Liu W, Wang L J, Qi J L, Liu J M, You J L, Lin L, Yin P, Zhou M G
Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Jul 10;42(7):1225-1230. doi: 10.3760/cma.j.cn112338-20200908-01139.
To analyze the trend of the incidence, mortality and disease burden of breast cancer in women in China during 1990-2017. Based on the estimation of data in China from the Global Burden of Disease 2017 (GBD2017), the incidence,mortality, disability- adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) on breast cancer for women in China during 1990-2017 were standardized by the world standard population used for GBD2017. The GBD study applied the attributable burden formula to estimate the attributable deaths by five risk factors of breast cancer, including alcohol use, high body mass index (BMI), high fasting plasma glucose, low physical activity and tobacco smoking. The incidence, mortality, attributable deaths and the disease burden due to breast cancer in women in China were analyzed. In 2017, a total of 357.6 thousand female breast cancer cases, including 84.8 thousand deaths, were reported in China, with the age-standardized incidence rate of 35.62/100 000, which increased by 286.18%, 114.14% and 88.77% respectively compared with 1990. The age-standardized mortality rate decreased from 8.57/100 000 in 1990 to 7.84 /100 000 in 2007, then increased to 8.71 /100 000 in 2015, and then decreased to 8.47/100 000 in 2017. The mortality of breast cancer increased with age in 1990 and 2017. From 1990 to 2017, the trend of standardized DALY rate and standardized YLL rate were the same as that of standardized mortality, while the standardized YLD rate and the proportion of YLD in DALY increased year by year. In 2017, the standardized DALY rate, standardized YLL rate and standardized YLD rate of breast cancer were 253.00/100 000, 228.96/100 000, and 24.05/100 000, respectively. Compared with 1990, the change rates were -6.88% and -11.73% and 95.85% respectively. The proportion of breast cancer deaths attributable to high BMI increased significantly by 165.76%, from 5.49% in 1990 to 14.59% in 2017. The proportion of breast cancer deaths attributable to alcohol use and high fasting blood glucose increased; and the proportion of breast cancer deaths attributed to low physical activity and smoking remained stable. In 2017, the three provinces with the highest age-standardized mortality rate of female breast cancer were Hongkong (9.93/100 000), Guangxi (9.52/100 000) and Liaoning (9.49/100 000). Compared with 1990, the age-standardized mortality of 19 provinces decreased, and Beijing (-27.17%), Macao (-26.06%) and Jilin (-23.89%) had the fastest decrease. The two provinces with the highest growth rates were Hebei (28.85%) and Henan (24.34%). The disease burden of female breast cancer in China increased during 1990-2017. Therefore it is necessary to strengthen the prevention and treatment of breast cancer.
分析1990 - 2017年中国女性乳腺癌的发病率、死亡率及疾病负担趋势。基于《2017年全球疾病负担》（GBD2017）中国数据估算，采用GBD2017所用的世界标准人口对1990 - 2017年中国女性乳腺癌的发病率、死亡率、伤残调整生命年（DALY）、寿命损失年（YLL）和带病生存年（YLD）进行标准化。GBD研究应用归因负担公式估算乳腺癌5种风险因素（包括饮酒、高体重指数（BMI）、高空腹血糖、低体力活动和吸烟）所致的归因死亡数。分析中国女性乳腺癌的发病率、死亡率、归因死亡数及疾病负担。2017年，中国共报告35.76万例女性乳腺癌病例，其中8.48万例死亡，年龄标准化发病率为35.62/10万，与1990年相比分别上升了286.18%、114.14%和88.77%。年龄标准化死亡率从1990年的8.57/10万降至2007年的7.84/10万，随后在2015年升至8.71/10万，2017年又降至8.47/10万。1990年和2017年乳腺癌死亡率均随年龄增长而升高。1990 - 2017年，标准化DALY率和标准化YLL率趋势与标准化死亡率相同，而标准化YLD率及YLD在DALY中的占比逐年上升。2017年，乳腺癌标准化DALY率、标准化YLL率和标准化YLD率分别为253.00/10万、228.96/10万和24.05/10万。与1990年相比，变化率分别为 - 6.88%、 - 11.73%和95.85%。归因于高BMI的乳腺癌死亡占比显著上升165.76%，从1990年的5.49%升至2017年的14.59%。归因于饮酒和高空腹血糖的乳腺癌死亡占比上升；归因于低体力活动和吸烟的乳腺癌死亡占比保持稳定。2017年，女性乳腺癌年龄标准化死亡率最高的三个省份是香港（9.93/10万）、广西（9.52/10万）和辽宁（9.49/10万）。与1990年相比，19个省份的年龄标准化死亡率下降，北京（ - 27.17%）、澳门（ - 26.06%）和吉林（ - 23.89%）下降幅度最大。增长率最高的两个省份是河北（28.85%）和河南（24.34%）。1990 - 2017年中国女性乳腺癌疾病负担增加。因此，有必要加强乳腺癌的防治工作。
