Chen De-Sheng, Chen Ze-Ping, Zhu Dong-Zi, Guan Lv-Xin, Zhu Qi, Lou Yi-Chao, He Ze-Ping, Chen Hao-Nan, Sun Hong-Cheng
Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
World J Gastrointest Oncol. 2024 Oct 15;16(10):4177-4193. doi: 10.4251/wjgo.v16.i10.4177.
Hepatobiliary and pancreatic (HBP) cancers impose a considerable burden on young populations (aged 15 to 49 years), resulting in a substantial number of new cases and fatalities each year. In young populations, the HBP cancers shows extensive variance worldwide and the updated data in China is lacking.
To investigate the current status, trends, projections, and underlying risk factors of HBP cancers among young populations in China.
The Global Burden of Disease Study 2019 provided data on the annual incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) of HBP cancers in young Chinese adults between 1990 and 2019. Temporal trends were assessed using estimated annual percentage change and hierarchical clustering. Sex-specific mortality and DALYs caused by various risks were analyzed across China and other regions, with future trends until 2035 projected using the Bayesian age-period-cohort model.
From 1990 to 2019, incident cases, deaths, DALYs, ASIR, ASMR, and ASDR for liver cancer (LC) in young Chinese individuals decreased, classified into 'significant decrease' group. Conversely, cases of gallbladder and biliary tract cancer and pancreatic cancer rose, categorized as either 'significant increase' or 'minor increase' groups. The contribution of risk factors to mortality and DALYs for HBP tumors increased to varying degrees. Healthy lifestyle behaviors, such as tobacco control, weight management, alcohol moderation, and drug avoidance, could lower HBP cancers incidence. Moreover, except for LC in females, which is likely to initially decline slightly and then rise, the forecasting model predicted that the ASIR and ASMR for all HPB cancers subtypes by gender will increase among young adults.
HBP cancers burden among young adults in China is expected to increase until 2035, necessitating lifestyle interventions and targeted treatment strategies to mitigate the public health impact of these cancers.
肝胆胰（HBP）癌症给年轻人群（15至49岁）带来了相当大的负担，每年导致大量新发病例和死亡。在年轻人群中，HBP癌症在全球范围内表现出广泛差异，而中国缺乏最新数据。
调查中国年轻人群中HBP癌症的现状、趋势、预测及潜在风险因素。
《2019年全球疾病负担研究》提供了1990年至2019年中国年轻成年人中HBP癌症的年发病率、死亡率、伤残调整生命年（DALYs）、年龄标准化发病率（ASIR）、死亡率（ASMR）和DALYs率（ASDR）的数据。使用估计的年度百分比变化和层次聚类评估时间趋势。分析了中国和其他地区由各种风险导致的性别特异性死亡率和DALYs，并使用贝叶斯年龄-时期-队列模型预测了到2035年的未来趋势。
1990年至2019年，中国年轻个体中肝癌（LC）的发病病例、死亡人数、DALYs、ASIR、ASMR和ASDR下降，归类为“显著下降”组。相反，胆囊和胆管癌以及胰腺癌的病例增加，归类为“显著增加”或“轻微增加”组。风险因素对HBP肿瘤死亡率和DALYs的贡献有不同程度增加。控烟、体重管理、适度饮酒和避免吸毒等健康生活方式行为可降低HBP癌症发病率。此外，除女性LC可能最初略有下降然后上升外，预测模型预测，按性别划分的所有HPB癌症亚型的ASIR和ASMR在年轻成年人中将增加。
预计到2035年中国年轻成年人中HBP癌症负担将增加，需要采取生活方式干预措施和有针对性的治疗策略，以减轻这些癌症对公众健康的影响。
