2019年全球疾病负担研究：204个国家和地区成人唇、口腔和咽癌的全球、区域和国家负担的系统分析。
The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019.
发表日期：2023 Sep 07
作者：
, Amanda Ramos da Cunha, Kelly Compton, Rixing Xu, Rashmi Mishra, Mark Thomas Drangsholt, Jose Leopoldo Ferreira Antunes, Alexander R Kerr, Alistair R Acheson, Dan Lu, Lindsey E Wallace, Jonathan M Kocarnik, Weijia Fu, Frances E Dean, Alyssa Pennini, Hannah Jacqueline Henrikson, Tahiya Alam, Emad Ababneh, Sherief Abd-Elsalam, Meriem Abdoun, Hassan Abidi, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Tigist Demssew Adane, Isaac Yeboah Addo, Aqeel Ahmad, Sajjad Ahmad, Tarik Ahmed Rashid, Maxwell Akonde, Hanadi Al Hamad, Fares Alahdab, Yousef Alimohamadi, Vahid Alipour, Sadeq Ali Al-Maweri, Ubai Alsharif, Alireza Ansari-Moghaddam, Sumadi Lukman Anwar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Aleksandr Y Aravkin, Raphael Taiwo Aruleba, Malke Asaad, Tahira Ashraf, Seyyed Shamsadin Athari, Sameh Attia, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Muhammad Badar, Nayereh Baghcheghi, Maciej Banach, Mainak Bardhan, Hiba Jawdat Barqawi, Nasir Z Bashir, Azadeh Bashiri, Habib Benzian, Eduardo Bernabe, Devidas S Bhagat, Vijayalakshmi S Bhojaraja, Tone Bjørge, Souad Bouaoud, Dejana Braithwaite, Nikolay Ivanovich Briko, Daniela Calina, Giulia Carreras, Promit Ananyo Chakraborty, Vijay Kumar Chattu, Akhilanand Chaurasia, Meng Xuan Chen, William C S Cho, Dinh-Toi Chu, Isaac Sunday Chukwu, Eunice Chung, Natália Cruz-Martins, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Reza Darvishi Cheshmeh Soltani, Aso Mohammad Darwesh, Sisay Abebe Debela, Meseret Derbew Molla, Fikadu Nugusu Dessalegn, Mostafa Dianati-Nasab, Lankamo Ena Digesa, Shilpi Gupta Dixit, Abhinav Dixit, Shirin Djalalinia, Iman El Sayed, Maha El Tantawi, Daniel Berhanie Enyew, Daniel Asfaw Erku, Rana Ezzeddini, Adeniyi Francis Fagbamigbe, Luca Falzone, Getahun Fetensa, Takeshi Fukumoto, Piyada Gaewkhiew, Silvano Gallus, Mesfin Gebrehiwot, Ahmad Ghashghaee, Paramjit Singh Gill, Mahaveer Golechha, Pouya Goleij, Ricardo Santiago Gomez, Giuseppe Gorini, Andre Luiz Sena Guimaraes, Bhawna Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Arvin Haj-Mirzaian, Esam S Halboub, Rabih Halwani, Asif Hanif, Ninuk Hariyani, Mehdi Harorani, Hamidreza Hasani, Abbas M Hassan, Soheil Hassanipour, Mohammed Bheser Hassen, Simon I Hay, Khezar Hayat, Brenda Yuliana Herrera-Serna, Ramesh Holla, Nobuyuki Horita, Mehdi Hosseinzadeh, Salman Hussain, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Gaetano Isola, Abhishek Jaiswal, Chinmay T Jani, Tahereh Javaheri, Umesh Jayarajah, Shubha Jayaram, Nitin Joseph, Vidya Kadashetti, Eswar Kandaswamy, Shama D Karanth, Ibraheem M Karaye, Joonas H Kauppila, Harkiran Kaur, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Javad Khanali, Mahalaqua Nazli Khatib, Hamid Reza Khayat Kashani, Mohammad Amin Khazeei Tabari, Min Seo Kim, Farzad Kompani, Hamid Reza Koohestani, G Anil Kumar, Om P Kurmi, Carlo La Vecchia, Dharmesh Kumar Lal, Iván Landires, Savita Lasrado, Caterina Ledda, Yo Han Lee, Massimo Libra, Stephen S Lim, Stefan Listl, Platon D Lopukhov, Ahmad R Mafi, Rashidul Alam Mahumud, Ahmad Azam Malik, Manu