Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Second Medical Center of Chinese PLA General Hospital and Chinese PLA Medical School, Beijing 100853, China.
Department of Gastroenterology, First Medical Center of Chinese PLA General Hospital and Chinese PLA Medical School, Beijing 100853, China.
Chin Med J (Engl). 2022 Jul 20;135(14):1697-1706. doi: 10.1097/CM9.0000000000002258.
Gallbladder and biliary tract cancer (GBTC) has greatly damaged the health of patients and is accompanied by a dismal prognosis. The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking. This study was to determine the current status, trends, and predictions in the burden of GBTC over the past 30 years in China.
This was a descriptive, epidemiological, secondary analysis of the Global Burden of Disease, Injuries, and Risk Factor Study 2019 data. Data including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC in China by year, age, and sex were assessed. Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019. Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044.
Nationally, there were 38,634 (95% uncertainty interval [UI]: 27,350-46,512) new cases and 47,278 (95% UI: 32,889-57,229) patients due to GBTC, causing 34,462 (95% UI: 25,220-41,231) deaths, and 763,584 (95% UI: 566,755-920,493) DALYs in 2019. Both cases and rates of burden owing to GBTC were heavier among males and at old age. From 1990 to 2019, the age-standardized rates of incidence, prevalence, mortality, and DALYs of GBTC generally increased from 1990 to 2019, with average annual percentage change at 0.8% (95% confidential interval [CI]: 0.6-1.0%), 1.3% (95% CI: 1.1-1.5%), 0.4% (95% CI: 0.2-0.6%), and 0.2% (95% CI: 0.1-0.4%), respectively. Even though the age-standardized incidence rate and age-standardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044, the number of new cases and deaths were expected to grow steadily.
GBTC is becoming a major health burden in China, particularly among males and older individuals. Given the aging population and increasing burden, effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.
胆囊和胆道癌（GBTC）极大地损害了患者的健康，并伴有预后不良。GBTC 在全球的分布存在广泛差异，而中国缺乏最新数据。本研究旨在确定过去 30 年来中国 GBTC 负担的现状、趋势和预测。
这是对 2019 年全球疾病、伤害和危险因素研究的描述性、流行病学、二次分析。评估了中国按年份、年龄和性别划分的胆囊和胆道癌的发病率、患病率、死亡率和伤残调整生命年（DALYs）数据。采用 Joinpoint 回归分析评估了 1990 年至 2019 年 GBTC 疾病负担的趋势。采用 Nordpred 年龄-时期-队列分析预测 2019 年至 2044 年 GBTC 的死亡率和发病率。
全国范围内，2019 年胆囊和胆道癌新发病例 38634 例（95%置信区间[UI]：27350-46512），患者 47278 例（95% UI：32889-57229），导致 34462 例（95% UI：25220-41231）死亡和 763584 例（95% UI：566755-920493）伤残调整生命年（DALYs）。男性和老年人群的胆囊和胆道癌负担发生率和发生率更高。1990 年至 2019 年，胆囊和胆道癌的发病率、患病率、死亡率和 DALYs 的年龄标准化率普遍从 1990 年上升到 2019 年，平均年变化率分别为 0.8%（95%置信区间[CI]：0.6-1.0%）、1.3%（95% CI：1.1-1.5%）、0.4%（95% CI：0.2-0.6%）和 0.2%（95% CI：0.1-0.4%）。尽管 2019 年至 2044 年，男女两性的年龄标准化发病率和死亡率预计将逐渐下降，但新发病例和死亡人数预计将稳步增长。
胆囊和胆道癌在中国已成为一个主要的健康负担，尤其是在男性和老年人中。鉴于人口老龄化和负担增加，需要采取有效的策略和措施来预防或减少胆囊和胆道癌的新发病例和死亡人数。
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