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1990 - 2021年脑癌和中枢神经系统癌症的全球疾病负担、趋势及不平等情况:一项基于人群的研究及到2036年的预测

Global Disease Burden, Trends, and Inequalities of Brain and Central Nervous System Cancers, 1990-2021: A Population-Based Study with Projections to 2036.

作者信息

Kuang Zhixing, Tu Jiannan, Jiang Meina, Chen Zhuhong, Zhang Mingwei, Hong Jinsheng, Xu Benhua

机构信息

Department of Radiotherapy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China.

Department of Medical Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, People's Republic of China.

出版信息

World Neurosurg. 2025 Jun;198:123970. doi: 10.1016/j.wneu.2025.123970. Epub 2025 Apr 22.


DOI:10.1016/j.wneu.2025.123970
PMID:40274017
Abstract

BACKGROUND: Brain and central nervous system (CNS) cancers pose a significant global health challenge, with marked regional variations. Updated evidence is essential to optimize resource allocation and inform targeted interventions. METHODS: Data from the Global Burden of Disease 2021 were systematically analyzed, including incidence, mortality, and disability-adjusted life years (DALYs), along with their corresponding age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR). Temporal trends were evaluated using Joinpoint regression, health disparities were assessed with inequality metrics, and burden contributors were identified through decomposition analysis. Future trends were projected using Bayesian age-period-cohort models. RESULTS: Over the past 30 years, CNS cancer incidence rose by 106.52%, DALYs by 49.59%, and mortality by 89.87%. High-Socio-Demographic Index (SDI) regions (e.g., Europe, North America, East Asia) reported the highest ASIR, with aging as the primary driver of increasing DALYs and mortality. In low-SDI regions (e.g., Africa, Latin America), population growth was the leading contributor to the rising burden. Although ASDRs and ASMRs have declined in high-SDI regions, significant increases have been detected among individuals aged 65 years and more. Low-SDI regions continue to bear a heavy disease burden, particularly among those aged more than 10 years. Disparities across SDI levels are projected to widen, especially in low-income areas. Nonetheless, advances in neuroscience suggest declines in ASIR, ASDR, and ASMR over the next 15 years. CONCLUSIONS: The growing CNS cancer burden highlights the urgent need for targeted interventions. Enhancing healthcare access and bolstering prevention and treatment in underserved regions are critical priorities.

摘要

背景:脑癌和中枢神经系统(CNS)癌症对全球健康构成重大挑战,存在显著的地区差异。最新证据对于优化资源分配和指导针对性干预至关重要。 方法:系统分析了2021年全球疾病负担的数据,包括发病率、死亡率和伤残调整生命年(DALYs),以及相应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DALY率(ASDR)。使用Joinpoint回归评估时间趋势,用不平等指标评估健康差异,并通过分解分析确定负担的影响因素。使用贝叶斯年龄-时期-队列模型预测未来趋势。 结果:在过去30年中,中枢神经系统癌症发病率上升了106.52%,伤残调整生命年上升了49.59%,死亡率上升了89.87%。高社会人口指数(SDI)地区(如欧洲、北美、东亚)报告的年龄标准化发病率最高,老龄化是伤残调整生命年和死亡率上升的主要驱动因素。在低SDI地区(如非洲、拉丁美洲),人口增长是负担上升的主要原因。尽管高SDI地区的年龄标准化DALY率和年龄标准化死亡率有所下降,但在65岁及以上人群中发现有显著增加。低SDI地区继续承受着沉重的疾病负担,尤其是在10岁以上人群中。预计不同SDI水平之间的差距将会扩大,特别是在低收入地区。尽管如此,神经科学的进展表明,在未来15年中,年龄标准化发病率、年龄标准化DALY率和年龄标准化死亡率将会下降。 结论:中枢神经系统癌症负担的增加凸显了针对性干预的迫切需求。加强医疗服务可及性以及在服务不足地区加强预防和治疗是关键优先事项。

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