中国大陆胃癌流行趋势：现状与未来预测
Stomach cancer epidemic in Chinese mainland: Current trends and future predictions
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影响因子:7.3
分区:医学2区 / 医学：内科2区
发表日期:2025 Jan 20
作者:
Wenxuan Zhu, Wanyue Dong, Yunning Liu, Ruhai Bai
DOI:
10.1097/CM9.0000000000002993
摘要
中国是胃癌负担最重的国家之一。本研究的目的是分析1990年至2019年中国大陆胃癌的发病率和死亡率的长期趋势，并对至2030年的趋势进行预测。胃癌数据来源于2019年全球疾病负担研究（Global Burden of Diseases Study 2019）。人口数据同样来自于2019年全球疾病负担研究和《世界人口展望2019》。本研究采用年龄-时期-队列模型及分解分析。胃癌的净趋势变化率（net drift）为男性每年0.2%（95%置信区间[CI]：0到0.4%），女性为-1.8%（95% CI：-2.0%至-1.6%）。死亡率的净趋势变化率为男性-1.6%（95% CI：-1.8%至-1.3%），女性为-3.3%（95% CI：-3.5%至-3.1%）。在过去的10-15年中，男女胃癌的发生和死亡风险持续下降。就出生队列而言，尽管整体上1920年以后出生的男性和女性的死亡风险有所降低，但近期出生队列的发病风险有所上升（男性1970年后出生，女性1985年后出生）。预计男性的年龄标准化发病率将上升，女性则会下降，年龄标准化死亡率预计两性均会下降。未来发病和死亡人数增加的最大驱动力是人口老龄化，预计老年人的发病和死亡比例将增加。在过去三十年中，中国大陆男性的胃癌发病率持续上升，且这一趋势预计将继续。老龄化将成为未来胃癌发病和死亡增加的主要因素。为了减轻胃癌的健康影响，需要采取更多措施。
Abstract
China is one of the countries with the highest burdens of stomach cancer. The objective of this study was to analyze long-term trends in the incidence and mortality of stomach cancer in Chinese mainland from 1990 to 2019 and to make projections until 2030.Data on stomach cancer were extracted from the Global Burden of Diseases Study 2019. Population data were extracted from the Global Burden of Diseases Study 2019 and World Population Prospects 2019. An age-period-cohort framework and decomposition analysis were used in this study.The net drift for the incidence of stomach cancer was 0.2% (95% confidence interval [CI]: 0, 0.4%) per year for men and -1.8% (95% CI: -2.0%, -1.6%) for women. The net drift for mortality was -1.6% (95% CI: -1.8%, -1.3%) per year for men and -3.3% (95% CI: -3.5%, -3.1%) for women. In the last 10-15 years, the risk of stomach cancer occurrence and death has continued to decline for both sexes. Regarding birth cohorts, although the risk of stomach cancer death decreased in general among women and men born after 1920, the risk of occurrence increased in recent birth cohorts (men born after 1970 and women born after 1985). It is expected that the age-standardized incidence will increase among men and decrease among women, and age-standardized mortality will decrease for both sexes. The largest contributor to the projected increase in incident cases and deaths is population aging, and elderly individuals are projected to have an increased proportion of occurrence and death.In the past three decades, the incidence of stomach cancer among men has increased in Chinese mainland, and this trend is projected to continue. Aging will be the main contributor to future increased stomach cancer occurrence and deaths. To reduce the health impact of stomach cancer, more efforts are needed.