1990年至2019年中国饮食风险因素所致结直肠癌的疾病负担
[Disease burden of colorectal cancer attributable to dietary risk factors from 1990 to 2019 in China].
作者信息
Zhao Q Y, Zhang C X
机构信息
School of Public Health, Sun Yat-sen University, Guangzhou 510080, China School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
出版信息
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Feb 10;45(2):200-206. doi: 10.3760/cma.j.cn112338-20230919-00168.
To analyze the trend of mortality rate and disability-adjusted life year (DALY) of colorectal cancer attributable to dietary risk factors from 1990 to 2019 in China. Mortality rate and DALY rate of colorectal cancer attributable to dietary risk factors (diet high in processed meat, diet high in red meat, diet low in calcium, diet in low in fiber, diet low in milk, diet low in whole grains, dietary risks) were collected from the Global Burden of Disease study 2019 (GBD2019). Joinpoint regression model was selected to analyze the trend and an age-period-cohort model was used to estimate the effects of age, period and birth cohort. Joinpoint regression analysis showed that the age-standardized mortality rate and age-standardized DALY rate of colorectal cancer attributable to diet high in processed meat, diet high in red meat, diet low in milk, diet low in whole grains and dietary risks showed an upward trend (<0.05) from 1990 to 2019, while those attributable to diet low in calcium and diet low in fiber showed a downward trend (<0.05). The mortality rate and DALY rate of colorectal cancer attributable to diet high in processed meat, diet high in red meat, diet low in milk, diet low in whole grains and dietary risks in age groups from 65 to 79 years showed a quicker upward trend than those in age groups from 25 to 64 years. The mortality rate and DALY rate attributable to diet low in calcium and diet low in fiber in age groups from 65 to 79 years showed a slower downward trend than those in age groups from 25 to 64 years. The mortality rate and DALY rate of colorectal cancer attributable to diet high in processed meat, diet high in red meat, diet low in calcium, diet low in fiber, diet low in milk, diet low in whole grains, and dietary risks increased with age after adjusting for period effect and cohort effect (<0.05). The mortality rate and DALY rate attributable to diet high in processed meat, diet high in red meat, diet low in calcium, diet low in milk, diet low in whole grains and dietary risks increased with period or cohort, while those attributable to diet low in fiber decreased with period or cohort. Period and cohort effect of dietary risk factors in this study were statistically significant (<0.001). Disease burden of colorectal cancer attributable to dietary risk factors in China showed an upward trend in general. Elderly population is high at risk and more attention should be paid to science popularization and education on dietary risk factors in prevention and treatment of colorectal cancer.
分析1990年至2019年中国饮食风险因素所致结直肠癌死亡率和伤残调整生命年(DALY)的变化趋势。从《2019年全球疾病负担研究》(GBD2019)中收集饮食风险因素(加工肉类含量高的饮食、红肉含量高的饮食、钙含量低的饮食、纤维含量低的饮食、牛奶含量低的饮食、全谷物含量低的饮食、饮食风险)所致结直肠癌的死亡率和DALY率。选择Joinpoint回归模型分析趋势,并使用年龄-时期-队列模型估计年龄、时期和出生队列的影响。Joinpoint回归分析表明,1990年至2019年,加工肉类含量高的饮食、红肉含量高的饮食、牛奶含量低的饮食、全谷物含量低的饮食和饮食风险所致结直肠癌的年龄标准化死亡率和年龄标准化DALY率呈上升趋势(P<0.05),而钙含量低的饮食和纤维含量低的饮食所致者呈下降趋势(P<0.05)。65至79岁年龄组中,加工肉类含量高的饮食、红肉含量高的饮食、牛奶含量低的饮食、全谷物含量低的饮食和饮食风险所致结直肠癌的死亡率和DALY率上升趋势比25至64岁年龄组更快。65至79岁年龄组中,钙含量低的饮食和纤维含量低的饮食所致结直肠癌的死亡率和DALY率下降趋势比25至64岁年龄组更慢。调整时期效应和队列效应后,加工肉类含量高的饮食、红肉含量高的饮食、钙含量低的饮食、纤维含量低的饮食、牛奶含量低的饮食、全谷物含量低的饮食和饮食风险所致结直肠癌的死亡率和DALY率随年龄增加(P<0.05)。加工肉类含量高的饮食、红肉含量高的饮食、钙含量低的饮食、牛奶含量低的饮食、全谷物含量低的饮食和饮食风险所致结直肠癌的死亡率和DALY率随时期或队列增加,而纤维含量低的饮食所致者随时期或队列下降。本研究中饮食风险因素的时期和队列效应具有统计学意义(P<0.001)。中国饮食风险因素所致结直肠癌的疾病负担总体呈上升趋势。老年人群风险高,在结直肠癌防治中应更加重视饮食风险因素的科普教育。