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全球、区域和国家膀胱癌负担,1990 年至 2016 年:来自 2016 年全球疾病负担研究的结果。

Global, Regional and National Burden of Bladder Cancer, 1990 to 2016: Results from the GBD Study 2016.

机构信息

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences , Tehran , Iran.

Uro-Oncology Research Center, Tehran University of Medical Sciences , Tehran , Iran.

出版信息

J Urol. 2019 May;201(5):893-901. doi: 10.1097/JU.0000000000000025.

Abstract

PURPOSE

Bladder cancer is among the leading causes of cancer death worldwide. Data on the bladder cancer burden are valuable for policy-making. We aimed to estimate the burden of bladder cancer by country, age group, gender and sociodemographic status between 1990 and 2016.

MATERIALS AND METHODS

Data from vital registration systems and cancer registries were the input to estimate the bladder cancer burden. Mortality was estimated in an ensemble model approach, incidence was estimated by dividing mortality by the mortality-to-incidence ratio and prevalence was estimated using the mortality-to-incidence ratio as a surrogate for survival. We modeled the years lived with disability using disability weights of bladder cancer sequelae. Years of life lost were calculated by multiplying the number of deaths by age by the standard life expectancy at that age. Disability adjusted life-years were calculated by summing the years lived with disability and the years of life lost. Moreover, we also estimated the burden attributable to bladder cancer risk factors, smoking and high fasting plasma glucose using the comparative risk assessment framework of the Global Burden of Disease study.

RESULTS

In 2016 there were 437,442 incident cases (95% UI 426,709-447,912) of bladder cancer with an age standardized incidence rate of 6.69/100,000 (95% UI 6.52-6.85). Bladder cancer led to 186,199 deaths (95% UI 180,453-191,686) in 2016 with an age standardized rate of 2.94/100,000 (95% UI 2.85-3.03). Bladder cancer was responsible for 3,315,186 disability adjusted life-years (95% UI 3,193,248-3,425,530) in 2016 with an age standardized rate of 49.45/100,000 (95% UI 47.68-51.11). Of bladder cancer deaths 26.84% (95% UI 19.78-33.91) and 7.29% (95% UI 1.49-16.19) were due to smoking and high fasting glucose, respectively, in 2016.

CONCLUSIONS

Although the number of bladder cancer incident cases is growing globally, the age standardized incidence and number of deaths are decreasing, as mirrored by a decreasing smoking contribution.

摘要

目的

膀胱癌是全球癌症死亡的主要原因之一。膀胱癌负担数据对于政策制定具有重要价值。本研究旨在估计 1990 年至 2016 年间各国、年龄组、性别和社会人口地位的膀胱癌负担。

材料和方法

本研究使用来自生命登记系统和癌症登记处的数据来估计膀胱癌负担。采用综合模型方法估计死亡率,通过死亡率除以死亡率与发病率之比来估计发病率,通过死亡率与发病率之比来估计患病率。我们使用膀胱癌后遗症的残疾权重来估计残疾生命年。通过将死亡人数乘以年龄再乘以该年龄的标准预期寿命来计算生命损失年数。通过将残疾生命年数和生命损失年数相加来计算伤残调整生命年数。此外,我们还使用全球疾病负担研究的比较风险评估框架来估计膀胱癌风险因素(吸烟和高空腹血糖)的负担。

结果

2016 年,膀胱癌新发病例 437442 例(95%置信区间 426709-447912),年龄标准化发病率为 6.69/100000(95%置信区间 6.52-6.85)。2016 年膀胱癌导致 186199 人死亡(95%置信区间 180453-191686),年龄标准化死亡率为 2.94/100000(95%置信区间 2.85-3.03)。2016 年膀胱癌导致 3315186 残疾调整生命年(95%置信区间 3193248-3425530),年龄标准化率为 49.45/100000(95%置信区间 47.68-51.11)。2016 年,膀胱癌死亡人数中有 26.84%(95%置信区间 19.78-33.91)和 7.29%(95%置信区间 1.49-16.19)分别归因于吸烟和高空腹血糖。

结论

尽管全球膀胱癌新发病例数在增加,但年龄标准化发病率和死亡人数正在减少,这反映出吸烟的影响在减少。

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