Song Yiming, Wang Xiaoyi, Shen Yufeng, Chen Liping, Yang Liuyi, Wang Ruilan, Lu Junyu, Gao Zhifang, Lin Xiaolu, Song Yan, Zhang Qingwei, Li Xiaobo
Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Gastroenterology and Hepatology, Shanghai Geriatric Medical Center, Shanghai, China.
Gut. 2024 Dec 31. doi: 10.1136/gutjnl-2024-333932.
GI cancers pose an increasing global health burden, with their impact on the working-age population (WAP) aged 15-64 years remaining largely unexplored despite the crucial role of this group in societal and economic well-being.
To assess trends and cross-country inequality in the global burden of six GI cancers from 1990 to 2021 among individuals in the WAP.
The 2021 Global Burden of Disease study dataset was used to obtain estimates of GI cancer incidence and 95% uncertainty intervals, including the number of cases, crude incidence rate and age-standardised incidence rate (ASIR). WAP GI cancer epidemiology was assessed at the national, regional and global levels, evaluating trends from 1990 to 2021 from overall, local and Sociodemographic Index (SDI) perspectives and using standard health equity methods to quantify cross-country inequality.
Colorectal cancer exhibited the greatest burden of GI cancer among the WAP in 2021. From 1990 to 2021, the number of GI cancer cases rose by 51.9%, although the ASIR declined by 23.4%. These rates exhibit geographic variation, with the most cases and the highest ASIR in China and Mongolia, respectively. Incidence was disproportionately concentrated in higher SDI countries, and worsening inequality was evident over time.
While the ASIR of GI cancer is trending downwards among the WAP, high incidence rates, regional variability and an unequal burden of disease emphasise the need for flexible, targeted medical interventions to support policymaking and medical resource allocation.
胃肠道癌症给全球健康带来日益沉重的负担，尽管15 - 64岁的劳动年龄人口在社会和经济福祉中发挥着关键作用，但它们对这一年龄段人群的影响在很大程度上仍未得到充分研究。
评估1990年至2021年期间全球六种胃肠道癌症在劳动年龄人口中的负担趋势和国家间不平等情况。
使用2021年全球疾病负担研究数据集来获取胃肠道癌症发病率的估计值以及95%的不确定性区间，包括病例数、粗发病率和年龄标准化发病率（ASIR）。从国家、区域和全球层面评估劳动年龄人口的胃肠道癌症流行病学，从总体、局部和社会人口指数（SDI）角度评估1990年至2021年的趋势，并使用标准的健康公平方法来量化国家间的不平等。
2021年，结直肠癌在劳动年龄人口中表现出最大的胃肠道癌症负担。1990年至2021年期间，胃肠道癌症病例数增加了51.9%，尽管年龄标准化发病率下降了23.4%。这些发病率存在地理差异，中国病例数最多，蒙古年龄标准化发病率最高。发病率不成比例地集中在社会人口指数较高的国家，并且随着时间的推移不平等状况明显恶化。
虽然劳动年龄人口中胃肠道癌症的年龄标准化发病率呈下降趋势，但高发病率、区域差异和疾病负担不平等强调了需要灵活、有针对性的医疗干预措施来支持政策制定和医疗资源分配。
