中国常见消化系统恶性肿瘤伤残调整寿命年归因于人口老龄化的比例分析和趋势预测

doi:10.11904/j.issn.1002-3070.2025.05.002

摘要/Abstract

摘要： 目的分析1990—2021年中国常见消化系统恶性肿瘤伤残调整寿命年(disability-adjusted life year,DALY)归因于人口老龄化的比例,预测2022—2046年DALY归因于人口老龄化的比例及其趋势。方法基于2021年全球疾病负担研究(Global Burden of Disease Study 2021,GBD 2021),选择1990—2021年中国≥25岁人群食管癌、胃癌、结直肠癌、胰腺癌、肝癌、胆囊和胆道癌的DALY数据,采用年龄-时期-队列模型预测2022—2046年恶性肿瘤的DALY,将1990—2046年DALY的变化分解为人口数增长、人口老龄化和年龄别DALY率变化,分析DALY变化归因于人口老龄化的比例及其变化趋势。结果 1990—2021年中国25岁以上人群食管癌、胃癌、结直肠癌、胰腺癌、肝癌、胆囊和胆道癌DALY的变化率分别为18.20%、-0.34%、98.10%、164.16%、58.21%和90.62%。参考2021年,1990年6种恶性肿瘤DALY变化归因于人口老龄化的比例为-38.32%~-19.72%,归因比例前三位的癌种依次是胃癌(-38.32%)、食管癌(-38.07%)、胆囊和胆道癌(-29.78%)。2021—2046年预计上述6种恶性肿瘤DALY的变化率依次为20.72%、11.50%、58.19%、57.38%、21.36%和48.39%。参考2021年,2046年6种恶性肿瘤DALY变化归因于人口老龄化的比例为18.82%~47.83%,归因比例前三位的癌种依次是胆囊和胆道癌(47.83%)、结直肠癌(43.07%)和胰腺癌(38.76%)。2022—2046年,6种恶性肿瘤DALY变化归因于人口老龄化的比例将继续上升(P＜0.001)。结直肠癌和胰腺癌归因于人口老龄化的比例和年龄别DALY率的比例均为正值且呈上升趋势(P＜0.001),最终将推动DALY进一步增加。结论人口老龄化已成为中国常见消化系统恶性肿瘤DALY增长的主要驱动因素,未来对结直肠癌、胰腺癌DALY的影响突出,应制定针对性防控策略,积极应对人口老龄化。

关键词: 恶性肿瘤, 消化系统, 伤残调整寿命年, 人口老龄化, 趋势预测

Abstract: Objective The aim of this study was to analyze the proportion of disability adjusted life years(DALYs)attributed to aging population in common digestive system malignancies in China,and predict the proportion and the trends of DALYs attributed to aging proportion from 2022 to 2046. Methods Based on the Global Burden of Disease Study 2021,the DALY data of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer of Chinese people aged ≥25 years from 1990 to 2021 were selected.The age-period-birth models were used to predict the DALY of malignant tumors from 2022 to 2046.The changes of DALY from 1990 to 2046 were decomposed into population growth,population aging,and age-specific DALY rate changes,and analyze the proportion of DALY changes attributable to population aging and its change trend. Results From 1990 to 2021,the DALY change rates of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer in Chinese people aged ≥25 years were 18.20%,-0.34%,98.10%,164.16%,58.21% and 90.62%,respectively.Compared with 2021,the proportion of DALY changes attributed to population aging for six types of malignant tumors in 1990 was from -38.32% to -19.72%.The top three cancer types with the highest attribution ratios were stomach cancer(-38.32%),esophageal cancer(-38.07%),gallbladder and biliary tract cancer(-29.78%).The expected change rates of DALY for the six types of malignant tumors from 2021 to 2046 were 20.72%,11.50%,58.19%,57.38%,21.36% and 48.39%,respectively.By compared with 2021,the proportion of DALY changes of six malignant tumors attributed to population aging in 2046 was from 18.82% to 47.83%,and the top three cancers attributed to the proportion were gallbladder and biliary tract cancer(47.83%),colorectal cancer(43.07%)and pancreatic cancer(38.76%).From 2022 to 2046,the proportion of DALY changes attributed to aging population for the six types of malignant tumors would continue to rise(P＜0.001).The proportions of colorectal cancer and pancreatic cancer attributed to population aging and the proportion of age-specific DALY rate were both positive and rising(P＜0.001),which would eventually promote the further increase of DALY. Conclusion Population aging has become the main driving factor for the growth of DALY in digestive system malignant tumors in China.The impact on DALY of colorectal cancer and pancreatic cancer will be prominent in the future.Targeted prevention and control strategies should be developed to actively respond to population aging.

Key words: cancer, digestive system, disability-adjusted life year, population aging, forecasting

中图分类号:

R195.4
R735

李吉, 陈杨, 张茂镕, 杨昭, 唐娴, 文洪梅. 中国常见消化系统恶性肿瘤伤残调整寿命年归因于人口老龄化的比例分析和趋势预测[J]. 实用肿瘤学杂志, 2025, 39(5): 372-380.

LI Ji, CHEN Yang, ZHANG Maorong, YANG Zhao, TANG Xian, WEN Hongmei. Analysis of proportion and trend prediction of disability-adjusted life years attributed to aging population in common digestive system malignant tumors in China[J]. Journal of Practical Oncology, 2025, 39(5): 372-380.

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