Tu Jiannan, Shi Liangwen, Chen Zhuhong, Kuang Zhixing
Department of Medical Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, People's Republic of China.
Department of Otorhinolaryngology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China.
J Clin Neurosci. 2025 Aug;138:111409. doi: 10.1016/j.jocn.2025.111409. Epub 2025 Jun 19.
Brain and central nervous system (CNS) cancers constitute a substantial public health burden in the Western Pacific Region. However, there is a paucity of contemporary, comprehensive epidemiological data on this matter.
A thorough and methodologically rigorous evaluation of the Global Burden of Disease (GBD) 2021 data was conducted, incorporating key epidemiological indicators such as age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and age-standardized disability-adjusted life years (ASDRs). Temporal trends from 1990 to 2021 were assessed using Joinpoint regression, with decomposition analysis identifying factors driving changes in disease burden. Bayesian age-period-cohort models were employed to project future trends through 2036.
In 2021, the Western Pacific reported 130,080 incident cases (95 % UI: 103,369-158,977), 80,488 deaths (95 % UI: 62,373-100,431), and 2,640,226 DALYs (95 % UI: 2,054,858-3,300,564) from CNS cancers, reflecting increases of 129.8 %, 81.1 %, and 25 % since 1990, respectively. China accounted for 81.13 % of incidence, 85.61 % of mortality, and 85.13 % of DALYs. ASIRs correlated positively with Socio-Demographic Index and per capita healthcare expenditure. Declines in ASDRs and ASMRs were observed in Australia, New Zealand, China, and South Korea, signaling advancements in disease management. However, ASIRs are projected to rise over the next 15 years, driven by increased healthcare investments and socioeconomic development in low- and middle-income countries.
While reductions in ASDRs and ASMRs over 30 years highlight progress in CNS cancer management, rising ASIRs emphasize the urgent need for enhanced prevention, innovative treatment strategies, and equitable healthcare access to address the growing burden and persistent regional disparities.
脑癌和中枢神经系统（CNS）癌症给西太平洋地区带来了沉重的公共卫生负担。然而，目前缺乏关于这一问题的全面、最新的流行病学数据。
对《2021年全球疾病负担》（GBD 2021）数据进行了全面且方法严谨的评估，纳入了年龄标准化发病率（ASIRs）、年龄标准化死亡率（ASMRs）和年龄标准化残疾调整生命年（ASDRs）等关键流行病学指标。使用Joinpoint回归评估了1990年至2021年的时间趋势，通过分解分析确定了推动疾病负担变化的因素。采用贝叶斯年龄-时期-队列模型预测了到2036年的未来趋势。
2021年，西太平洋地区报告了130,080例新发病例（95%不确定区间：103,369 - 158,977）、80,488例死亡（95%不确定区间：62,373 - 100,431）以及2,640,226个伤残调整生命年（DALYs，95%不确定区间：2,054,858 - 3,300,564），这表明自1990年以来分别增长了129.8%、81.1%和25%。中国的发病率占81.13%，死亡率占85.61%，伤残调整生命年占85.13%。年龄标准化发病率与社会人口指数和人均医疗保健支出呈正相关。在澳大利亚、新西兰、中国和韩国观察到年龄标准化残疾调整生命年和年龄标准化死亡率有所下降，这表明疾病管理取得了进展。然而，由于低收入和中等收入国家医疗保健投资增加和社会经济发展，预计未来15年年龄标准化发病率将上升。
虽然30年来年龄标准化残疾调整生命年和年龄标准化死亡率的下降凸显了中枢神经系统癌症管理方面的进展，但年龄标准化发病率的上升强调迫切需要加强预防、创新治疗策略以及公平获得医疗保健服务，以应对不断增加的负担和持续存在的地区差异。
