Department of Epidemiology and Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Clinical Epidemiology Unit, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China.
J Cancer Res Clin Oncol. 2023 Jul;149(7):3209-3218. doi: 10.1007/s00432-022-04217-5. Epub 2022 Jul 29.
This study aimed to identify and project the epidemiological trends and the burden of lung cancer in China.
We extracted incidence, mortality, disability-adjusted life-years (DALYs) and age-standardized rates of lung cancer in China, between 1990 and 2019, from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was applied to quantify the trends of lung cancer burden. Furthermore, we used the Bayesian age-period-cohort model to project the incidence and mortality in the next decade.
From 1990 to 2019, the estimated national number of lung cancer incident cases increased by 224.0% to 832,920, deaths increased by 195.4% to 757,170 and DALYs increased by 146.1% to 17,128,580, respectively. Meanwhile, the ASIR, ASMR and ASDR showed an upward trend (EAPC of 1.33, 0.94 and 0.42, respectively). The ASIR and ASMR among males were about 2 times more than females, but the increase in ASIR in females (EAPC = 2.24) was more obvious than those in males (EAPC = 0.10) from 2020 to 2030. In China, smoking remained responsible for the highest burden of lung cancer, but the contribution of ambient particulate matter pollution to DALYs increased from 10.6% in 1990 to 22.5% in 2019 in total population. Moreover, we predicted that the number of deaths from lung cancer will increase by 42.7% in China by 2030.
In China, the burden of lung cancer has been increasing over the past three decades, which highlights more targeted intervention measures are needed to reduce the burden of lung cancer.
本研究旨在识别和预测中国肺癌的流行病学趋势和疾病负担。
我们从全球疾病负担研究（2019 年）中提取了 1990 年至 2019 年中国肺癌的发病率、死亡率、伤残调整生命年（DALYs）和年龄标准化率。应用估计年度百分比变化（EAPC）来量化肺癌负担的变化趋势。此外，我们使用贝叶斯年龄-时期-队列模型来预测未来十年的发病率和死亡率。
1990 年至 2019 年，中国肺癌发病病例数估计增加了 224.0%，达到 832920 例；死亡病例数增加了 195.4%，达到 757170 例；伤残调整生命年增加了 146.1%，达到 17128580 例。与此同时，ASIR、ASMR 和 ASDR 呈上升趋势（EAPC 分别为 1.33、0.94 和 0.42）。男性的 ASIR 和 ASMR 约为女性的两倍，但从 2020 年到 2030 年，女性 ASIR 的增长（EAPC=2.24）比男性更为明显（EAPC=0.10）。在中国，吸烟仍然是导致肺癌负担最重的因素，但大气颗粒物污染对 DALYs 的贡献从 1990 年的 10.6%增加到 2019 年的 22.5%。此外，我们预测到 2030 年中国肺癌死亡人数将增加 42.7%。
过去三十年来，中国肺癌负担不断增加，这表明需要采取更有针对性的干预措施来降低肺癌负担。
