Lin Xiuquan, Liu Shiwen, Ding Yating, Zhao Jianhui, He Fei, Zhong Wenling
Department for Chronic and Noncommunicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, No. 386 Chong'an Road, Jin'an District, Fuzhou, Fujian, 350012, China.
Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, 1 Xuefu North Road, Fujian Province, 350122, China.
BMC Cancer. 2025 Aug 11;25(1):1298. doi: 10.1186/s12885-025-14645-4.
This study aims to explore the temporal trends of tracheal, bronchus, and lung cancer burden in Fujian Province, China, and globally. Additionally, it evaluates changes in attributable risk factors and the quality of care.
Based on data from the Fujian Provincial Center for Disease Control and Prevention and the Global Burden of Disease (GBD), the age-standardized rates (ASRs) of incidence, death, and disability-adjusted life years (DALY) were collected and analyzed. Joinpoint regression analysis and age-period-cohort models were used to estimate temporal trends, and principal component analysis was used to estimate the quality-of-care index (QCI).
In 2019, the ASRs of incidence, death, and DALYs were 39.08, 35.29, and 778.39 per 100,000 population in Fujian Province, respectively. From 1990 to 2019, ASRs increased, with average annual percent changes (AAPCs) of 1.08% (95% confidence interval [CI]: 0.77-1.38%), 0.65% (95% CI: 0.35-0.95%), and 0.18% (95% CI: -0.07-0.42%), respectively. The burden sharply increased after age 50 and the ASRs of incidence, death, and DALY in males in Fujian Province were all over 3-folds higher than in females. However, females burden showed increasing trend from 2015 to 2019. Compared with 1990, age‑standardized DALY rates attributable to ambient particulate matter pollution increased markedly, whereas those attributable to household solid fuel use declined. Moreover, we founded that QCI increased with age. The temporal trends indicated decrease in QCI from 1990 to 2019.
The burden of tracheal, bronchus, and lung cancer in Fujian Province remained significant. Smoking, secondhand smoke, and ambient particulate matter pollution were the main risk factors. The quality of care for patients needed improvement.
本研究旨在探讨中国福建省及全球范围内气管、支气管和肺癌负担的时间趋势。此外，评估可归因危险因素的变化及医疗质量。
基于福建省疾病预防控制中心和全球疾病负担（GBD）的数据，收集并分析发病率、死亡率和伤残调整生命年（DALY）的年龄标准化率（ASR）。采用Joinpoint回归分析和年龄-时期-队列模型估计时间趋势，主成分分析用于估计医疗质量指数（QCI）。
2019年，福建省每10万人口中发病率、死亡率和DALY的ASR分别为39.08、35.29和778.39。1990年至2019年，ASR呈上升趋势，年均变化百分比（AAPC）分别为1.08%（95%置信区间[CI]：0.77-1.38%）、0.65%（95%CI：0.35-0.95%）和0.18%（95%CI：-0.07-0.42%）。50岁后负担急剧增加，福建省男性的发病率、死亡率和DALY的ASR均比女性高3倍以上。然而，2015年至2019年女性负担呈上升趋势。与1990年相比，归因于环境颗粒物污染的年龄标准化DALY率显著增加，而归因于家用固体燃料使用的则下降。此外，我们发现QCI随年龄增加。时间趋势表明1990年至2019年QCI下降。
福建省气管、支气管和肺癌负担仍然较重。吸烟、二手烟和环境颗粒物污染是主要危险因素。患者的医疗质量需要改善。
