1992-2021年中国肝癌发病和死亡的年龄-时期-队列模型分析OA
Age-period-cohort model analysis of liver cancer incidence and mortality in China from 1992 to 2021
目的 分析我国肝癌发病和死亡的长期变化趋势,为肝癌防控策略制定提供参考.方法 基于全球疾病负担研究2021(Global Burden of Disease Study 2021,GBD 2021)数据库,系统分析1992-2021年中国肝癌的发病和死亡趋势,并采用年龄-时期-队列(age-period-cohort,APC)模型,探讨不同年龄、时期和出生队列对肝癌发病和死亡变化的影响.结果 1992-2021年,中国肝癌的发病数和死亡数分别增长93.94％和75.26％,粗发病率和粗死亡率分别增长64.33％和48.53％,但标化发病率和标化死亡率分别下降9.16％和20.32％.性别分层分析显示,女性的标化发病率和标化死亡率降幅分别为17.54％和24.84％,大于男性的4.14％和16.61％.APC模型结果表明,肝癌发病率和死亡率均随年龄增加而上升,发病率在总人群和女性中于85～89岁年龄组达到峰值,在男性中于90～94岁年龄组达到峰值;死亡率在总人群、男性和女性中均于90～94岁年龄组达到峰值.时期效应分析显示,发病和死亡的率比(rate ratio,RR)在总人群、男性和女性中均整体呈波动下降趋势,其中在女性中下降更明显.队列效应结果表明,不同出生队列人群的发病与死亡RR亦呈波动式下降趋势,女性出生队列的下降幅度最大.结论 1992-2021年中国肝癌的总体疾病负担呈下降趋势,但由于人口老龄化,其负担仍然严峻.未来应继续加强对高危人群的干预,推进乙型肝炎防控、早筛早诊和精准治疗,重点加强老年男性的干预,以进一步降低肝癌发病率和死亡率.
Objective To analyze the long-term trends in liver cancer incidence and mortality in China,and provide evidence for the de-velopment of liver cancer prevention and control strategies.Methods Based on the data from the Global Burden of Disease Study 2021(GBD 2021),the trends in liver cancer incidence and mortality in China from 1992 to 2021 were analyzed.An age-period-cohort(APC)model was applied to assess the independent effects of age,period,and birth cohort on the burden of liver cancer.Results From 1992 to 2021,the numbers of liver cancer cases and deaths in China increased by 93.94％and 75.26％,respectively,the crude incidence and mortali-ty rates increased by 64.33％and 48.53％,whereas the age-standardized incidence and mortality rates decreased by 9.16％and 20.32％.Sex-stratified analysis showed that the decreases in the age-standardized incidence and mortality rates were greater among females than those among males,with reductions of 17.54％and 24.84％in females and 4.14％and 16.61％in males,respectively.APC analysis showed that the incidence and mortality rates of liver cancer both increased with age.The incidence rate peaked in the 85-to 89-year-old age group in the overall population and females,and in the 90-to 94-year-old age group in males.The mortality rate peaked in the 90-to 94-year-old age group in the overall population,maIes,and females.Period effects showed overall fluctuating downward trends in the rate ratios(RRs)of liver cancer incidence and mortality in the overall population,males,and females,with more pronounced declines in females.Birth cohort effects also showed overall fluctuating downward trends in the RRs of incidence and mortality across different sex groups,with the largest declines observed in females.Conclusions From 1992 to 2021,the burden of liver cancer in China generally declined,yet remaining substantial in the context of population aging.Future interventions targeting high-risk populations especially elder males and the promotion of hepatitis B prevention and control,early screening and diagnosis,and precision treatment should be strengthened to decrease the incidence and mortality rates of liver cancer.
陈伟龙;汪威言;袁晓岚;韩喜娟
哈尔滨市第四医院消化科,黑龙江哈尔滨 150026哈尔滨市第四医院消化科,黑龙江哈尔滨 150026哈尔滨市第四医院消化科,黑龙江哈尔滨 150026哈尔滨市第四医院消化科,黑龙江哈尔滨 150026
肝癌发病死亡年龄-时期-队列模型
liver cancerincidencemortalityage-period-cohort model
《实用肿瘤杂志》 2026 (4)
319-324,6
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