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1990年至2021年10岁以下儿童视网膜母细胞瘤造成的全球、区域和国家负担。

Global, regional and national burden due to retinoblastoma in children aged younger than 10 years from 1990 to 2021.

作者信息

Li Cong, Zhang Lijun, Zhang Jie, Jiao Jinghua, Hua Guangyao, Wang Yan, He Xue, Cheng Chingyu, Yu Honghua, Yang Xiaohong, Liu Lei

机构信息

Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

School of Medicine, South China University of Technology, Guangzhou, China.

出版信息

BMC Med. 2024 Dec 31;22(1):604. doi: 10.1186/s12916-024-03827-9.

Abstract

BACKGROUND

Retinoblastoma (RB), an aggressive intraocular malignancy, significantly adds to the global disease burden in early childhood. This study offers insights into the global burden of retinoblastoma (RB) in children aged 0-9 years, examining incidence, mortality, and DALYs from 1990 to 2021, across age, sex, location, and SDI levels. It aims to inform health policy, resource allocation, and RB combat strategies.

METHODS

Data were retrieved from newly released Global Burden of Disease (GBD) study. The measures were estimated both as numerical counts and age-standardised rates per 100,000 population. Joinpoint regression analysis was used to rigorously examine temporal trends, estimating the average annual percentage change (AAPC). Spearman's correlation test was used to examine the relationship between SDI and the burden of RB by location and year.

RESULTS

Globally, the age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR), and age-standardised DALYs rate (ASDR) for RB among young children in 2021 were 0.09 [95% uncertainty interval (UI): 0.05 to 0.13], 0.04 (95%UI: 0.03 to 0.06), and 3.65 (95%UI: 2.21 to 4.96), respectively. Despite an overall increasing trend in incidence [AAPC: 0.62; 95% confidence interval (CI): 0.42 to 0.82], the RB incidence rate demonstrated a significant decline from 2019 to 2021, while mortality and DALYs rate for RB showed overall downward trends. Trends in ASIR varied across regions, with the highest increase in East Asia. Among all GBD regions, only Southern Sub-Saharan Africa exhibited rising trends in mortality and DALYs rate. Gender comparisons showed negligible differences in ASIR, ASMR and ASDR in 2021. Moreover, the highest disease burden was noted in early neonatal (0-6 days), and in children aged 2-4 years at both global and regional levels. Analysis by SDI indicated that RB incidence rates increased with higher SDI levels. In addition, a significantly negative correlation was found between SDI level and both ASMR and ASDR of RB among children aged 0-9 years.

CONCLUSIONS

From 1990 to 2021, RB-related incidence, mortality, and DALYs varied by age and location. Evaluating spatiotemporal trends underscores the impact of health policies and substantial public health interventions on RB control.

摘要

背景

视网膜母细胞瘤(RB)是一种侵袭性眼内恶性肿瘤,显著增加了全球幼儿疾病负担。本研究深入探讨了0至9岁儿童视网膜母细胞瘤(RB)的全球负担,考察了1990年至2021年期间不同年龄、性别、地区和社会人口指数(SDI)水平下的发病率、死亡率和伤残调整生命年(DALYs)。其目的是为卫生政策、资源分配和RB防治策略提供依据。

方法

数据取自新发布的全球疾病负担(GBD)研究。各项指标以数值计数和每10万人的年龄标准化率进行估算。采用Joinpoint回归分析严格考察时间趋势,估算平均年度百分比变化(AAPC)。使用Spearman相关性检验考察SDI与不同地区和年份的RB负担之间的关系。

结果

在全球范围内,2021年幼儿RB的年龄标准化发病率(ASIR)、年龄标准化死亡率(ASMR)和年龄标准化伤残调整生命年率(ASDR)分别为0.09 [95%不确定区间(UI):0.05至0.13]、0.04(95%UI:0.03至0.06)和3.65(95%UI:2.21至4.96)。尽管发病率总体呈上升趋势[AAPC:0.62;95%置信区间(CI):0.42至0.82],但RB发病率在2019年至2021年期间显著下降,而RB的死亡率和伤残调整生命年率总体呈下降趋势。ASIR的趋势因地区而异,东亚地区增幅最大。在所有GBD地区中,只有撒哈拉以南非洲南部的死亡率和伤残调整生命年率呈上升趋势。性别比较显示,2021年ASIR、ASMR和ASDR的差异可忽略不计。此外,在全球和地区层面,新生儿早期(0至6天)以及2至4岁儿童的疾病负担最高。按SDI分析表明,RB发病率随SDI水平升高而增加。此外,在0至9岁儿童中,发现SDI水平与RB的ASMR和ASDR均呈显著负相关。

结论

1990年至2021年期间,与RB相关的发病率、死亡率和伤残调整生命年因年龄和地区而异。评估时空趋势凸显了卫生政策和大量公共卫生干预措施对RB控制的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f1d/11686879/1818d28767e2/12916_2024_3827_Fig1_HTML.jpg

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