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| 2020-2030年京津冀地区人群恶性肿瘤归因风险变迁分析 |
| Trend Analysis of Attributable Risk of Cancer in the Beijing-Tianjin-Hebei Region, 2020-2030 |
| 投稿时间：2026-04-16 修订日期：2026-05-11 |
| DOI： |
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| 中文关键词: 恶性肿瘤 可干预危险因素 人群可归因风险 变迁分析 京津冀地区 |
| 英文关键词:cancer modifiable risk factors population attributable fraction trend analysis Beijing-Tianjin-Hebei region |
| 基金项目:首都卫生发展专项[2024-2G-40213]；北京市高层次创新创业人才支持计划[202504841003]；中央高水平医院临床科研专项[2025-LYZX-R-A03]；国家自然科学基金面上项目[82273704] |
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| 中文摘要: |
| 目的：估算并比较2020年和2030年京津冀地区20岁及以上人群恶性肿瘤负担及归因负担，识别主要危险因素及前十位恶性肿瘤归因特征，为区域恶性肿瘤精准防控提供科学依据。
方法：基于中国国家肿瘤登记处数据和第七次全国人口普查资料，估算2020年京津冀地区恶性肿瘤发病和死亡负担，并结合2010—2020年各年度通过质量审核的所有肿瘤登记处数据，采用贝叶斯年龄—时期—队列模型预测2030年负担水平。基于2013—2023年中国疾病预防控制中心监测资料及高质量Meta分析中获取的危险因素暴露率和全国性队列研究中获取的相对风险（Relative risk, RR）值，采用Levin法计算恶性肿瘤人群归因分值（Population attributable fraction, PAF）及归因病例数。
结果：京津冀地区20岁及以上人群中，2020年与2030年恶性肿瘤世标发病率基本持平，世标死亡率呈下降趋势。2020年，34.28%的恶性肿瘤新发病例（102 134例）和38.81%的死亡病例（65 517例）可归因于14种可干预危险因素；预计2030年发病（PAF：37.42%；归因病例数：129 828例）和死亡（PAF：43.48%；归因病例数：79 547例）归因负担有所增加。与2020年相比，2030年感染相关危险因素所致恶性肿瘤PAF下降，而行为、代谢和膳食相关危险因素PAF上升，其中代谢相关危险因素增幅最大。吸烟仍是导致恶性肿瘤发病和死亡的首位危险因素，肺癌为归因病例数最多的癌种。
结论：京津冀地区20岁及以上人群恶性肿瘤可归因负担预计在2030年较2020年进一步增加。未来恶性肿瘤防控应在持续推进控烟工作的基础上，将体重过高、糖尿病等危险因素作为重要干预方向。本研究为京津冀地区明确恶性肿瘤防控重点和优化资源配置提供了科学参考。 |
| 英文摘要: |
| Purpose: To estimate and compare the cancer burden and attributable burden among adults aged 20 years and older in the Beijing-Tianjin-Hebei region in 2020 and 2030, identify major risk factors and the top 10 cancers in terms of attributable burden, and provide scientific evidence for precision cancer prevention and control in the region.
Methods: Based on data from the National Cancer Registry of China and the Seventh National Population Census, the incidence and mortality of cancer in the Beijing-Tianjin-Hebei region in 2020 was estimated. Using data from all cancer registries that passed quality control each year from 2010 to 2020, a Bayesian age-period-cohort model was applied to predict the cancer burden in 2030. The prevalence of risk factor exposure was obtained from surveillance data from the Chinese Center for Disease Control and Prevention during 2013-2023 and high-quality meta-analyses, while relative risk (RR) estimates were derived from national cohort studies. The Levin formula was used to calculate the population attributable fraction (PAF) and the number of attributable cancer cases.
Results: Among the population aged 20 years and older in the Beijing-Tianjin-Hebei region, the age-standardized incidence rate of cancer was generally stable between 2020 and 2030, whereas the age-standardized mortality rate showed a declining trend. In 2020, 34.28% of new cancer cases (102,134 cases) and 38.81% of cancer deaths (65,517 deaths) were attributable to 14 modifiable risk factors. By 2030, the attributable burden of cancer incidence (PAF: 37.42%; attributable cases: 129,828) and mortality (PAF: 43.48%; attributable deaths: 79,547) is projected to increase. Compared with 2020, the PAF of cancers attributable to infection-related risk factors is expected to decline in 2030, whereas the PAFs attributable to behavioral, metabolic, and dietary risk factors are expected to increase, with the largest increase observed for metabolic risk factors. Smoking remains the leading risk factor for both cancer incidence and mortality, and lung cancer accounts for the largest number of attributable cases.
Conclusion: The attributable cancer burden among adults aged 20 years and older in the Beijing-Tianjin-Hebei region is projected to increase further in 2030 compared with 2020. Future cancer prevention and control should continue to strengthen tobacco control and prioritize interventions targeting risk factors such as excess body weight and diabetes. This study provides scientific evidence for identifying cancer prevention and control priorities and optimizing resource allocation in the Beijing-Tianjin-Hebei region. |
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