Yan X X, Li Y J, Cao M D, Wang H, Liu C C, Wang X, Ran J C, Liang L, Lei L, Peng J, Shi J F
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China Department of Healthcare-Associated Infection Management, Third People's Hospital of Shenzhen (Second Affiliated Hospital of Southern University of Science and Technology), Shenzhen 518114, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Dec 10;42(12):2156-2163. doi: 10.3760/cma.j.cn112338-20210506-00373.
Based on the data of Global Burden of Disease 2019 data, to analyze the past, current, and future burden of disability-adjusted life years (DALYs) in China and compare with the international status. The total number of DALYs, age-standardized DALY rate, and the composition of different subgroups were extracted and described to analyze the time trend in 2000-2019 and the current situation in 2019 for Chinese female breast cancer. The burden of DALYs in 2050 was predicted by Joinpoint using average annual percent change (AAPC). In 2000-2019, the ranking of DALYs caused by female breast cancer in China rose from the fourth to the second in all female cancers. The total DALYs increased by 48.4%, of which the years lived with disability increased from 4.8% to 8.8%. The age-standardized DALY rate only slightly decreased (AAPC=-0.3%; which increased during 2016-2019, AAPC=1.6%). In 2019, the age-standardized DALY rate for breast cancer in China was 278.0/100 000. The DALYs were 2.88 million (accounting for 14.2% of the global burden and 12.1% of all female cancers burden in China), 26.5% of which attributed known risk factors (overweight and obesity were the largest: 0.34 million DALYs, but some common breast cancer risk factors were not available on the platform, such as menstruation and fertility). In 2050, the prediction suggests that the total DALYs caused by female breast cancer in China will reach 3.80 million person-years-5.16 million person-years, increasing 32.1%-79.4% over 2019. From 2000 to 2019, the peak age of DALYs and DALY rate became older, and the DALYs among females aged 65 years and above increased faster than those younger than 65 years (AAPC were 4.8% and 1.3%, respectively). In 2019, females aged 45-74 (the starting age recommended by local guidelines for breast cancer screening) contributed 74.3% of the total DALYs. Over the past 20 years, the age-standardized DALY rate for breast cancer in female populations in China has not changed obviously. Without the continuous expansion of effective intervention and population aging, the burden of DALYs for female breast cancer in China will increase. DALYs for breast cancer attributed leading risk factors were still limited.
基于《2019年全球疾病负担》数据，分析中国残疾调整生命年（DALYs）的过去、当前和未来负担，并与国际状况进行比较。提取并描述了中国女性乳腺癌2000 - 2019年的DALYs总数、年龄标准化DALY率以及不同亚组的构成，以分析时间趋势和2019年的现状。使用平均年度百分比变化（AAPC）通过Joinpoint预测2050年的DALYs负担。2000 - 2019年，中国女性乳腺癌导致的DALYs在所有女性癌症中的排名从第四升至第二。DALYs总数增加了48.4%，其中带病生存年数从4.8%增至8.8%。年龄标准化DALY率仅略有下降（AAPC = -0.3%；2016 - 2019年有所上升，AAPC = 1.6%）。2019年，中国乳腺癌的年龄标准化DALY率为278.0/10万。DALYs为288万（占全球负担的14.2%，占中国所有女性癌症负担的12.1%），其中26.5%归因于已知风险因素（超重和肥胖最为突出：34万DALYs，但平台上没有一些常见的乳腺癌风险因素，如月经和生育）。2050年的预测表明，中国女性乳腺癌导致的DALYs总数将达到380万 - 516万人年，比2019年增加32.1% - 79.4%。2000年至2019年，DALYs和DALY率的峰值年龄变大，65岁及以上女性的DALYs增长速度快于65岁以下女性（AAPC分别为4.8%和1.3%）。2019年，45 - 74岁（当地乳腺癌筛查指南推荐的起始年龄）女性贡献了74.3%的DALYs总数。在过去20年中，中国女性人群中乳腺癌的年龄标准化DALY率没有明显变化。如果不持续扩大有效干预措施且人口老龄化持续，中国女性乳腺癌的DALYs负担将会增加。乳腺癌归因于主要风险因素的DALYs仍然有限。
