Dong Yu, Fan Zhuan-Zhuan, Li Wen-Ting, Kang Jian, Zhang Yan, Guan Yue, Xu Hui-Qing, Yuan Jie, Xu Fei
Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
Department of Primary Healthcare Management, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, Jiangsu Province, China.
World J Gastrointest Oncol. 2024 Sep 15;16(9):3955-3979. doi: 10.4251/wjgo.v16.i9.3955.
Although gastrointestinal (GI) cancers have been becoming a great public health concern in China, there is currently a lack of comprehensive literature on the overall burden and changing trends of GI cancers in the working-age population.
To assess the burden of GI cancers and to examine the overall, age- and gender-specific trends among the working-age population in China from 1990 to 2019.
Data were extracted from the Global Burden of Disease Study 2019. The burden of GI cancers was indicated by incidence, mortality, disability-adjusted life-years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate, and age-standardized DALYs rate. Trends in the burden of GI cancers from 1990 to 2019 were examined using annual percent change and average annual percent change with Joinpoint regression models.
For overall GI cancers, a declining trend was observed in the ASIR, age-standardized mortality rate, and age-standardized DALYs rate, with reductions of 0.74%, 2.23%, and 2.22%, respectively, from 1999 to 2019 in the Chinese working-age population. However, an increasing trend was observed in the ASIR for overall GI cancers from 2016-2019. The number of either incident cases, mortality cases, and DALYs was higher for colon/rectum cancer and liver cancer in younger participants but lower for esophageal, gallbladder, biliary tract, pancreatic, and stomach cancer among older subjects. Moreover, sex disparity in the GI cancers burden was also examined over 30 years.
The total burden of GI cancers remained heavy among the working-age population in China, although declining trends were observed from 1999 to 2019. Disparities in the GI cancers burden existed between sexes, age groups, and cancer types. Population-based precision prevention strategies are needed to tackle GI cancers among working-age individuals, considering the age, sex, and cancer type disparities in China.
尽管胃肠道癌症在中国已成为一个重大的公共卫生问题，但目前缺乏关于劳动年龄人口胃肠道癌症总体负担及变化趋势的综合文献。
评估胃肠道癌症负担，并研究1990年至2019年中国劳动年龄人口中总体、按年龄和性别的趋势。
数据取自《2019年全球疾病负担研究》。胃肠道癌症负担通过发病率、死亡率、伤残调整生命年（DALYs）、年龄标准化发病率（ASIR）、年龄标准化死亡率和年龄标准化DALYs率来表示。使用年度百分比变化和平均年度百分比变化以及Joinpoint回归模型研究1990年至2019年胃肠道癌症负担的趋势。
对于总体胃肠道癌症，在中国劳动年龄人口中，1999年至2019年期间，年龄标准化发病率、年龄标准化死亡率和年龄标准化DALYs率呈下降趋势，分别下降了0.74%、2.23%和2.22%。然而，2016 - 2019年总体胃肠道癌症的年龄标准化发病率呈上升趋势。年轻参与者中结肠癌/直肠癌和肝癌的发病病例、死亡病例及DALYs数量较多，而老年受试者中食管癌、胆囊癌、胆管癌、胰腺癌和胃癌的相应数量较少。此外，还研究了30年来胃肠道癌症负担的性别差异。
尽管1999年至2019年观察到下降趋势，但中国劳动年龄人口中胃肠道癌症的总负担仍然很重。胃肠道癌症负担在性别、年龄组和癌症类型之间存在差异。考虑到中国在年龄、性别和癌症类型方面的差异，需要基于人群的精准预防策略来应对劳动年龄人群中的胃肠道癌症。
