1990 年至 2017 年 33 个国家的角质形成细胞皮肤癌发病率、死亡率和疾病负担趋势。

Trends in keratinocyte skin cancer incidence, mortality and burden of disease in 33 countries between 1990 and 2017.

机构信息

Medical Data Research Collaborative, London, UK.

Department of Medicine, Mount Auburn Hospital, Cambridge, MA, USA.

出版信息

Br J Dermatol. 2023 Feb 10;188(2):237-246. doi: 10.1093/bjd/ljac064.

DOI:10.1093/bjd/ljac064

PMID:36763862

Abstract

BACKGROUND

Keratinocyte cancers (KCs) are the most common type of cancer in the White population worldwide, with associated high healthcare costs. Understanding the epidemiological trends for KCs, namely basal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (SCCs), is required to assess burden of disease, project future trends and identify strategies for addressing this pressing global health issue.

OBJECTIVES

To report trends in BCC and SCC incidence, and SCC mortality and disability-adjusted life-years (DALYs).

METHODS

An observational study of the Global Burden of Disease (GBD) database between 1990 and 2017 was performed. European Union countries and other selected high-income countries, including the UK and the USA, classified as having high-quality mortality data, were included. Annual age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs) and DALYs for each country were obtained from the GBD database. Trends were described using joinpoint regression analysis.

RESULTS

Overall, 33 countries were included. For both BCC and SCC in 2015-2017, the highest ASIRs were observed in the USA and Australia. Males had higher ASIRs than females at the end of the observation period in all countries for SCC, and in all countries but two for BCC. In contrast, the highest ASDRs for SCC were observed in Australia and Latvia for males, and in Romania and Croatia for females. The highest DALYs for SCC for both sexes were seen in Australia and Romania. Over the observation period, there were more countries demonstrating decreasing trends in mortality than in incidence, and disparities were observed between which countries had comparatively high mortality rates and which had high incidence rates. Overall reductions in SCC DALYs were observed in 24 of 33 countries for males, and 25 countries for females.

CONCLUSIONS

Over the past 27 years, although trends in SCC incidence have risen in most countries, there is evidence that mortality rates have been decreasing. Burden of disease as assessed using DALYs has decreased in the majority of countries. Future work will explore potential explanatory factors for the observed disparity in trends in SCC incidence and mortality.

摘要

背景

角蛋白细胞癌（KCs）是全球白种人群中最常见的癌症类型，相关医疗保健费用高昂。了解角蛋白细胞癌（包括基底细胞癌（BCC）和皮肤鳞状细胞癌（SCC））的流行病学趋势，对于评估疾病负担、预测未来趋势以及确定解决这一紧迫的全球健康问题的策略至关重要。

目的

报告 BCC 和 SCC 发病率以及 SCC 死亡率和伤残调整生命年（DALYs）的趋势。

方法

对 1990 年至 2017 年全球疾病负担（GBD）数据库进行了一项观察性研究。包括欧盟国家和其他选定的高收入国家，如英国和美国，这些国家被归类为具有高质量死亡率数据。从 GBD 数据库中获得了每个国家的年度年龄标准化发病率（ASIRs）、年龄标准化死亡率（ASDRs）和 DALYs。使用 joinpoint 回归分析描述趋势。

结果

共有 33 个国家被纳入研究。2015-2017 年期间，BCC 和 SCC 的最高 ASIRs 在美国和澳大利亚观察到。在所有国家，男性的 SCC 终末 ASIR 均高于女性，除了两个国家之外，其他国家均如此。相比之下，男性的 SCC 最高 ASDRs 在澳大利亚和拉脱维亚观察到，女性的最高 ASDRs 在罗马尼亚和克罗地亚观察到。男女 SCC 的最高 DALYs 在澳大利亚和罗马尼亚观察到。在观察期间，死亡率呈下降趋势的国家比发病率呈下降趋势的国家更多，并且死亡率高的国家和发病率高的国家之间存在差异。在 24 个男性国家和 25 个女性国家中，SCC DALYs 总体呈下降趋势。