首页|期刊导航|中国医学科学院学报|1990至2021年中国人群归因于超重肥胖的早发性癌症疾病负担分析与模型预测

1990至2021年中国人群归因于超重肥胖的早发性癌症疾病负担分析与模型预测OA

Analysis and Model Prediction of the Burden of Early-Onset Cancer Attributed to Overweight and Obesity in the Chinese Population From 1990 to 2021

中文摘要英文摘要

目的 分析1990 至2021 年中国归因于超重肥胖的早发性癌症疾病负担变化趋势,并预测其未来15 年的变化,为我国癌症防控提供参考依据.方法 数据来源于2021 年全球疾病负担研究数据库,采用死亡率、伤残调整寿命年(DALY)率及其年龄标准化率描述疾病负担.利用 R4.4.1 软件分析不同性别、不同年龄组的疾病负担差异及变化;运用 Joinpoint回归模型量化1990 至2021 年中国人群归因于超重肥胖的早发性癌症疾病负担的时间变化趋势,计算年龄标准化死亡率和年龄标准化 DALY率的平均年度变化百分比(AAPC);构建自回归滑动平均混合模型预测未来 15 年的疾病负担变化.结果 1990 至2021 年中国归因于超重肥胖的早发性癌症疾病负担呈上升趋势.男性和女性的年龄标准化死亡率的 AAPC分别为2.94%(95%CI=2.90~2.97)和1.98%(95%CI=1.93~2.02),年龄标准化DALY率的AAPC分别为2.88%(95%CI=2.83~2.91)和1.82%(95%CI=1.77~1.86)(P 均<0.001).相较于1990 年,2021 年30~34 岁因超重肥胖所致癌症死亡率和 DALY率增幅最显著,分别上升88.24%和91.02%.预测结果显示:未来15 年,除女性子宫癌外,其余癌种归因于超重肥胖的年龄标准化 DALY率均将持续增加.男性疾病负担顺位前五的癌种分别为结直肠癌、肝癌、白血病、肾癌、胆囊/胆管癌;女性在2028 年及以前顺位前五的癌种分别为结直肠癌、乳腺癌、肝癌、子宫癌、白血病,2029~2036 年卵巢癌将超越白血病,跃居第5 位.结论 1990 至2021 年及未来15 年,中国归因于超重肥胖的早发性癌症疾病负担总体呈上升趋势.男性主要负担癌种为结直肠癌、肝癌、白血病、肾癌、胆囊/胆管癌;女性主要负担癌种为结直肠癌、乳腺癌、肝癌、子宫癌、白血病、卵巢癌.建议强化超重肥胖综合防控策略,针对高风险癌种及特定人群实施精准干预措施,以降低相关癌症疾病负担.

Objective To analyze the trends in the burden of early-onset cancer attributed to overweight and obesity in China from 1990 to 2021 and to predicted its changes over the next 15 years,thus providing a ref-erence for cancer prevention and control in China.Methods The data were sourced from the 2021 Global Burden of Disease database.The disease burden was described based on mortality rates,disability-adjusted life year(DALY)rates,and their age-standardized rates.R 4.4.1 software was used to analyze the differences and changes in dis-ease burden across different gender and age groups.The Joinpoint regression model was adopted to quantify the temporal trends of the burden of early-onset cancer attributed to overweight and obesity in the Chinese population from 1990 to 2021,and the average annual percentage of change(AAPC)was calculated for age-standardized mortality rates and age-standardized DALY rates.An autoregressive integrated moving average model was estab-lished to predict changes in disease burden over the next 15 years.Results Between 1990 and 2021,the burden of early-onset cancers attributed to overweight and obesity in China showed an upward trend.The AAPC values of age-standardized mortality rates for men and women were 2.94%(95%CI=2.90-2.97)and 1.98%(95%CI=1.93-2.02),respectively,while those of age-standardized DALY rates were 2.88%(95%CI=2.83-2.91)and 1.82%(95%CI=1.77-1.86),respectively(all P<0.001).The age group of 30-34 years old in 2021 compared with 1990 saw the most significant increases(88.24%and 91.02%,respectively)in cancer mortality and DALY rates due to overweight and obesity.It was predicted that in the next 15 years,the age-standardized DALY rates for cancers(except female uterine cancer)attributed to overweight and obesity would keep ris-ing.The top five cancers contributing to the disease burden in men would be colorectal cancer,liver cancer,leu-kemia,kidney cancer,and gallbladder and biliary tract cancer.For women,the top five cancers contributing to the disease burden in 2028 and earlier would be colon and rectum cancer,breast cancer,liver cancer,uterine cancer,and leukemia.From 2029 to 2036,ovarian cancer would surpass leukemia,rising to the fifth position.Conclusions From 1990 to 2021 and in the next 15 years,the burden of early-onset cancer attributed to over-weight and obesity in China shows an overall upward trend.The main cancers causing the burden on men are colon and rectum cancer,liver cancer,leukemia,kidney cancer,and gallbladder and biliary tract cancer.The main cancers imposing the burden on women are colon and rectum cancer,breast cancer,liver cancer,uterine canc-er,leukemia,and ovarian cancer.It is recommended that comprehensive prevention and control strategies should be improved for overweight and obesity and targeted interventions should be implemented for high-risk cancers and specific populations to reduce the burden of related cancer diseases.

张婷;李帆;王宇萍

中国医学科学院 北京协和医学院 群医学及公共卫生学院,北京 100005中国医学科学院 北京协和医学院 群医学及公共卫生学院,北京 100005中国医学科学院 北京协和医学院 群医学及公共卫生学院,北京 100005

医药卫生

癌症超重肥胖疾病负担全球疾病负担预测

canceroverweight and obesitydisease burdenglobal burden of diseaseprediction

《中国医学科学院学报》 2026 (4)

676-685,10

10.3881/j.issn.1000-503X.17015

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