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全球 2022 年肝癌流行病学:重点关注地理差异。

Global epidemiology of liver cancer 2022: An emphasis on geographic disparities.

机构信息

Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing100021, China.

Department of Anesthesiology, 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

Chin Med J (Engl). 2024 Oct 5;137(19):2334-2342. doi: 10.1097/CM9.0000000000003264. Epub 2024 Sep 3.

Abstract

BACKGROUND

Liver cancer remains the sixth most commonly diagnosed cancer and the third leading cause of cancer-related deaths worldwide, causing a heavy burden globally. An updated assessment of the global epidemiology of the liver cancer burden that addresses geographical disparities is necessary to better understand and promote healthcare delivery.

METHODS

Data were extracted from the GLOBOCAN 2022 database, including the number, crude, and age-standardized rates of incidence and mortality at the global, country, continent, and human development index (HDI) regional levels. Age-standardized rates (incidence and mortality) per 100,000 person-years were adjusted based on the Segi-Doll World standard population. The mortality-to-incidence ratios (MIR) for each region and country were calculated. The HDI and gross national income (GNI) for 2022 were obtained, and a Pearson correlation analysis was conducted with the incidence, mortality, and MIR.

RESULTS

In 2022, approximately 866,136 new liver cancer cases and 758,725 related deaths were recorded worldwide, with a global MIR of 0.86. Males had a disproportionately higher burden than females across all levels, and the highest burden was observed in the elderly population. Geographically, the regions with the highest incidence rates included Micronesia, Eastern Asia, and Northern Africa, and the regions with the highest mortality rates included Northern Africa, Southeastern Asia, Eastern Asia, and Micronesia. Notably, Mongolia had a strikingly high burden compared to other countries. The highest MIR was observed in North America and the lowest in Africa. Negative associations of HDI and GNI with liver cancer mortality and MIR were identified, irrespective of sex.

CONCLUSIONS

The current liver cancer burden underscores the presence of remarkable geographic heterogeneity, which is particularly evident across countries with varying HDI levels, highlighting the urgent need to prioritize health accessibility and availability to achieve health inequities.

摘要

背景

肝癌仍是全球第六大常见癌症和第三大癌症相关死亡原因,在全球范围内造成了沉重的负担。为了更好地了解和促进医疗保健服务,有必要对全球肝癌负担的流行病学进行最新评估,以解决地域差异问题。

方法

从 GLOBOCAN 2022 数据库中提取数据,包括全球、国家、大陆和人类发展指数(HDI)区域水平的肝癌发病、死亡病例数、粗率和年龄标准化率。根据 Segi-Doll 世界标准人口,对每 100,000 人年的年龄标准化率(发病率和死亡率)进行了调整。计算了每个区域和国家的死亡率与发病率比(MIR)。获取了 2022 年的 HDI 和国民总收入(GNI),并对发病率、死亡率和 MIR 进行了 Pearson 相关性分析。

结果

2022 年,全球约有 866,136 例肝癌新发病例和 758,725 例相关死亡病例,全球 MIR 为 0.86。男性在所有水平上的负担都明显高于女性,而老年人的负担最高。从地域上看,发病率最高的地区包括密克罗尼西亚、东亚和北非,死亡率最高的地区包括北非、东南亚、东亚和密克罗尼西亚。值得注意的是,蒙古与其他国家相比负担极高。北美的 MIR 最高,非洲的最低。无论性别如何,都发现 HDI 和 GNI 与肝癌死亡率和 MIR 呈负相关。

结论

当前的肝癌负担突出了显著的地域异质性,这在不同人类发展指数水平的国家中尤为明显,强调了优先考虑卫生可及性和可用性以实现卫生公平的迫切需要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c52/11441870/3e401adaaab2/cm9-137-2334-g001.jpg

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