关键词: 消化道肿瘤, 发病率, 死亡率, 疾病负担, 中国

Abstract: Objective This study analyzed the incidence and mortality trends of four types of digestive tract tumors in China from 1990 to 2019,including gastric cancer,esophageal cancer,colorectal cancer,and liver cancer,in order to provide scientific basis for the formulation of prevention and control strategies for digestive tract tumors in China. Methods The Global Burden of Disease Study 2019(GBD 2019)database was used to analyze the trends of standardized incidence and standardized mortality of digestive tract tumors in China by the Joinpoint regression model.The age-period-cohort model was used to explore the age-period and cohort effects on the incidence and mortality of digestive tract tumors. Results The incidence order of digestive tract tumors in 2019 was stomach cancer(43.09/100,000),Colon and rectum(42.74/100,000),esophageal cancer(19.55/100,000)and liver cancer(14.80/100,000).The death order was gastric cancer(29.64/100,000),Colon and rectum(18.40/100,000),esophageal cancer(18.09/100,000)and liver cancer(13.20/100,000).After eliminating the influence of population age structure,the standardized incidence and standardized mortality of liver cancer,gastric cancer and esophageal cancer from 1990 to 2019 showed a decreasing trend year by year(AAPC liver cancer incidence=-3.1%,AAPC gastric cancer incidence=-0.07%,AAPC esophageal cancer incidence=-1.5%;AAPC liver cancer death=-3.4%,AAPC gastric cancer death=-1.9%,AAPC esophageal cancer death=-1.8%)(P＜0.001),and the standardized incidence and standardized mortality of Colon and rectum showed an increasing trend year by year(AAPC Colon and rectum incidence=3.1%,AAPC Colon and rectum death=1.1%)(P＜0.001).The results of age-period-cohort model showed that the incidence and mortality of gastric cancer,esophageal cancer and Colon and rectum were increasing with age,reached the peak in 85+group,80-84 group and 85+group,respectively.The incidence and mortality of liver cancer peaked in the 55-59 group and then decreased.The risk of Colon and rectum showed an increasing trend year by year,and the risk of death showed a first increasing trend and then decreasing trend.The incidence and mortality of liver cancer showed a decreasing trend followed by an increasing trend,while the overall incidence and mortality of gastric cancer and esophageal cancer showed a decreasing trend year by year.The earlier birth cohort of esophageal cancer and liver cancer,the higher risk of morbidity and mortality,while the later birth cohort of Colon and rectum,the higher risk of morbidity and mortality.The risk of gastric cancer showed the fluctuation. Conclusion The disease burden of digestive tract tumors in China is still heavy in China,especially the standardized incidence and standardized mortality of Colon and rectum are still increasing year by year.It is necessary to implement targeted prevention and treatment measures to effectively reduce the disease burden of digestive tract tumors.

Key words: Digestive tract tumors, Incidence, Mortality, Disease burden, China