全球和区域老龄化人口中癌症的发生情况，1990 年至 2019 年。
The occurence of cancer in ageing populations at global and regional levels, 1990 to 2019.
机构信息
Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
出版信息
Age Ageing. 2023 Sep 1;52(9). doi: 10.1093/ageing/afad043.
BACKGROUND
population ageing contributes to increased cancer cases and deaths and has profound implications for global healthcare systems. We estimated the trends of cancer cases and deaths in ageing populations at global and regional levels.
METHODS
using data from the Global Burden of Disease Study 2019, we analysed the change in cancer cases and deaths associated with population ageing, population growth and epidemiological factors from 1990 to 2019 using decomposition analysis. Additionally, we estimated the proportions of people aged 65 years and over accounting for total cases and deaths, and investigated relationships between the proportions and the Sociodemographic Index (SDI) using the Pearson correlation coefficient.
RESULTS
from 1990 to 2019, there was an increase of 128.9% for total cases and 74.8% for total deaths in all cancers combined; the percentages of older people increased from 48.6% to 56.4% for cases and from 52.0% to 61.9% for deaths. Population ageing contributed to the largest increase in global cancer occurrence, with 56.5% for cases and 63.3% for deaths. However, the changes attributed to epidemiological factors was 5.2% for cancer cases and -33.4% for cancer deaths. The proportions of total cases and deaths of older adults were positively correlated with socioeconomic development of the country.
CONCLUSION
our findings revealed that the main contributor to increased cancer cases and deaths has changed from comprehensive epidemiological factors to demographic shifts. To respond to the rapidly growing occurrence of cancer in ageing populations, the global health priority should focus on meeting the rising demand for cancer diagnosis, treatment and care services for older people.
背景
人口老龄化导致癌症病例和死亡人数增加，对全球医疗保健系统产生深远影响。我们估计了全球和区域层面老龄化人口中癌症病例和死亡的趋势。
方法
使用 2019 年全球疾病负担研究的数据，我们通过分解分析，分析了 1990 年至 2019 年与人口老龄化、人口增长和流行病学因素相关的癌症病例和死亡变化。此外，我们估计了 65 岁及以上人群在总病例和死亡中的比例，并使用 Pearson 相关系数调查了这些比例与社会人口指数（SDI）之间的关系。
结果
从 1990 年到 2019 年，所有癌症的总病例增加了 128.9%，总死亡增加了 74.8%；老年人的比例从病例的 48.6%增加到 56.4%，从死亡的 52.0%增加到 61.9%。人口老龄化是全球癌症发病率增加的最大原因，病例占 56.5%，死亡占 63.3%。然而，归因于流行病学因素的变化在癌症病例中为 5.2%，在癌症死亡中为-33.4%。老年人总病例和死亡比例与国家的社会经济发展呈正相关。
结论
我们的研究结果表明，导致癌症病例和死亡增加的主要因素已从综合流行病学因素转变为人口结构变化。为了应对老龄化人口中癌症发病率的迅速增长，全球卫生重点应侧重于满足老年人对癌症诊断、治疗和护理服务不断增长的需求。
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