASPR)31.71/10万及年龄标准化DALY率(ASDR)197.22/10万人年均居首位.5个区域2023年LOC发病率与死亡率均为男性高于女性,尤其在35~79岁年龄段.1990-2023年东南亚地区LOC整体疾病负担上升幅度最大,ASMR、ASPR、ASIR和ASDR的平均年度百分比变化(AAPC)分别为0.46%、1.63%、1.04%、0.63%;中亚地区LOC整体疾病负担下降幅度最大,ASMR、ASPR、ASIR和ASDR的AAPC分别为-0.72%、0.01%、-0.40%、-0.87%.A-P-C模型结果显示,LOC患病率随年龄增长而上升,主要集中在60~80岁的人群;时期-队列效应显示,同一出生队列的人群近期的患病率高于早期;年龄-队列效应显示,在同一年龄段,近期出生人群的患病率高于早期出生人群.BAPC预测模型显示,到2035年南亚地区疾病负担显著上升(ASMR:5.4/10万,ASIR:9.7/10万),中亚地区疾病负担显著下降(ASMR:0.8/10万,ASIR:1.5/10万).结论 亚洲大部分地区LOC疾病负担仍在持续增加,不同区域差异明显.建议南亚和东南亚优先加强高危人群筛查,并对烟草、酒精等风险因素进行适当干预;中亚与东亚的流行病学改善经验可为其他地区提供参考;未来应关注南亚和东南亚快速上升的死亡率与发病率,优化资源配置,并深入探究生活方式、环境暴露等流行病学机制,为区域化防控策略提供依据.
Objective To analyze the disease burden of lip and oral cavity cancer(LOC)in five Asia regions(Central Asia,South Asia,Southeast Asia,East Asia,and the high-income Asia-Pacific region)from 1990 to 2023,and predict the future trends.Methods Based on the Global Burden of Disease(GBD)2023 database,data on mortality,incidence,prevalence,and disability-adjusted life years(DALYs)of LOC were extracted.Joinpoint regression was used to analyze trends changes,and the age-period-cohort(APC)model was employed to assess the age,period,and cohort effects.Using a Bayesian age-period-cohort(BAPC)model,with 2023 observed value as the baseline,the disease burden trends for 2024-2035 were predicted.Results In 2023,South Asia had the heaviest LOC disease burden,ranking first in terms of age-standardized mortality rate(ASMR)(6.9/100,000),age-standardized incidence rate(ASIR)(10.72/100,000),age-standardized prevalence rate(ASPR)(31.71/100,000),and age-standardized DALY rate(ASDR)(197.22/100,000 person-years).In 2023,the incidence and mortality rates of LOC were higher in men than in women across all five regions,particularly in the 35-79 years age group.From 1990 to 2023,Southeast Asia experienced the largest increase in the overall disease burden of LOC,the average annual percentage change(AAPC)for ASMR,ASPR,ASIR,and ASDR were 0.46%,1.63%,1.04%,and 0.63%,respectively,while Central Asia showed the largest decrease in overall LOC disease burden,the AAPC for ASMR,ASPR,ASIR,and ASDR were-0.72%,0.01%,-0.40%,and-0.87%,respectively.The APC model results indicated that the prevalence of LOC increased with age,concentrating in the population aged 60-80 years;the period-cohort effect showed that individuals from the same birth cohort have higher prevalence rates in recent years compared to the earlier years;the age-cohort effect indicated that,within the same age group,individuals born more recently had higher prevalence rates than those born earlier.The BAPC projection model indicated that the disease burden in South Asia will rise significantly by 2035(ASMR:5.4/100,000;ASIR:9.7/100,000),while the disease burden in Central Asia will decline significantly(ASMR:0.8/100,000;ASIR:1.5/100,000).Conclusion The disease burden of LOC continues to increase in most of Asia,with significant regional differences.South and Southeast Asia should prioritize screening high-risk populations and implementing appropriate interventions against risk factors such as tobacco and alcohol use.Epidemiological improvements in Central and East Asia offer valuable reference for other regions.Future attention should be paid to rapidly increasing mortality and incidence rates in South Asia and Southeast Asia,and optimize resource allocation,and conduct in-depth investigations into epidemiological mechanisms involving lifestyle and environmental exposures to inform regional prevention and control strategies.
操文聪;高恺;荣一;吴章靖;喻勇
湖北医药学院公共卫生与健康学院(湖北 十堰 442000)湖北医药学院公共卫生与健康学院(湖北 十堰 442000)湖北医药学院公共卫生与健康学院(湖北 十堰 442000)湖北医药学院公共卫生与健康学院(湖北 十堰 442000)湖北医药学院公共卫生与健康学院(湖北 十堰 442000)||湖北医药学院卫生管理与卫生事业发展研究中心(湖北 十堰 442000)
医药卫生
唇和口腔癌疾病负担年龄-时期-队列模型贝叶斯年龄-时期-队列模型
Lip and oral cavity cancerDisease burdenAge-period-cohort modelingBayesian age-period-cohort modeling
《医学新知》 2026 (5)
541-549,9
湖北省普通高等学校人文社会科学重点研究基地开放基金项目(2022ZD001、2020ZD001)
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