Chen Bijuan, Zhan Zhouwei, Xu Yun, Yu Sisi, Huang Jiali, Fang Yunxiang, Liu Yifei, Lin Ruyu, Pan Jianji, Lin Shaojun, Guo Qiaojuan, Hong Jinsheng
Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China.
Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China.
Radiother Oncol. 2025 Jan;202:110613. doi: 10.1016/j.radonc.2024.110613. Epub 2024 Nov 1.
Nasopharyngeal carcinoma (NPC) is a significant public health issue in China, with distinctive epidemiological characteristics and evolving trends. This study aims to analyze long-term trends in NPC burden from 1990 to 2021 and provide projections.
Data from the Global Burden of Disease (GBD) database (1990-2021) was utilized to evaluate NPC metrics, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Joinpoint regression identified significant changes over time. Age-period-cohort (APC) analyses assessed the effects of age, period, and cohort. A decomposition analysis identified factors influencing changes in NPC incidence, prevalence, and DALYs. Projections were made for future trends up to 2030.
In 2021, NPC significantly impacted China, with males experiencing higher incidence (5.16 per 100,000) and mortality rates (2.32 per 100,000) than females. NPC prevalence was 342,477 cases, with males accounting for 260,164. DALYs totaled 982,657, predominantly affecting males. From 1990 to 2021, the age-standardized incidence rate (ASIR) in China decreased from 4.64 to 3.42 per 100,000, while globally it declined from 1.74 to 1.38 per 100,000. Between 1990 and 2021, trends showed an initial decline in ASIR and age-standardized prevalence rate (ASPR), followed by a steady increase from 2006 onwards, with males experiencing more significant rises. Mortality rates showed a general downward trend, yet males remained disproportionately affected. Comparative global data indicated that while NPC metrics are declining worldwide, the burden remains higher in China. Decomposition analysis highlighted aging and population growth as major contributors to the NPC burden. Bayesian age-period-cohort (BAPC) projections indicated a continuing rise in age-standardized incidence and prevalence rates for both males and females up to 2030.
The burden of NPC in China remains significant, particularly among the male population. Despite declining mortality rates, the increasing prevalence suggests that more people are living with NPC. Targeted public health interventions are urgently needed to address these gender-specific trends and reduce the disease burden.
鼻咽癌（NPC）是中国一个重大的公共卫生问题，具有独特的流行病学特征和演变趋势。本研究旨在分析1990年至2021年期间鼻咽癌负担的长期趋势并进行预测。
利用全球疾病负担（GBD）数据库（1990 - 2021年）中的数据来评估鼻咽癌指标，包括发病率、患病率、死亡率和伤残调整生命年（DALYs）。Joinpoint回归确定了随时间的显著变化。年龄 - 时期 - 队列（APC）分析评估了年龄、时期和队列的影响。分解分析确定了影响鼻咽癌发病率、患病率和DALYs变化的因素。对截至2030年的未来趋势进行了预测。
2021年，鼻咽癌对中国产生了重大影响，男性的发病率（每10万人5.16例）和死亡率（每10万人2.32例）高于女性。鼻咽癌患病率为342,477例，其中男性占260,164例。DALYs总计982,657例，主要影响男性。从1990年到2021年，中国的年龄标准化发病率（ASIR）从每10万人4.64例降至3.42例，而全球范围内从每10万人1.74例降至1.38例。1990年至2021年期间，趋势显示ASIR和年龄标准化患病率（ASPR）最初下降，随后从2006年起稳步上升，男性上升更为显著。死亡率总体呈下降趋势，但男性受影响程度仍然过高。全球比较数据表明，虽然全球范围内鼻咽癌指标在下降，但中国的负担仍然较高。分解分析强调老龄化和人口增长是鼻咽癌负担的主要贡献因素。贝叶斯年龄 -时期 - 队列（BAPC）预测表明，到2030年，男性和女性的年龄标准化发病率和患病率将持续上升。
中国鼻咽癌负担仍然很重，尤其是在男性人群中。尽管死亡率在下降，但患病率上升表明有更多人患有鼻咽癌。迫切需要有针对性的公共卫生干预措施来应对这些性别特异性趋势并减轻疾病负担。
