北非和中东地区脑癌及其他中枢神经系统癌症的流行病学：1990 - 2019年全球疾病负担研究的系统分析
Epidemiology of Brain and Other Central Nervous System Cancers in the North Africa and Middle East Region: A Systematic Analysis of the Global Burden of Disease Study 1990-2019.
作者信息
Mohammadi Esmaeil, Moghaddam Sahar Saeedi, Azadnajafabad Sina, Maroufi Seyed Farzad, Rashidi Mohammad-Mahdi, Naderian Mohammadreza, Jafari Ali, Sharifi Guive, Ghasemi Erfan, Rezaei Nazila, Malekpour Mohammad-Reza, Kompani Farzad, Rezaei Negar, Larijani Bagher, Farzadfar Farshad
机构信息
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Kiel Institute for the World Economy, Kiel, Germany.
出版信息
World Neurosurg. 2023 Mar;171:e796-e819. doi: 10.1016/j.wneu.2022.12.112. Epub 2022 Dec 28.
OBJECTIVE
To present estimates of prevalence and incidence of and contributors to central nervous system (CNS) cancers, death, years of life lost, years lived with disability, and disability-adjusted life years from 1990 to 2019 in North Africa and the Middle East.
METHODS
Primary measures were retrieved from Global Burden of Disease 2019. Contribution of various factors to observed incidence and mortality changes was investigated with decomposition and age-period-cohort analyses.
RESULTS
In 2019, 27,529 (95% uncertainty interval [UI]: 18,554-32,579; percent change compared with 1990: +152.5%) new CNS cancers and 17,773 (95% UI:12,096-20,936; percent change compared with 1990: +111.5%) deaths occurred. Meanwhile, 71.0% increase led to 71,6271 (95% UI: 493,932-848,226) disability-adjusted life years in 2019 with a halved years of life lost/years lived with disability ratio of 66.3% (proxy of worse care quality). Altogether, 97,195 (95% UI: 64,216-115,621; percent change compared with 1990: +280.5%) patients with prevalent cases were alive in 2019. All decomposed indices, including aging, cause-specific incidence, and population growth, contributed substantially to increased incidence of CNS cancers. Moreover, age brackets, study period (1990-2019), and 5-year cohorts all demonstrated positive effects, while age had a mixed influence in different age groups. Palestine harbored the highest age-standardized disability-adjusted life years rate in 2019 (232.0 [95% UI: 175.6-279.5]), while Tunisia had the lowest (41.8 [95% UI: 27.6-57.1] per 100,000). The greatest burden increase was found in Saudi Arabia (32.3%).
CONCLUSIONS
The burden of CNS cancers is rising in North Africa and the Middle East, with major heterogeneities among countries. Improved early detection and health care access across countries are required to bridge inequalities and address the rising burden of CNS malignancies.
目的
呈现1990年至2019年北非和中东地区中枢神经系统（CNS）癌症的患病率、发病率、死亡情况、寿命损失年数、残疾生存年数以及残疾调整生命年数的估计值。
方法
主要指标取自《2019年全球疾病负担》。通过分解分析和年龄-时期-队列分析，研究各种因素对观察到的发病率和死亡率变化的贡献。
结果
2019年，新发中枢神经系统癌症27,529例（95%不确定区间[UI]：18,554 - 32,579；与1990年相比的百分比变化：+152.5%），死亡17,773例（95% UI：12,096 - 20,936；与1990年相比的百分比变化：+111.5%）。同时，2019年残疾调整生命年数增加了71.0%，达到716,271（95% UI：493,932 - 848,226），寿命损失年数/残疾生存年数的比例减半，为66.3%（反映医疗质量较差）。2019年共有97,195例（95% UI：64,216 - 115,621；与1990年相比的百分比变化：+280.5%）现患病例存活。所有分解指标，包括老龄化、特定病因发病率和人口增长，对中枢神经系统癌症发病率的增加都有很大贡献。此外，年龄组、研究时期（1990 - 2019年）和5年队列均显示出积极影响，而年龄在不同年龄组中的影响则各不相同。2019年，巴勒斯坦的年龄标准化残疾调整生命年率最高（232.0[95% UI：175.6 - 279.5]），而突尼斯最低（每10万人中为41.8[95% UI：27.6 - 57.1]）。负担增加最大的是沙特阿拉伯（32.3%）。
结论
北非和中东地区中枢神经系统癌症的负担正在上升，各国之间存在重大差异。需要在各国改善早期检测和医疗服务可及性，以弥合不平等现象并应对中枢神经系统恶性肿瘤负担的上升。
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