Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan Province, China; Henan Key Laboratory of Tumor Epidemiology and State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, 450052, Henan Province, China.
Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan Province, China.
Public Health. 2024 Sep;234:112-119. doi: 10.1016/j.puhe.2024.06.008. Epub 2024 Jul 6.
This study aimed to assess the burden of early-onset gastrointestinal (GI) cancers in China over three decades.
A comprehensive analysis was performed using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.
Data on early-onset GI cancers in 2020 and from 1990 to 2019 were extracted from GLOBOCAN 2020 database and GBD 2019, respectively. The average annual percent change (AAPC) was calculated to analyze the temporal trends using the Joinpoint Regression Program. The Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2030.
In China, there were 185,980 incident cases and 119,116 deaths of early-onset GI cancer in 2020, with the highest incidence and mortality observed in liver cancer (new cases: 71,662; deaths: 62,412). The spectrum of early-onset GI cancers in China has transitioned over the last 30 years. The age-standardized rates of incidence, mortality, and disability-adjusted life years for colorectal and pancreatic cancers exhibited rapid increases (AAPC >0, P ≤ 0.001). The fastest-growing incidence rate was found in colorectal cancer (AAPC: 3.06, P < 0.001). Despite the decreases in liver, gastric, and esophageal cancers, these trends have been reversed or flattened in recent years. High body mass index was found to be the fastest-growing risk factor for early-onset GI cancers (estimated annual percentage change: 2.75-4.19, P < 0.05). Projection analyses showed an increasing trend in age-standardized incidence rates for almost all early-onset GI cancers during 2020-2030.
The transitioning pattern of early-onset GI cancers in China emphasizes the urgency of addressing this public health challenge.
本研究旨在评估中国三十多年来早发性胃肠道（GI）癌症的负担。
使用来自全球疾病、伤害和风险因素研究（GBD）2019 的数据进行全面分析。
从 GLOBOCAN 2020 数据库和 GBD 2019 中分别提取 2020 年和 1990 年至 2019 年早发性 GI 癌症的数据。使用 Joinpoint 回归程序计算平均年变化百分比（AAPC），以分析时间趋势。使用贝叶斯年龄-时期-队列（BAPC）模型预测 2030 年前的未来趋势。
2020 年中国有 185980 例早发性 GI 癌症新发病例和 119116 例死亡病例，肝癌的发病率和死亡率最高（新发病例：71662 例；死亡：62412 例）。中国早发性 GI 癌症的谱在过去 30 年中发生了转变。结直肠癌和胰腺癌的发病率、死亡率和伤残调整生命年的年龄标准化率呈快速上升趋势（AAPC>0，P≤0.001）。结直肠癌的发病率增长最快（AAPC：3.06，P<0.001）。尽管肝癌、胃癌和食管癌的发病率有所下降，但近年来这些趋势已经逆转或趋于平稳。高身体质量指数被认为是早发性 GI 癌症增长最快的风险因素（估计年百分比变化：2.75-4.19，P<0.05）。预测分析显示，2020-2030 年期间，几乎所有早发性 GI 癌症的年龄标准化发病率都呈上升趋势。
中国早发性 GI 癌症的转变模式强调了应对这一公共卫生挑战的紧迫性。
