Zhao Jianhui, Xu Liying, Sun Jing, Song Mingyang, Wang Lijuan, Yuan Shuai, Zhu Yingshuang, Wan Zhengwei, Larsson Susanna, Tsilidis Konstantinos, Dunlop Malcolm, Campbell Harry, Rudan Igor, Song Peige, Theodoratou Evropi, Ding Kefeng, Li Xue
Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA.
BMJ Oncol. 2023 Sep 5;2(1):e000049. doi: 10.1136/bmjonc-2023-000049. eCollection 2023.
This study aimed to explore the global burden of early-onset cancer based on the Global Burden of Disease (GBD) 2019 study for 29 cancers worldwid.
Incidence, deaths, disability-adjusted life years (DALYs) and risk factors for 29 early-onset cancer groups were obtained from GBD.
Global incidence of early-onset cancer increased by 79.1% and the number of early-onset cancer deaths increased by 27.7% between 1990 and 2019. Early-onset breast, tracheal, bronchus and lung, stomach and colorectal cancers showed the highest mortality and DALYs in 2019. Globally, the incidence rates of early-onset nasopharyngeal and prostate cancer showed the fastest increasing trend, whereas early-onset liver cancer showed the sharpest decrease. Early-onset colorectal cancers had high DALYs within the top five ranking for both men and women. High-middle and middle Sociodemographic Index (SDI) regions had the highest burden of early-onset cancer. The morbidity of early-onset cancer increased with the SDI, and the mortality rate decreased considerably when SDI increased from 0.7 to 1. The projections indicated that the global number of incidence and deaths of early-onset cancer would increase by 31% and 21% in 2030, respectively. Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.
Early-onset cancer morbidity continues to increase worldwide with notable variances in mortality and DALYs between areas, countries, sex and cancer types. Encouraging a healthy lifestyle could reduce early-onset cancer disease burden.
本研究旨在基于全球疾病负担（GBD）2019研究，探索全球早发性癌症的负担情况，涉及全球范围内的29种癌症。
从GBD获取了29个早发性癌症组的发病率、死亡率、伤残调整生命年（DALYs）及风险因素。
1990年至2019年间，全球早发性癌症发病率增长了79.1%，早发性癌症死亡人数增长了27.7%。2019年，早发性乳腺癌、气管、支气管和肺癌、胃癌及结直肠癌的死亡率和伤残调整生命年最高。在全球范围内，早发性鼻咽癌和前列腺癌的发病率增长趋势最快，而早发性肝癌的发病率下降最为明显。早发性结直肠癌在男性和女性中均位列伤残调整生命年前五。高中社会人口指数（SDI）地区和中等SDI地区的早发性癌症负担最重。早发性癌症的发病率随SDI升高而增加，当SDI从0.7升至1时，死亡率大幅下降。预测表明，到2030年，全球早发性癌症的发病数和死亡数将分别增加31%和21%。饮食风险因素（红肉含量高、水果含量低、钠含量高、牛奶含量低等的饮食）、饮酒和吸烟是早发性癌症的主要潜在风险因素。
全球早发性癌症发病率持续上升，不同地区、国家、性别和癌症类型之间的死亡率和伤残调整生命年存在显著差异。鼓励健康的生活方式可减轻早发性癌症的疾病负担。
