Zhan Zhouwei, Zheng Xiuhui, Xu Shaohua, Zheng Hanchen, Zheng Lina, Wang Jie, Lin Hui, Yu Jiami, Guo Zengqing, Chen Bijuan
Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China.
Department of Medical Affairs, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China.
PLoS One. 2025 Jul 1;20(7):e0327009. doi: 10.1371/journal.pone.0327009. eCollection 2025.
Pancreatic cancer is one of the most lethal malignancies globally, with increasing incidence and mortality trends. In China, the disease burden has escalated over the past three decades, yet comprehensive national assessments remain limited. This study aims to evaluate the long-term trends, driving factors, and future projections of pancreatic cancer burden in China from 1990 to 2021. Data on incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were extracted from the Global Burden of Disease (GBD) Study 2021. Temporal trends were analyzed using Joinpoint regression and age-period-cohort models, while decomposition analysis quantified the contributions of population aging, growth, and epidemiological change. Bayesian age-period-cohort (BAPC) models were applied to project disease burden trends through 2030. In 2021, pancreatic cancer accounted for 118,665 new cases and over 2.9 million DALYs in China, with a significantly higher burden among males. Age-standardized rates of incidence, prevalence, and DALYs increased markedly between 1990 and 2021, outpacing global trends. The burden was concentrated in older age groups and driven primarily by years of life lost. Joinpoint regression identified periods of accelerated increase after 2015. Age-period-cohort analysis revealed that disease burden rises sharply after age 50 and is highest among more recent birth cohorts. Decomposition analysis showed that population aging and epidemiological transitions were the main contributors to increased burden. Projections using BAPC models indicate that incidence, prevalence, and DALY rates will continue to rise through 2030. The burden of pancreatic cancer in China has increased substantially over the past three decades and is projected to rise further. These findings highlight the need for intensified public health interventions focused on prevention, early detection, and effective treatment strategies.
胰腺癌是全球最致命的恶性肿瘤之一，其发病率和死亡率呈上升趋势。在中国，过去三十年来疾病负担不断加重，但全国性的综合评估仍然有限。本研究旨在评估1990年至2021年中国胰腺癌负担的长期趋势、驱动因素及未来预测。从《2021年全球疾病负担研究》中提取了发病率、患病率、死亡率、伤残调整生命年（DALYs）、带病生存年数（YLDs）和生命损失年数（YLLs）的数据。使用Joinpoint回归和年龄-时期-队列模型分析时间趋势，同时分解分析量化了人口老龄化、增长和流行病学变化的贡献。应用贝叶斯年龄-时期-队列（BAPC）模型预测到2030年的疾病负担趋势。2021年，中国胰腺癌新发病例达118,665例，DALYs超过290万，男性负担明显更高。1990年至2021年期间，年龄标准化发病率、患病率和DALYs显著上升，超过全球趋势。负担集中在老年人群体，主要由生命损失年数驱动。Joinpoint回归确定2015年后为加速上升期。年龄-时期-队列分析显示，50岁后疾病负担急剧上升，在最近出生队列中最高。分解分析表明，人口老龄化和流行病学转变是负担增加的主要因素。使用BAPC模型的预测表明，到2030年发病率、患病率和DALY率将继续上升。在过去三十年中，中国胰腺癌负担大幅增加，预计还将进一步上升。这些发现凸显了加强公共卫生干预措施的必要性，这些措施应侧重于预防、早期检测和有效的治疗策略。
