1990—2019年中国和全球食管癌疾病负担和危险因素趋势分析

doi:10.12183/j.scjpm.2025.0010

摘要/Abstract

摘要： 目的分析1990—2019年中国和全球食管癌的疾病负担和危险因素变化情况,为我国食管癌的防治提供参考。方法根据2019全球疾病负担（GBD 2019）数据库,提取食管癌发病例数、死亡例数、伤残调整寿命年（disability-adjusted life years,DALYs）及其标化率等指标,采用年估计百分比变化（estimated annual percentage change,EAPC）评估1990—2019年食管癌趋势变化,利用人群归因分值（population attributable proportion,PAF）量化分析危险因素对食管癌的影响。结果 1990—2019年中国和全球食管癌标化发病率呈下降趋势,EAPC分别为-1.58%（95% CI：-2.03%~-1.13%）和-0.90%（95% CI：-1.18%~-0.62%）;标化死亡率呈下降趋势,EAPC分别为-1.96%（95% CI：-2.42%~-1.49%）和-1.19%（95% CI：-1.47%~-0.91%）;标化DALYs率呈下降趋势,EAPC分别为-2.27%（95% CI：-2.76%~-1.78%）和-1.41%（95% CI：-1.70%~-1.12%）。在标化率降幅上,中国的降幅均大于全球,女性的降幅均大于男性。亚洲食管癌疾病负担均远高于非洲、欧洲和美洲,标化发病率、标化死亡率和标化DALYs率呈下降趋势,EAPC分别为-1.36%（95% CI：-1.71%~-1.01%）、-1.71%（95% CI：-2.07%~-1.36%）和-1.91%（95% CI：-2.28%~-1.54%）。2019年中国和全球食管癌危险因素按PAF排序,依次为吸烟、饮酒、高BMI、水果摄入不足、咀嚼烟草和蔬菜摄入不足。结论中国和全球食管癌疾病负担有所下降,建议居民保持健康膳食和均衡饮食,积极摄入水果、蔬菜,戒烟限酒并进行合理运动,加强食管癌筛查并定期进行体检,积极推进早发现、早诊断、早治疗。

关键词: 食管癌, 疾病负担, 伤残调整寿命年, 人群归因分值, 年估计百分比变化

Abstract: Objective To analyze the changes in disease burden and risk factors of esophageal cancer in China and globally from 1990 to 2019, and to provide the scientific references for the prevention and treatment of esophageal cancer in China. Methods Based on the Global Burden of Disease 2019 (GBD 2019) database, the number of esophageal cancer incidences, deaths, disability-adjusted life years (DALYs), and their standardized rates were extracted. The estimated annual percentage change (EAPC) was used to assess the trend in esophageal cancer from 1990 to 2019. Additionally, the impact of risk factors on esophageal cancer was quantitatively analyzed using the population attributable proportion (PAF). Results From 1990 to 2019, both China and the global community experienced a declining trend in the age-standardized incidence rate of esophageal cancer, with EAPCs of -1.58% (95% CI: -2.03% - -1.13%) and -0.90% (95% CI: -1.18% - -0.62%), respectively. Similarly, the age-standardized mortality rate showed a downward trend, with EAPCs of -1.96% (95% CI: -2.42% - -1.49%) and -1.19% (95% CI: -1.47% - -0.91%), respectively. The age-standardized DALYs rate also decreased, with EAPCs of -2.27% (95% CI: -2.76% - -1.78%) and -1.41% (95% CI: -1.70%- -1.12%), respectively. The extent of the decline in age-standardized rates was greater in China compared to the global average, and more pronounced in females than in males. The burden of esophageal cancer in Asia was significantly higher than in Africa, Europe, and the Americas. The age-standardized incidence rate, mortality rate, and DALYs rate in Asia all demonstrated a declining trend, with EAPCs of -1.36% (95% CI: -1.71% - -1.01%), -1.71% (95% CI: -2.07% - -1.36%), and -1.91% (95% CI: -2.28% - -1.54%), respectively. In 2019, the primary risk factors for esophageal cancer, ranked by PAF, were smoking, alcohol consumption, high BMI, insufficient fruit intake, tobacco chewing, and insufficient vegetable intake. Conclusions The burden of esophageal cancer has decreased in China and globally. It is recommended that residents maintain a balanced diet, consume fruits and vegetables actively, quit smoking, limit alcohol consumption, engage in regular physical activity, strengthen esophageal cancer screening and regular physical examination, and actively promote early detection, diagnosis, and treatment.

Key words: Esophageal cancer, Disease burden, Disability-adjusted life years, Population attributable proportion, Estimated annual percentage change

中图分类号:

R195.4

张瑜瑜, 赵飞, 刘兴荣. 1990—2019年中国和全球食管癌疾病负担和危险因素趋势分析[J]. 华南预防医学, 2025, 51(1): 10-15.

ZHANG Yuyu, ZHAO Fei, LIU Xingrong. Analysis of disease burden and risk factors for esophageal cancer in China and globally, 1990-2019[J]. South China Journal of Preventive Medicine, 2025, 51(1): 10-15.

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