Tu Shifan, Huang Xiaolu, Fan Xiaoxuan, Zhang Yi, Huang Lan, Li Kai, Wang Xinyue, Gao Yunpeng, Zhao Xiaoping, Feng Zhaoqun
Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Arch Public Health. 2025 Jul 28;83(1):195. doi: 10.1186/s13690-025-01683-4.
Primary central nervous system (CNS) cancers remain a leading global cause of mortality and morbidity. However, comparative analyses between China and global regions during the 1990-2021 period remain lacking in the existing literature.Leveraging data from the Global Burden of Disease Study 2021 (GBD 2021), this study addresses this gap by providing a comparison of primary CNS cancer trends in China and global regions from 1990 to 2021. Through systematic analysis of temporal trends in age- and sex-specific burdens of primary CNS cancers in China-including incidence, prevalence, mortality, and disability-adjusted life years (DALYs)-this study establishes a novel comparative framework aligned with global disease burden metrics. Leveraging the most recent data from the GBD 2021, we elucidate disparities in disease burden and evolving trends between China and global regions. These updated findings provide critical insights for optimizing resource allocation and informing tailored interventions.
Using open data from the GBD 2021 database, we analyzed characteristics of CNS cancer burden in China and globally from 1990 to 2021, including changes in incidence, prevalence, mortality, and DALYs.We employed Joinpoint regression analysis to calculate the average annual percentage change (AAPC) with 95% confidence intervals (95%CI), evaluating temporal trends in CNS cancer burden.A comparative analysis was conducted across multiple dimensions (age, sex, and time periods) to examine differences in CNS cancer burden between China and other world regions.
From 1990 to 2021, the age-standardized incidence rate (ASIR) of CNS cancers in China increased from 4.69 to 6.12 per 100,000 population, while the global ASIR rose from 3.75 to 4.28 per 100,000.The age-standardized prevalence rate (ASPR) in China increased from 9.68 to 21.23 per 100,000, compared with a global increase from 8.66 to 12.01 per 100,000.China's age-standardized mortality rate (ASMR) declined from 4.05 to 3.63 per 100,000, whereas the global ASMR showed a marginal increase from 3.04 to 3.06 per 100,000.The age-standardized DALY rate (ASDR) decreased from 174.36 to 134.15 per 100,000 in China, with a corresponding global decline from 119.88 to 107.91 per 100,000.The average annual percentage changes (AAPCs) were 0.86%, 2.53%, -0.34%, and - 0.87% for ASIR, ASPR, ASMR, and ASDR in China, respectively, compared with global AAPCs of 0.42%, 1.06%, 0.01%, and - 0.35%.Age and sex exhibited differential impacts on CNS cancer burden.
From 1990 to 2021, China experienced sustained increases in both ASIR and ASPR of CNS cancers, indicating a growing disease burden.The disease burden exhibited significant age and sex disparities: males showed higher ASIR, ASMR, and ASDR, whereas females had higher ASPR.Age-specific analysis revealed higher ASIR, ASPR, ASMR and ASDR among pediatric and elderly populations in China.Given China's large population and accelerating aging demographics, CNS cancers remain a major public health challenge.We recommend developing targeted surveillance strategies for aging and high-risk populations, establishing a comprehensive "prevention-diagnosis-rehabilitation" management framework.This would facilitate a paradigm shift from passive treatment to proactive prevention, systematically alleviating the public health burden of CNS tumors.
原发性中枢神经系统（CNS）癌症仍然是全球死亡和发病的主要原因。然而，现有文献中仍缺乏1990 - 2021年期间中国与全球其他地区的比较分析。本研究利用《2021年全球疾病负担研究》（GBD 2021）的数据，通过比较1990年至2021年中国和全球其他地区原发性中枢神经系统癌症的趋势，填补了这一空白。通过系统分析中国原发性中枢神经系统癌症按年龄和性别的负担的时间趋势，包括发病率、患病率、死亡率和伤残调整生命年（DALYs），本研究建立了一个与全球疾病负担指标相一致的新型比较框架。利用GBD 2021的最新数据，我们阐明了中国与全球其他地区在疾病负担和演变趋势方面的差异。这些更新后的发现为优化资源分配和制定针对性干预措施提供了关键见解。
我们使用GBD 2021数据库中的公开数据，分析了1990年至2021年中国和全球中枢神经系统癌症负担的特征，包括发病率、患病率、死亡率和DALYs的变化。我们采用Joinpoint回归分析来计算平均年度百分比变化（AAPC）及其95%置信区间（95%CI），评估中枢神经系统癌症负担的时间趋势。我们在多个维度（年龄、性别和时间段）进行了比较分析，以研究中国与世界其他地区中枢神经系统癌症负担的差异。
1990年至2021年，中国中枢神经系统癌症的年龄标准化发病率（ASIR）从每10万人4.69例增加到6.12例，而全球ASIR从每10万人3.75例上升到4.28例。中国的年龄标准化患病率（ASPR）从每10万人9.68例增加到21.23例，而全球从每10万人8.66例增加到12.01例。中国的年龄标准化死亡率（ASMR）从每10万人4.05例下降到3.63例，而全球ASMR略有上升，从每10万人3.04例升至3.06例。中国的年龄标准化伤残调整生命年率（ASDR）从每10万人174.36例降至134.15例，全球相应地从每10万人119.88例降至107.91例。中国ASIR、ASPR、ASMR和ASDR的平均年度百分比变化（AAPCs）分别为0.86%、2.53%、 - 0.34%和 - 0.87%，而全球的AAPCs分别为0.42%、1.06%、0.01%和 - 0.35%。年龄和性别对中枢神经系统癌症负担有不同影响。
1990年至2021年，中国中枢神经系统癌症的ASIR和ASPR持续上升，表明疾病负担不断增加。疾病负担存在显著的年龄和性别差异：男性的ASIR、ASMR和ASDR较高，而女性的ASPR较高。按年龄分析显示，中国儿童和老年人群的ASIR、ASPR、ASMR和ASDR较高。鉴于中国人口众多且人口老龄化加速，中枢神经系统癌症仍然是一项重大的公共卫生挑战。我们建议针对老龄化和高危人群制定有针对性的监测策略，建立全面的“预防 - 诊断 - 康复”管理框架。这将有助于从被动治疗向主动预防的模式转变，系统地减轻中枢神经系统肿瘤的公共卫生负担。
