| 孔维嘉,孙玉婷,葛媛莎,等.1990—2021年全球及中国老年乳腺癌发病趋势分析及2022—2035年变化趋势预测[J].中国肿瘤,2025,34(10):813-820. |
| 1990—2021年全球及中国老年乳腺癌发病趋势分析及2022—2035年变化趋势预测 |
| Incidence Trends of Elderly Breast Cancer in China and Globally from 1990 to 2021 and Prediction of Future Trends from 2022 to 2035 |
| 投稿时间：2025-05-22 |
| DOI：10.11735/j.issn.1004-0242.2025.10.A008 |
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| 中文关键词: 乳腺癌 老年人 发病 预测 趋势分析 |
| 英文关键词:breast cancer elderly incidence forecasting trend analysis |
| 基金项目:国家自然科学基金（82274608） |
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| 中文摘要: |
| 摘 要：［目的］分析1990—2021年全球及中国老年乳腺癌发病情况及变化趋势，并预测2022—2035 年发病情况。［方法］从 2021 年全球疾病负担（Global Burden of Disease Study，GBD）数据库提取全球与中国老年乳腺癌的新发病例数、粗发病率，分性别和年龄组计算年龄标化发病率；采用Joinpoint回归模型，计算年度变化百分比（annual percentage change，APC）和平均年度变化百分比（average annual percentage change，AAPC），描述1990—2021年老年乳腺癌发病趋势，使用贝叶斯年龄-时期-队列模型预测2022—2035年老年乳腺癌发病情况。［结果］ 1990—2021年，全球老年乳腺癌新发病例数从416 444例增至1 023 776例，中国从26 371例增至158 085例；全球标化发病率从89.04/10万增至 94.73/10万，中国从 27.24/10万增至58.40/10万。分性别看，全球老年女性标化发病率从155.19/10万增至170.54/10万；老年男性标化发病率从2.78/10万增至4.72/10万。中国老年女性标化发病率从49.13/10万增至106.00/10万；老年男性标化发病率从1.69/10万增至6.81/10万。分年龄看，1990—2021年全球老年女性及男性乳腺癌发病率均在85~89岁达到峰值；中国老年女性60~64岁、男性70~74岁年龄组发病率上升最显著，2021年分别成为各自性别老年乳腺癌中发病率最高的年龄组。Joinpoint分析显示，1990—2021年中国老年乳腺癌标化发病率呈持续上升趋势（AAPC=2.51%），2016—2019年上升最快（APC=5.14%）；全球标化发病率仅呈轻微波动上升（AAPC=0.20%），仅1990—1995年、2003—2010年呈显著上升。贝叶斯年龄-时期-队列模型预测显示，2035 年全球老年乳腺癌标化发病率将达107.84/10万（女性192.26/10万、男性6.02/10万），中国老年乳腺癌标化发病率将达104.35/10万（女性188.08/10万、男性13.32/10万）。［结论］ 1990—2021年中国和全球老年乳腺癌发病均呈上升趋势，老年男性发病增长尤为明显；未来中国老年乳腺癌疾病负担将持续加重，需强化一级预防与二级预防，优化老年人群筛查方案，以降低发病风险、改善预后。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the incidence and changing trends of elderly breast cancer (defined as diagnosis at age ≥ 60 years old) in China and globally from 1990 to 2021， and to predict its trends from 2022 to 2035. ［Methods］ Data on the number of new cases and crude incidence rate of elderly breast cancer in China and globally were extracted from the 2021 Global Burden of Disease Study (GBD) database. The age-standardized incidence rate (ASIR) was calculated by sex and age group. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change(AAPC)， to describe the incidence trend of elderly breast cancer from 1990 to 2021. The Bayesian age-period-cohort (BAPC) model was applied to predict the incidence of elderly breast cancer from 2022 to 2035. ［Results］ From 1990 to 2021， the number of new breast cancer cases among elderly individuals globally increased from 416 444 to 1 023 776， while in China， the number rose from 26 371 to 158 085. The ASIR increased from 89.04/105 to 94.73/105 globally and from 27.24/105 to 58.40/105 in China. By sex， the ASIR of elderly females increased from 155.19/105 to 170.54/105 globally and from 49.13/105 to 106.00/105 in China； the ASIR of elderly males increased from 2.78/105 to 4.72/105 globally and from 1.69/105 to 6.81/105 in China. By age group， from 1990 to 2021， the incidence rates of breast cancer in elderly female and male both peaked in the age group of 85~89 years old globally. In China， the most significant increases in incidence rates were observed in the age group of 60~64 years old for elderly females and the age group of 70~74 years old for elderly males； these two age groups had the highest incidence rates in their respective sexes in 2021. Joinpoint analysis showed that the ASIR of elderly breast cancer in China presented a continuous upward trend from 1990 to 2021 (AAPC=2.51%)， with the fastest growth during 2016—2019 (APC=5.14%). The global ASIR showed only a slight fluctuating upward trend (AAPC=0.20%)， with significant increases only during 1990—1995 and 2003—2010. Predictions from the BAPC model indicated that by 2035， the global ASIR of elderly breast cancer would reach 107.84/105 (192.26/105 for females and 6.02/105 for males)， while the ASIR in China would reach 104.35/105 (188.08/105 for females and 13.32/105 for males). ［Conclusion］ From 1990 to 2021， the incidence of elderly breast cancer showed an upward trend both in China and globally， with a particularly pronounced increase in elderly male. The disease burden of elderly breast cancer in China is expected to continue increasing in the future， necessitating strengthened primary and secondary prevention measures， as well as optimized screening programs for the elderly population to reduce disease risks and improve prognosis. |
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