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1990—2021年中国与全球非吸烟女性人群恶性肿瘤的疾病负担分析

Analysis of Disease Burden of Malignant Tumors in Chinese and Global Non-smoking Female Population, 1990—2021

投稿时间：2025-01-15 修订日期：2025-03-10

DOI：

中文关键词: 恶性肿瘤非吸烟女性疾病负担中国全球

英文关键词:malignant tumors non-smoking female burden of disease China global

基金项目:

作者	单位	邮编
黄丹琪	国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院	100021
杨敏	国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院	100021
王慧琳	国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院	100021
刘婧一	国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院	100021
陈万青	国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院	100021
袁金秋	中山大学附属第七医院	518107
翟静波	天津中医药大学	301617
李江^*	国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院	100021

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中文摘要:

[目的] 分析1990—2021年中国与全球非吸烟女性人群恶性肿瘤的疾病负担及其变化趋势。 [方法] 从2021年全球疾病负担研究项目（Global Burden of Disease 2021，GBD 2021）提取1990—2021年中国与全球非吸烟女性恶性肿瘤死亡和伤残调整生命年（disability adjusted life year，DALY）数据。采用Joinpoint回归模型分析中国与全球各个疾病负担指标的平均年度变化百分比（average annual percentage change，AAPC）。 [结果] 1990—2021年，中国非吸烟女性人群恶性肿瘤死亡病例数由13.71万例增加至26.81万例，与全球相比，上升更明显（中国：AAPC = 2.19%，95% CI：2.06%~2.33%；全球：AAPC：1.92%，95% CI：1.80%~2.04%；P = 0.003）；标化死亡率由32.42/10万减少至24.58/10万，较全球下降得更明显（中国：AAPC = -0.88%，95% CI：-1.00%~-0.76%；全球：AAPC：-0.59%，95% CI：-0.68%~-0.51%；P < 0.001）。中国恶性肿瘤DALY由412.96万人年增加至691.20万人年，与全球上升趋势相似（中国：AAPC = 1.68%，95% CI：1.56%~1.81%；全球：AAPC：1.63%，95% CI：1.52%~1.75%；P = 0.536）；标化DALY率由889.58/10万减少至642.65/10万，较全球下降得更明显（中国：AAPC = -1.04%，95% CI：-1.15%~-0.92%；全球：AAPC：-0.69%，95% CI：-0.78%~-0.61%；P < 0.001）。2021年，中国标化死亡率排名前5位的恶性肿瘤分别为气管、支气管和肺癌、结直肠癌、宫颈癌、乳腺癌和肝癌；全球标化死亡率排名前5位的恶性肿瘤分别为宫颈癌、结直肠癌、乳腺癌、气管、支气管和肺癌和胰腺癌。中国乳腺癌、肝癌、胰腺癌和子宫癌的标化死亡率、标化DALY均呈整体上升趋势（P均<0.05）。 [结论] 1990—2021年中国与全球非吸烟女性恶性肿瘤的死亡病例数和DALY均呈整体上升趋势，标化死亡率和标化DALY率均呈整体下降趋势。在未来，需要采取更有针对性的癌症预防措施，以降低非吸烟女性人群恶性肿瘤的疾病负担。

英文摘要:

[Purpose] To analyze the disease burden of malignant tumors and its changing trends in Chinese and global non-smoking female population from 1990 to 2021. [Methods] Data of mortality and disability adjusted life year (DALY) for Chinese and global non-smoking female malignant tumors from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021), and the data were analyzed using Joinpoint regression model to calculate the average annual percentage change (AAPC). [Results] From 1990 to 2021, the number of deaths for malignant tumors in Chinese non-smoking female population increased from 13.71×104 to 26.81×104, with a higher increased trend compared with the global (China: AAPC = 2.19%, 95% CI: 2.06%~2.33%; Global: AAPC = 1.92%, 95% CI: 1.80%~2.04%; P = 0.003); the standardized mortality rate decreased from 32.42/105 to 24.58/105, with a higher decreased trend compared with the global (China: AAPC = -0.88%, 95% CI: -1.00%~-0.76%; Global: AAPC = -0.59%, 95% CI: -0.68%~-0.51%; P < 0.001). The DALY for malignant tumors in China increased from 412.96×104 to 691.20×104 person-years, with a similar changing trend compared with the global (China: AAPC = 1.68%, 95% CI: 1.56%~1.81%; Global: AAPC = 1.63%, 95% CI: 1.52%~1.75%; P = 0.536); the standardized DALY rate decreased from 889.58/105 to 642.65/105, with a higher decreased trend compared with the global (China: AAPC = -1.04%, 95% CI: -1.15%~-0.92%; Global: AAPC = -0.69%, 95% CI: -0.78%~-0.61%; P < 0.001). The top five malignant tumors of high standardized mortality rate in China in 2021 were tracheal, bronchus and lung cancer, colon and rectum cancer, cervical cancer, breast cancer, and liver cancer. The top five malignant tumors of high standardized mortality rate globally in 2021 were cervical cancer, colon and rectum cancer, breast cancer, tracheal, bronchus and lung cancer, and pancreatic cancer. The standardized mortality rate and DALY rate of breast cancer, liver cancer, pancreatic cancer and uterine cancer showed overall upward trends (all P<0.05). [Conclusion] From 1990 to 2021, the number of deaths and DALY of malignant tumors in Chinese and global non-smoking female population showed overall increased trends, and standardized mortality rate and DALY rate showed overall decreased trends. In future, more targeted cancer prevention measures are needed to reduce the disease burden of malignant tumors in non-smoking female population.

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