| 许傲伦,丁 昊,翟铁民,等.1992—2021年中国肝癌伤残调整寿命年变化趋势及2022—2030年预测[J].中国肿瘤,2026,35(5):363-370. |
| 1992—2021年中国肝癌伤残调整寿命年变化趋势及2022—2030年预测 |
| Analysis of the Change Trends in Disability-Adjusted Life Years for Liver Cancer in China from 1992 to 2021 and Prediction from 2022 to 2030 |
| 投稿时间：2025-08-21 |
| DOI：10.11735/j.issn.1004-0242.2026.05.A004 |
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| 中文关键词: 肝癌 伤残调整寿命年 年龄-时期-队列模型 预测 疾病负担 中国 |
| 英文关键词:liver cancer disability-adjusted life years age-period-cohort model prediction disease burden China |
| 基金项目:国家科技重大专项（2023ZD0509600） |
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| 中文摘要: |
| 摘 要：［目的］ 分析1992—2021年中国人群肝癌所致伤残调整寿命年（disability-adjusted life years，DALY）的变化趋势，并预测2022—2030年变化情况。［方法］ 基于全球疾病负担（Global Burden of Disease，GBD）2021数据库提取肝癌DALY相关数据，分析2021年中国肝癌DALY流行现状，比较1992—2021年中国与其他国家的肝癌DALY水平，并使用Joinpoint软件计算率的平均年度变化百分比（average annual percentage change，AAPC）；利用年龄-时期-队列模型分析疾病负担的年龄、时期及队列效应，采用自回归积分滑动平均（auto regressive integrated moving average，ARIMA）模型预测我国2022—2030年肝癌DALY和年龄标化DALY率的变化。［结果］ 1992—2021年，我国肝癌DALY数量从323.66万人年增至379.25万人年，呈上升趋势，但年龄标准化DALY率从311.43/10万下降至182.72/10万（AAPC=-2.01%），下降速度快于全球水平（AAPC=-0.74%）。从年龄效应看，校正时期与队列效应后，肝癌DALY率随年龄增长呈上升趋势，纵向年龄曲线显示20岁以下年龄组DALY率处于较低水平，95岁及以上年龄组达到最高。时期效应表明，1992—2021年间时期率比持续下降，从1.46降至0.48。队列效应表明，出生队列越晚，队列率比越低，从1897年出生队列的23.85下降至2002年出生队列的0.23。与部分发达国家、发展中国家相比，我国肝癌DALY最高，年龄标准化DALY率高于日本、韩国等国家。模型预测结果显示，2022—2030年我国肝癌DALY总量将从409.92万人年升至414.55万人年，年龄标准化DALY率将从193.47/10万降至153.53/10万，呈持续下降趋势，且男性疾病负担显著高于女性。［结论］ 1992—2021年我国肝癌年龄标准化DALY率呈下降趋势，但DALY数量仍处高位，且存在明显的年龄与性别差异。预测表明，我国肝癌年龄标准化DALY率呈下降趋势，DALY数量仍处于较高水平，防控形势依然严峻。建议继续加强高危人群精准筛查、完善早诊早治体系、推进多维度危险因素干预，借鉴国际经验优化防控策略，实现疾病负担的持续下降。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the trends of disability-adjusted life years (DALY) attributable to liver cancer in the Chinese population from 1992 to 2021， and predict the relevant changes from 2022 to 2030. ［Methods］ Relevant data of liver cancer DALY were extracted from the Global Burden of Disease (GBD) 2021 database. We analyzed the epidemiological status of liver cancer DALY in China in 2021， compared the levels of liver cancer DALY between China and other countries from 1992 to 2021， and calculated the average annual percentage change (AAPC) of the rates using Joinpoint software. The age-period-cohort model (APC model) was used to analyze the age， period and cohort effects on liver cancer disease burden， and the autoregressive integrated moving average (ARIMA) model was applied to predict the changes of liver cancer DALY and age-standardized DALY rate in China from 2022 to 2030. ［Results］ From 1992 to 2021， the total number of liver cancer DALY in China increased from 3.236 6 million person-years to 3.792 5 million person-years， showing an upward trend； while the age-standardized DALY rate decreased from 311.43/105 to 182.72/105 (AAPC=-2.01%)， a faster decline than the global average (AAPC=-0.74%). For age effect， after adjusting for period and cohort effects， the DALY rate of liver cancer increased with age； the longitudinal age curve showed that the DALY rate was relatively low in the age group of under 20 years old， and reached the highest level in the age group of 95 years old and above. For period effect， the period rate ratio of liver cancer DALY decreased continuously from 1.46 to 0.48 from 1992 to 2021. For cohort effect， the later the birth cohort was， the lower the cohort rate ratio was， which decreased from 23.85 in the 1897 birth cohort to 0.23 in the 2002 birth cohort. Compared with some developed and developing countries， China had the highest total number of liver cancer DALY， and its age-standardized DALY rate was still higher than that of Japan， Republic of Korea and other selected countries. The model prediction results showed that from 2022 to 2030， the total number of liver cancer DALY in China would increase from 4.099 2 million person-years to 4.145 5 million person-years， while the age-standardized DALY rate would decrease from 193.47/105 to 153.53/105， showing a continuous downward trend， and the disease burden in males was significantly higher than that in females. ［Conclusion］ From 1992 to 2021， the age-standardized DALY rate of liver cancer in China showed a downward trend， but the number of DALY remained at a high level， with significant age and gender differences. The prediction results indicated that the age-standardized DALY rate of liver cancer in China would maintain a downward trend from 2022 to 2030， while the number of DALY would still remain at a high level， suggesting that the prevention and control situation of liver cancer in China is still severe. It is recommended to continuously strengthen the targeted screening for high-risk populations， improve the early diagnosis and treatment system， promote multi-dimensional risk factor intervention， and optimize prevention and control strategies by learning from international experience， so as to achieve the continuous reduction of liver cancer disease burden in China. |
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