1990年至2021年中国归因于高空腹血糖的癌症疾病负担及到2031年的预测。
Disease burden of cancers attributable to high fasting plasma glucose from 1990 to 2021 and projections until 2031 in China.
作者信息
Zheng Zhong, Xu Shaojie, Zhu Jicun, Yang Qian, Ye Hua, Li Meng, Zhang Xiaoyue, Liu Haiyan, Cheng Yifan, Zou Yuanlin, Lu Yin, Wang Peng
机构信息
College of Public Health, Zhengzhou University, Zhengzhou, Henan Province 450001, China; Henan Key Laboratory of Tumor Epidemiology and State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan Province 450052, China.
Department of Nursing, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China.
出版信息
Cancer Epidemiol. 2025 Feb;94:102725. doi: 10.1016/j.canep.2024.102725. Epub 2024 Dec 20.
BACKGROUND
High fasting plasma glucose (HFPG) has been indicated as one of the important risk factors for cancers. This study aimed to estimate the disease burden of cancers attributable to HFPG in China from 1990 to 2021 and predict the burden until 2031.
METHODS
The data of cancers attributable to HFPG were extracted from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 project. A joinpoint regression model was conducted to estimate the temporal trends from 1990 to 2021. The effects of age, period, and cohort were estimated by an age-period-cohort (APC) model. Lastly, a Bayesian APC model was employed to predict the disease burden for the next decade.
RESULTS
From 1990-2021, cancer deaths attributable to HFPG in China increased by 232 % (95 % uncertainty interval [UI]: 156-330.77 %), and disability-adjusted life-years (DALYs) increased by 195.4 % (95 % UI: 127.38-289.7 %). In addition, the average annual percentage change (AAPC) for the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were 0.6364 % (95 % confidence interval [CI]: 0.4234-0.8498 %) and 0.6263 % (95 % CI: 0.3024-0.9512 %), respectively. Among all cancer types, pancreatic cancer had the largest increase in disease burden. The risks of mortality and DALYs increased with age, while showing initial rapid increase with period growth followed by relative stabilization. The cohort effect indicates that males born later had higher risks of mortality and DALYs. Finally, despite a continuous decline in both ASMR and ASDR, the numbers of deaths and DALYs were projected to continue increasing in the next decade.
CONCLUSIONS
The disease burden of cancers attributable to HFPG significantly increased from 1990 to 2021 in China, and the numbers of deaths and DALYs would continuously increase in the next decade. Therefore, it is necessary to introduce targeted policies controlling the disease burden.
背景
空腹血糖升高（HFPG）已被视为癌症的重要危险因素之一。本研究旨在估算1990年至2021年中国因HFPG导致的癌症疾病负担，并预测至2031年的负担情况。
方法
从《2021年全球疾病、伤害及危险因素负担研究》（GBD 2021项目）中提取因HFPG导致的癌症数据。采用Joinpoint回归模型估算1990年至2021年的时间趋势。通过年龄-时期-队列（APC）模型评估年龄、时期和队列的影响。最后，采用贝叶斯APC模型预测未来十年的疾病负担。
结果
1990年至2021年，中国因HFPG导致的癌症死亡人数增加了232%（95%不确定区间[UI]：156 - 330.77%），伤残调整生命年（DALYs）增加了195.4%（95% UI：127.38 - 289.7%）。此外，年龄标准化死亡率（ASMR）和年龄标准化DALYs率（ASDR）的年均变化百分比（AAPC）分别为0.6364%（95%置信区间[CI]：0.4234 - 0.8498%）和0.6263%（95% CI：0.3024 - 0.9512%）。在所有癌症类型中，胰腺癌的疾病负担增加幅度最大。死亡率和DALYs风险随年龄增长而增加，同时随着时期增长呈最初快速上升随后相对稳定的趋势。队列效应表明，出生较晚的男性死亡率和DALYs风险更高。最后，尽管ASMR和ASDR均持续下降，但预计未来十年死亡人数和DALYs数量仍将继续增加。
结论
1990年至2021年中国因HFPG导致的癌症疾病负担显著增加，且未来十年死亡人数和DALYs数量将持续增加。因此，有必要出台针对性政策控制疾病负担。
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