Raj Mathur, Sazan Qadir Maulud, Jitendra Kumar Meena, Entezar Mehrabi Nasab, Tomislav Mestrovic, Reza Mirfakhraie, Awoke Misganaw, Sanjeev Misra, Prasanna Mithra, Yousef Mohammad, Mokhtar Mohammadi, Esmaeil Mohammadi, Ali H Mokdad, Mohammad Ali Moni, Paula Moraga, Shane Douglas Morrison, Hamid Reza Mozaffari, Sumaira Mubarik, Christopher J L Murray, Tapas Sadasivan Nair, Sreenivas Narasimha Swamy, Aparna Ichalangod Narayana, Hasan Nassereldine, Zuhair S Natto, Biswa Prakash Nayak, Serban Mircea Negru, Haruna Asura Nggada, Hasti Nouraei, Virginia Nuñez-Samudio, Bogdan Oancea, Andrew T Olagunju, Ahmed Omar Bali, Alicia Padron-Monedero, Jagadish Rao Padubidri, Anamika Pandey, Shahina Pardhan, Jay Patel, Raffaele Pezzani, Zahra Zahid Piracha, Navid Rabiee, Venkatraman Radhakrishnan, Raghu Anekal Radhakrishnan, Amir Masoud Rahmani, Vahid Rahmanian, Chythra R Rao, Sowmya J Rao, Goura Kishor Rath, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Nazila Rezaei, Negar Rezaei, Nima Rezaei, Aziz Rezapour, Abanoub Riad, Thomas J Roberts, Esperanza Romero-Rodríguez, Gholamreza Roshandel, Manjula S, Chandan S N, Basema Saddik, Mohammad Reza Saeb, Umar Saeed, Mohsen Safaei, Maryam Sahebazzamani, Amirhossein Sahebkar, Amir Salek Farrokhi, Abdallah M Samy, Milena M Santric-Milicevic, Brijesh Sathian, Maheswar Satpathy, Mario Šekerija, Subramanian Senthilkumaran, Allen Seylani, Omid Shafaat, Hamid R Shahsavari, Erfan Shamsoddin, Mequannent Melaku Sharew, Javad Sharifi-Rad, Jeevan K Shetty, K M Shivakumar, Parnian Shobeiri, Seyed Afshin Shorofi, Sunil Shrestha, Sudeep K Siddappa Malleshappa, Paramdeep Singh, Jasvinder A Singh, Garima Singh, Dhirendra Narain Sinha, Yonatan Solomon, Muhammad Suleman, Rizwan Suliankatchi Abdulkader, Yasaman Taheri Abkenar, Iman M Talaat, Ker-Kan Tan, Abdelghani Tbakhi, Arulmani Thiyagarajan, Amir Tiyuri, Marcos Roberto Tovani-Palone, Bhaskaran Unnikrishnan, Bay Vo, Simona Ruxandra Volovat, Cong Wang, Ronny Westerman, Nuwan Darshana Wickramasinghe, Hong Xiao, Chuanhua Yu, Deniz Yuce, Ismaeel Yunusa, Vesna Zadnik, Iman Zare, Zhi-Jiang Zhang, Mohammad Zoladl, Lisa M Force, Fernando N Hugo
来源：
BIOMEDICINE & PHARMACOTHERAPY
摘要：
唇、口腔和咽癌是全球癌症负担的重要因素，为了有效的政策规划，对其在全球、区域和国家范围内的负担进行全面评估是至关重要的。本文旨在使用2019年全球疾病、伤害和危险因素负担（GBD）研究的估计结果，分析包括唇腔和口腔癌（LOC）以及其他咽癌（OPC）在204个国家和地区以及社会人口指数（SDI）上的总体和风险相关负担。使用GBD 2019的方法估计了1990年至2019年LOC和OPC的发病率、死亡率和因残疾调整的生命年（DALY）。GBD 2019的比较风险评估框架用于估计2019年由于吸烟、烟草和酒精消费引起的LOC和OPC的死亡和DALY的比例。
2019年全球估计发生了370,000例（95%不确定性区间[UI] 338,000-401,000）LOC病例和199,000例（95% UI 181,000-217,000）LOC死亡，以及167,000例（95% UI 153,000-180,000）OPC病例和114,000例（95% UI 103,000-126,000）OPC死亡，这对应了分别贡献了5.5百万例（95% UI 5.0-6.0百万）和3.2百万例（95% UI 2.9-3.6百万）DALY。从1990年到2019年，低中和低SDI地区的LOC和OPC的年龄标准化死亡率一直处于最高水平，而高SDI组则表现出LOC的年龄标准化发病率下降和OPC的年龄标准化发病率上升。全球范围而言，吸烟是致命的OPC危险因素贡献最大的因素，男性占55.8%（95% UI 49.2%-62.0%），女性占17.4%（95% UI 13.8%-21.2%）。在男性中，吸烟和酒精对于LOC死亡贡献巨大，分别占所有相关癌症死亡的42.3%（95% UI 35.2%-48.6%）和40.2%（95% UI 33.3%-46.8%），而在女性中，咀嚼烟草是导致LOC死亡最大的致因因素，占27.6%（95% UI 21.5%-33.8%），主要由南亚和东南亚地区存在的高风险负担驱动。
本研究系统地分析了LOC和OPC负担在SDI范围内的差异，并发现其中相当一部分负担可归因于烟草和酒精的使用。这些估计数据有助于更好地了解LOC和OPC的全球分布和差异，并支持癌症控制规划工作。
Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.