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| 全球不同国家胃癌亚型的分布特征及其负担变化趋势分析 |
| Distribution Characteristics and Temporal Trends in the Incidence of Gastric Cancer Subtypes in Different Countries Worldwide |
| 投稿时间：2025-10-13 修订日期：2025-12-21 |
| DOI： |
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| 中文关键词: 胃贲门癌 胃非贲门癌 时间趋势 亚型差异 性别差异 |
| 英文关键词:Gastric cardia cancer Gastric non-cardia cancer Temporal trends Subtype differences Sex differences |
| 基金项目:首都卫生发展科研专项（2024-2G-40213）；北京市科技新星计划（202504841003）；中国医学科学院肿瘤医院人才激励计划（希望之星）；国家自然科学基金（82273704） |
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| 中文摘要: |
| 目的：基于《五大洲癌症发病率》（Cancer incidence in five continents, CI5）数据，本研究拟分析全球不同国家胃癌亚型发病负担的时间变化趋势，量化其亚型和性别差异的变化规律，为各国制定胃癌的针对性防控措施提供科学依据。
方法：选取CI5 VIII-XII卷（1993-2017）中具有高质量分型数据的24个国家进行胃癌亚型发病负担的趋势分析，以Segi""s世界标准人口为参照，计算胃癌亚型的年龄标准化发病率（Age-standardized incidence rate, ASIR）以及ASIR的亚型比值，并采用Joinpoint回归模型估计其年度变化百分比（Annual percentage change, APC）。CI5 XII卷（2013-2017）是截止目前全球基于肿瘤登记处真实上报数据的最新高质量数据集，单独筛选出该卷具有分型数据的48个国家进行胃癌亚型发病率性别差异的现况分析。
结果：1993-2017年，胃贲门癌（Gastric cardia cancer, GCC）的ASIR在7个国家中显著下降，其中中国（APC: -6.70%, 95% CI: -10.39%, -3.85%）降幅最明显，而在丹麦（APC: 1.84%, 95% CI: 1.13%, 2.61%）等8个国家中明显上升；胃非贲门癌（Gastric non-cardia cancer, GNCC）的ASIR在23个国家中显著下降，其中奥地利降幅最明显（APC: -5.42%, 95% CI: -7.45%, -3.69%）。亚型差异分析显示GCC的ASIR在全球范围内始终低于GNCC，但二者ASIR的差异在16个国家中显著缩小，而中国人群GCC与GNCC的ASIR比值从0.15显著下降至0.06。性别差异分析显示男性GCC和GNCC的ASIR均显著高于女性，且GCC的性别差异比GNCC更显著。
结论：本研究基于CI5 VIII至XII卷数据集，从国家的角度全面分析了胃癌亚型ASIR的时间变化趋势，揭示了潜在的胃癌高发亚型和性别差异特征，为各国针对胃癌高发亚型和性别制定特异性的预防控制措施提供了科学依据。 |
| 英文摘要: |
| Purpose: Using the Cancer Incidence in Five Continents (CI5) data, this study aims to analyze the temporal trends in the incidence of GC subtypes and quantify the pattern of variations in subtype- and sex-specific differences in different countries worldwide. The findings will provide scientific evidence for countries to formulate targeted prevention and control strategies for GC.
Methods: We analyzed temporal trends in the cancer burden of GC subtypes using 24 countries with high-quality subtype data in CI5 Volumes VIII-XII (1993-2017). The age-standardized incidence rates (ASIR) of GC subtypes and subtype ASIR ratios were calculated using Segi""s World Standard Population. Annual percentage changes (APC) were estimated using Joinpoint regression. CI5 Volume XII (2013-2017) is the latest high-quality dataset based on real reported data from cancer registries worldwide to date. Therefore, 48 countries with high-quality subtype data were individually selected from this volume for cross-sectional analyses of sex differences in the incidence of GC subtypes.
Results: From 1993 to 2017, Gastric cardia cancer (GCC) ASIRs decreased significantly in 7 countries, with the most pronounced decrease observed in China （APC: -6.70%, 95% CI: -10.39%, -3.85%）, while 8 countries exhibited increasing trends （Denmark， APC: 1.84%, 95% CI: 1.13%, 2.61%）. Gastric non-cardia cancer (GNCC) ASIRs decreased significantly in 23 countries, with the most pronounced decrease observed in Austria （APC: -5.42%, 95% CI: -7.45%, -3.69%）. Subtype-specific analysis showed that GCC ASIRs remained consistently lower than GNCC worldwide, the ASIR difference between the two subtypes significantly narrowed in 16 countries. In China, the GCC-to-GNCC ASIR ratios decreased from 0.15 to 0.06. Sex-specific analysis showed that males had consistently higher ASIRs than females for GCC and GNCC, with more pronounced sex differences observed for GCC.
Conclusion: Utilizing data from CI5 Volumes VIII-XII, this study provides a comprehensive national-level analysis of temporal trends in ASIRs for GC subtypes and reveals potential high-incidence subtypes and sex disparities. These findings provide scientific evidence to guide tailored prevention and control strategies for high-risk GC subtypes and sex differences. |
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