He Baozhen, Zhao Xingyu, Pu Yang, Sun Rong, Gao Xi, Liu Weiwei
Research Center for Medicine and Social Development, Chongqing, China.
Research Center for Public Health Security, Chongqing Medical University, Chongqing, China.
Thorac Cancer. 2024 Aug;15(22):1688-1704. doi: 10.1111/1759-7714.15332. Epub 2024 Jul 10.
Lung cancer (LC) is currently the number one malignancy death rate disease in China, and its disease burden is serious. The study aimed to analyze trends of LC and its risk factor attributable disease in China from 1990 to 2019 and predict the next 41 years.
The average annual percentage change (AAPC) was used to analyze the trend of LC and its risk factor attributable incidence, deaths, and disability-adjusted life years (DALYs) rate in China from 1990 to 2019, collected in the Global Burden of Disease 2019. Cochran-Armitage trends examine trends in lung cancer disease burden by sex, age, and attributable risk factor groups in China from 1990 to 2019. In addition, based on data on death and DALYs rate due to LC and its risk factors between 1990 and 2019, an autoregressive integrated moving average (ARIMA) model was developed to predict the change in the trend of burden of disease due to LC and its risk factors over the next 41 years, and the model was evaluated using the model parameters root mean square error, mean absolute error, and mean absolute percentage error.
From 1990 to 2019, the incidence, mortality and DALYs of LC were all increased. Among the eight risk factors associated with lung cancer, the DALYs rate and mortality rate of lung cancer risk factors for Chinese residents increased from 1990 to 2019, except for household air pollution from solid fuels and diet low in fruit, which showed a decrease; among them, the DALYs rate and mortality rate due to ambient particulate matter pollution showed the greatest increase with AAPC values of 2.880 and 3.310, respectively, while DALYs and mortality rates due to household air pollution from solid fuels showed the largest decreases, with AAPC values of -4.755 and -4.348, respectively. The results of the ARIMA model predictions show that both the mortality rate and the rate of DALYs for lung cancer are increasing yearly, and it is predicted that the rate of DALYs for lung cancer by 2060 will reach 740.095/100 000 and the mortality rate will reach 35.151/100 000. It is expected that by 2060, the top four risk factors for lung cancer in China will be, in order of DALYs rate and mortality rate, smoking, ambient particulate matter pollution, high fasting plasma glucose (HFPG), and secondhand smoke, with HFPG showing the greatest increase.
The LC burden increased from 1990 to 2019 in China, the LC burden that could be attributed to HFPG will continue to increase in the next 40 years, and will be the third most factor by 2060. Targeted interventions are warranted to facilitate the prevention of LC and improvement of health-related quality of life patients with LC.
肺癌目前是中国恶性肿瘤死亡率最高的疾病，其疾病负担严重。本研究旨在分析1990年至2019年中国肺癌及其危险因素所致疾病的趋势，并预测未来41年的情况。
采用平均年变化百分比（AAPC）分析1990年至2019年中国肺癌及其危险因素所致发病率、死亡率和伤残调整生命年（DALY）率的趋势，数据来自《2019年全球疾病负担》。 Cochr an-Armitage趋势分析了1990年至2019年中国按性别、年龄和可归因危险因素分组的肺癌疾病负担趋势。此外，基于1990年至2019年肺癌及其危险因素导致的死亡和DALY率数据，建立了自回归积分移动平均（ARIMA）模型，以预测未来41年肺癌及其危险因素所致疾病负担趋势的变化，并使用模型参数均方根误差、平均绝对误差和平均绝对百分比误差对模型进行评估。
1990年至2019年，肺癌的发病率、死亡率和DALY均有所上升。在与肺癌相关的8个危险因素中，1990年至2019年中国居民肺癌危险因素的DALY率和死亡率上升，其中固体燃料造成的家庭空气污染和水果摄入量低的饮食呈下降趋势；其中，环境颗粒物污染导致的DALY率和死亡率上升幅度最大，AAPC值分别为2.880和3.310，而固体燃料造成的家庭空气污染导致的DALY和死亡率下降幅度最大，AAPC值分别为-4.755和-4.348。ARIMA模型预测结果显示，肺癌死亡率和DALY率均逐年上升，预计到2060年肺癌DALY率将达到740.095/10万，死亡率将达到35.151/10万。预计到2060年，中国肺癌的前四大危险因素按DALY率和死亡率排序依次为吸烟、环境颗粒物污染、高空腹血糖（HFPG）和二手烟，其中HFPG上升幅度最大。
1990年至2019年中国肺癌负担加重，未来40年HFPG所致肺癌负担将持续上升，到2060年将成为第三大因素。有必要采取针对性干预措施，以促进肺癌的预防和改善肺癌患者的健康相关生活质量。
