Cheng Zhiyuan, Wang Tinglu, Jiao Yunfei, Qi Jinlei, Zhang Xun, Zhou Siwei, Xin Lei, Wan Rong, Zhou Maigeng, Li Zhaoshen, Wang Luowei
Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China.
Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
Chin Med J (Engl). 2024 Aug 14;137(18):2182-9. doi: 10.1097/CM9.0000000000003277.
Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies. However, comprehensive reports on the burden of digestive system diseases in China are lacking. Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.
This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence, mortality rate, disability-adjusted life years (DALYs), years of life disability, years of life lost, and changes in the burden of digestive diseases across 31 Chinese provinces from 1990 to 2019. The analysis of disease burden primarily examines the characteristics of sub-disease distribution, time trends, age distribution, and sex distribution. Additionally, we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index (SDI).
In 2019, there were 499.2 million cases of digestive system diseases in China, resulting in 1,557,310 deaths. Stomach cancer, colon and rectal cancer, and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases. Meanwhile, cirrhosis and other chronic liver diseases, gastroesophageal reflux disease, and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases. The risk of gastric cancer sharply increases among men after the age of 40 years, leading to a significant disparity in burden between men and women. As the SDI increased, the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.
Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI, providing valuable insights that can assist public health officials in the estimation of the disease burden in this area.
评估消化系统疾病的影响对于制定有效的预防策略至关重要。然而，中国缺乏关于消化系统疾病负担的全面报告。我们的研究旨在概述1990年至2019年中国及其各省消化系统疾病的负担和趋势。
这项横断面研究利用《2019年全球疾病负担研究》来估计1990年至2019年中国31个省份消化系统疾病的发病率、死亡率、伤残调整生命年（DALYs）、失能生命年、生命损失年以及疾病负担的变化。疾病负担分析主要考察亚疾病分布特征、时间趋势、年龄分布和性别分布。此外，我们将各省消化系统疾病的年龄标准化DALYs与基于社会人口学指数（SDI）的预期率进行了比较。
2019年，中国消化系统疾病病例达4.992亿例，导致1557310人死亡。胃癌、结肠癌和直肠癌以及食管癌是与消化系统疾病死亡率和DALYs相关的前三大疾病。同时，肝硬化和其他慢性肝病、胃食管反流病以及胆囊和胆道疾病是消化系统疾病中患病率最高的前三种疾病。40岁以后男性患胃癌的风险急剧增加，导致男女之间的负担存在显著差异。随着SDI的增加，中国及其各省与消化系统疾病相关的DALYs呈下降趋势。
我们的研究突出了与消化系统疾病相关的DALYs与SDI之间的负相关关系，提供了有价值的见解，可协助公共卫生官员评估该领域的疾病负担。
