Zhan Zhouwei, Chen Bijuan, Teng Wenhao, Huang Rui, Zheng Hanchen, Zhou Sijing, Xu Jingjie, Yu Jiami, Lin Hui, Wang Xiaojie, Guo Zengqing, Lin Xiaoyan
Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, 350014, Fujian, China.
Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, 350014, Fujian, China.
BMC Public Health. 2025 Jul 8;25(1):2409. doi: 10.1186/s12889-025-23601-7.
Gallbladder and biliary tract cancer (GBTC) poses a growing public health challenge in China, with considerable disparities across age and sex. Understanding long-term epidemiological patterns is essential for informing cancer control strategies and future projections.
Data from the Global Burden of Disease Study 2021 were used to assess GBTC burden in China from 1990 to 2021. Indicators analyzed included incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Joinpoint regression, age-period-cohort (APC) analysis, decomposition analysis, and Bayesian APC (BAPC) models were employed to explore temporal trends and project future burden through 2030.
In 2021, China reported 51,720 new GBTC cases, with an age-standardized incidence rate (ASIR) of 2.49 per 100,000. Males exhibited higher burden than females across all indicators. Incidence, prevalence, mortality, and DALYs were highest in older age groups. From 1990 to 2021, China experienced increasing trends in incidence and prevalence, while age-standardized mortality rates (ASMR) declined. Compared to global trends, China's ASIR rose while global rates declined. DALYs decreased in both contexts but more steeply globally. Joinpoint regression revealed sex-specific shifts, with males showing consistent increases in incidence and females experiencing periods of both decline and rise. APC analysis highlighted increasing incidence among post-1950 birth cohorts and decreasing mortality in recent cohorts. Decomposition analysis indicated that rising incidence was driven by epidemiological changes and population growth, while mortality reduction was linked to medical improvements. BAPC models projected a continued rise in incidence, particularly among males.
The burden of GBTC in China is rising, especially among men and older adults. While mortality has improved, incidence continues to grow, highlighting the need for targeted prevention, early detection, and gender-specific public health policies.
胆囊和胆道癌（GBTC）在中国对公共卫生构成了日益严峻的挑战，在年龄和性别方面存在显著差异。了解长期的流行病学模式对于制定癌症控制策略和未来预测至关重要。
利用2021年全球疾病负担研究的数据评估1990年至2021年中国GBTC的负担。分析的指标包括发病率、患病率、死亡率、伤残调整生命年（DALY）、带病生存年数（YLD）和寿命损失年数（YLL）。采用连接点回归、年龄-时期-队列（APC）分析、分解分析和贝叶斯APC（BAPC）模型来探讨时间趋势并预测到2030年的未来负担。
2021年，中国报告了51,720例新的GBTC病例，年龄标准化发病率（ASIR）为每10万人2.49例。在所有指标上，男性的负担均高于女性。发病率、患病率、死亡率和DALY在老年人群中最高。1990年至2021年，中国的发病率和患病率呈上升趋势，而年龄标准化死亡率（ASMR）下降。与全球趋势相比，中国的ASIR上升而全球发病率下降。两种情况下DALY均下降，但全球下降幅度更大。连接点回归显示了性别特异性变化，男性发病率持续上升，而女性经历了下降和上升阶段。APC分析强调1950年后出生队列的发病率上升以及近期队列的死亡率下降。分解分析表明，发病率上升是由流行病学变化和人口增长驱动的，而死亡率降低与医疗改善有关。BAPC模型预测发病率将持续上升，尤其是在男性中。
中国GBTC的负担正在上升，尤其是在男性和老年人中。虽然死亡率有所改善，但发病率仍在持续增长，这凸显了针对性预防、早期检测和针对性别的公共卫生政策的必要性。
