中国消化系统癌症死亡率趋势及预计负担分析：一项全国性纵向分析（2006 - 2020年）及至2045年的死亡率预测

Analysis of mortality trends and projected burden of digestive system cancer in China: a nationwide longitudinal analysis (2006-2020) with mortality forecasts to 2045.

作者信息

Feng Yajing, Chai Junhui, Zhu Jichun, Zhang Yuehua, Wang Kaijuan, Duan Fujiao

机构信息

Department of Nosocomial Infection Management, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Department of Medical Research Office, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China.

出版信息

Discov Oncol. 2025 Aug 26;16(1):1628. doi: 10.1007/s12672-025-03478-z.

DOI:10.1007/s12672-025-03478-z

PMID:40856876

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12381346/

Abstract

OBJECTIVE

To estimate mortality trends and disease burden of Digestive system cancer (DSC) in China during 2006-2020, using demographic and mortality data from cause-of-death surveillance dataset of China.

METHODS

Joinpoint regression was applied to calculate the crude mortality rate (CMR), age standardized mortality rate (ASMR), annual percentage change (APC), and average annual percentage change (AAPC) for analyzing the trend of death change, and years of life expectancy lost (LLE) and early death lost life (YLL) were utilized to assess disease burden. Bayesian Age-Period-Cohort models were employed to project future mortality trends up to 2045.

RESULTS

From 2006 to 2020, the combined ASMR and YLL rates for female DSC showed stability, with an average life expectancy loss of 7.06 years and the highest YLL rate in the 60-65 age group. Esophageal cancer, gastric cancer, and liver cancer showed a decreasing trend from 2015 to 2020, with APCs of -4.59% (P = 0.001), -5.25% (P = 0.002), and - 3.74% (P = 0.002), respectively. Colorectal cancer and pancreatic cancer showed an upward trend in 2016-2020, with APC of 1.85% (P = 0.021) and 2.74% (P = 0.023), respectively. The trend of standardized YLL rate changes was statistically significant (AAPC = - 2.8%, 95% CI: - 3.3%, 2.3%). The standardized YLL rates of esophageal cancer (AAPC=-5.0%, 95% CI: -5.6%, 4.5%), gastric cancer (AAPC = - 4.2%, 95% CI: - 4.8%, 3.7%), and liver cancer (AAPC = - 2.7%, 95% CI: - 3.3%, 2.2%) all showed a downward trend. By 2045, a significant downward trend in both death counts and ASMRs of DSC in China from 2006 to 2045 across all genders (P<0.001), with the most pronounced decline observed in males.

CONCLUSIONS

These findings reveal divergent trends in the distribution of DSC in China. Implementing gender-specific strategies, particularly for males, and strengthening cancer surveillance systems are crucial for sustained public health improvements.

摘要

目的

利用中国死因监测数据集的人口统计学和死亡率数据，估算2006 - 2020年中国消化系统癌症（DSC）的死亡率趋势和疾病负担。

方法

应用Joinpoint回归计算粗死亡率（CMR）、年龄标准化死亡率（ASMR）、年度百分比变化（APC）和平均年度百分比变化（AAPC）以分析死亡变化趋势，并利用寿命损失年数（LLE）和过早死亡损失寿命（YLL）评估疾病负担。采用贝叶斯年龄-时期-队列模型预测至2045年的未来死亡率趋势。

结果

2006年至2020年，女性DSC的综合ASMR和YLL率呈稳定状态，平均预期寿命损失7.06年，60 - 65岁年龄组的YLL率最高。2015年至2020年，食管癌、胃癌和肝癌呈下降趋势，APC分别为-4.59%（P = 0.001）、-5.25%（P = 0.002）和-3.74%（P = 0.002）。2016 - 2020年，结直肠癌和胰腺癌呈上升趋势，APC分别为1.85%（P = 0.021）和2.74%（P = 0.023）。标准化YLL率变化趋势具有统计学意义（AAPC = -2.8%，95%CI：-3.3%，2.3%）。食管癌（AAPC = -5.0%，95%CI：-5.6%，4.5%）、胃癌（AAPC = -4.2%，95%CI：-4.8%，3.7%）和肝癌（AAPC = -2.7%，95%CI：-3.3%，2.2%）的标准化YLL率均呈下降趋势。到2045年，2006年至2045年中国所有性别的DSC死亡人数和ASMR均呈显著下降趋势（P < 0.001），男性下降最为明显。