Gu J C, Liu Y, Wang X L, Zhang L L, Liu Y X
School of Stomatology, Weifang Medical University, Weifang 261053, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2023 Sep 9;58(9):919-925. doi: 10.3760/cma.j.cn112144-20221020-00544.
To analyze the trend of disease burden of oral cancer attributable to smoking in China from 1990 to 2019, and predict the mortality trend of oral cancer from 2020 to 2034, providing scientific basis for formulating targeted oral cancer prevention and treatment strategy to achieve the goal of "Healthy China 2030". Using partial data on the global burden of disease in China in 2019, attributive death and disability adjusted life year (DALY) were used to describe. The trend of changes in the burden of oral cancer disease attributed to smoking was analyzed by using the Joinpoint regression model to estimate the annual average percentage change (AAPC) of age standardized mortality and DALY rates. Meanwhile, the Bayesian age-period- cohort model is used to predict oral cancer deaths and DALY trends attributed to smoking over the next 15 years. The age-standardized mortality rate and DALY rate in China from 1990 to 2019 showed an overall upward trend, with an average annual increase of 1.49% (95: 1.34%-1.65%, 0.001) and 1.41% (95: 1.24%-1.59%, 0.001) respectively, higher than around the earth and in regions with different socio-demographic index (SDI). In 2019, 46.74% (10 584/22 642) of oral cancer deaths in China were attributed to smoking. Compared to 1990, the number of attributed deaths in 2019 increased by 293.75% (7 896/2 688), while DALY increased by 257.97% (189 039/73 280). Moreover, the growth rates of attributed deaths and DALY in males [304.95% (7 584/2 487) and 265.60% (183 349/69 033), respectively] were significantly higher than those in females [154.73% (311/201) and 133.95% (5 690/4 248), respectively] (0.001). The age group results showed that the proportion of deaths and DALY gradually transitioned towards the elderly (>60 years old). The expected number of deaths would increase from 10 731 in 2020 to 14 125 in 2034, with a rise of 31.63% (3 394/10 731). Simultaneously, DALY would increase from 267 064 person years in 2020 to 326 634 person years in 2034, with a rise of 22.31% (59 570/267 064). From 1990 to 2019, the burden of oral cancer diseases attributed to smoking in China showed an increasing trend, with a higher growth rates than in the global and different SDI regions. There were differences in gender and age, and the burden of oral cancer diseases attributed to smoking in China would continue to increase in the next 15 years. It is necessary to educate on the adverse effects of tobacco consumption and to conduct vigilant oral self-examination among high-risk groups to help early detection and intervention at the same time.
分析1990年至2019年中国吸烟所致口腔癌疾病负担趋势，并预测2020年至2034年口腔癌死亡率趋势，为制定针对性口腔癌防治策略以实现“健康中国2030”目标提供科学依据。利用2019年中国全球疾病负担的部分数据，采用归因死亡和伤残调整生命年（DALY）进行描述。运用Joinpoint回归模型估计年龄标准化死亡率和DALY率的年均变化百分比（AAPC），分析吸烟所致口腔癌疾病负担的变化趋势。同时，采用贝叶斯年龄-时期-队列模型预测未来15年吸烟所致口腔癌死亡和DALY趋势。1990年至2019年中国年龄标准化死亡率和DALY率总体呈上升趋势，年均分别上升1.49%（95%：1.34%-1.65%，P<0.001）和1.41%（95%：1.24%-1.59%，P<0.001），高于全球及不同社会人口指数（SDI）地区。2019年中国46.74%（10584/22642）的口腔癌死亡归因于吸烟。与1990年相比，2019年归因死亡数增加了293.75%（7896/2688），DALY增加了257.97%（189039/73280）。此外，男性归因死亡和DALY的增长率[分别为304.95%（7584/2487）和265.60%（183349/69033）]显著高于女性[分别为154.73%（311/201）和133.95%（5690/4248）]（P<0.001）。年龄组结果显示，死亡和DALY比例逐渐向老年人（>60岁）转移。预计死亡人数将从2020年的10731例增加到2034年的14125例，上升31.63%（3394/10731）。同时，DALY将从2020年的267064人年增加到2034年的326634人年，上升22.31%（59570/267064）。1990年至2019年，中国吸烟所致口腔癌疾病负担呈上升趋势，高于全球及不同SDI地区。存在性别和年龄差异，未来15年中国吸烟所致口腔癌疾病负担将持续增加。有必要开展烟草消费不良影响教育，并对高危人群进行口腔自我检查监测，以助于早期发现和干预。
