Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
BMC Cancer. 2022 Jul 30;22(1):836. doi: 10.1186/s12885-022-09940-3.
The disease burden of non-melanoma skin cancer (NMSC) has become a significant public health threat. We aimed to conduct a comprehensive analysis to mitigate the health hazards of NMSC.
This study had three objectives. First, we reported the NMSC-related disease burden globally and for different subgroups (sex, socio-demographic index (SDI), etiology, and countries) in 2019. Second, we examined the temporal trend of the disease burden from 1990 to 2019. Finally, we used the Bayesian age-period-cohort (BAPC) model integrated nested Laplacian approximation to predict the disease burden in the coming 25 years. The Norpred age-period-cohort (APC) model and the Autoregressive Integrated Moving Average (ARIMA) model were used for sensitivity analysis.
The disease burden was significantly higher in males than in females in 2019. The results showed significant differences in disease burden in different SDI regions. The better the socio-economic development, the heavier the disease burden of NMSC. The number of new cases and the ASIR of basal cell carcinoma (BCC) were higher than that of squamous cell carcinoma (SCC) in 2019 globally. However, the number of DALYs and the age-standardized DALYs rate were the opposite. There were statistically significant differences among different countries. The age-standardized incidence rate (ASIR) of NMSC increased from 54.08/100,000 (95% uncertainty interval (UI): 46.97, 62.08) in 1990 to 79.10/100,000 (95% UI: 72.29, 86.63) in 2019, with an estimated annual percentage change (EAPC) of 1.78. Other indicators (the number of new cases, the number of deaths, the number of disability-adjusted life years (DALYs), the age-standardized mortality rate (ASMR), and the age-standardized DALYs rate) showed the same trend. Our predictions suggested that the number of new cases, deaths, and DALYs attributable to NMSC would increase by at least 1.5 times from 2020 to 2044.
The disease burden attributable to NMSC will continue to increase or remain stable at high levels. Therefore, relevant policies should be developed to manage NMSC, and measures should be taken to target risk factors and high-risk groups.
非黑色素瘤皮肤癌（NMSC）的疾病负担已成为重大公共卫生威胁。我们旨在进行全面分析，以减轻 NMSC 的健康危害。
本研究有三个目标。首先，我们报告了 2019 年全球及不同亚组（性别、社会人口指数（SDI）、病因和国家）的 NMSC 相关疾病负担。其次，我们检测了 1990 年至 2019 年疾病负担的时间趋势。最后，我们使用贝叶斯年龄-时期-队列（BAPC）模型结合嵌套拉普拉斯近似法来预测未来 25 年的疾病负担。Norpred 年龄-时期-队列（APC）模型和自回归综合移动平均（ARIMA）模型用于敏感性分析。
2019 年男性的疾病负担明显高于女性。结果显示，不同 SDI 地区的疾病负担存在显著差异。社会经济发展越好，NMSC 的疾病负担越重。2019 年全球新发病例数和基底细胞癌（BCC）的发病率标准调整比（ASIR）均高于鳞状细胞癌（SCC），但伤残调整生命年（DALY）和年龄标准化 DALY 率则相反。不同国家之间存在统计学差异。NMSC 的发病率标准调整比（ASIR）从 1990 年的 54.08/100,000（95%不确定区间（UI）：46.97，62.08）增加到 2019 年的 79.10/100,000（95% UI：72.29，86.63），年估计百分比变化（EAPC）为 1.78。其他指标（新发病例数、死亡数、伤残调整生命年（DALY）数、死亡率标准调整比（ASMR）和年龄标准化 DALY 率）呈现相同趋势。我们的预测表明，2020 年至 2044 年，NMSC 导致的新发病例数、死亡数和 DALY 将至少增加 1.5 倍。
NMSC 疾病负担将继续增加或保持在高水平。因此，应制定相关政策来管理 NMSC，并采取措施针对危险因素和高危人群。
