Analysis of incidence and mortality trends of prostate cancer in China based on age-period-cohort model
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摘要: 目的 分析1990—2019年中国前列腺癌(prostate cancer，PCa)的发病及死亡现状和长期变化趋势。方法 数据来自2019年全球疾病负担数据库。采用Joinpoint软件和年龄-时期-队列模型在线分析工具，对1990—2019年中国PCa的数据进行分析。结果 1990—2019年，中国PCa发病率由4.33/10万逐年增长至21.17/10万；死亡率由3.34/10万逐年增长至7.50/10万；伤残调整寿命年(disability adjusted life year，DALY)率由66.06/10万逐年增长至138.32/10万。Joinpoint结果显示，标化发病率有升高趋势，标化死亡率有降低趋势。年龄-时期-队列模型结果显示，发病与死亡风险随年龄的增加而增高，发病风险随时期的增加而升高，死亡风险随时期的增加而降低，发病风险随队列的增加而升高，死亡风险随队列的升高而降低。结论 1990—2019年中国PCa的发病率、死亡率呈上升趋势，发病和死亡风险随年龄升高而升高，并且80岁以上人群发病风险最高，提示80岁以上老年人群应作为PCa防治工作的重点人群。
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关键词:
- 前列腺癌 /
- 发病率 /
- 死亡率 /
- 年龄-时期-队列模型 /
- 疾病负担
Abstract: Objective To analyze the current status and long-term trend of prostate cancer incidence and mortality in China from 1990 to 2019.Methods Data were collected from 2019 global burden of disease data. Joinpoint software analysis and age-period-cohort model online analysis tools were used to analyze the data of prostate cancer in China from 1990 to 2019.Results From 1990 to 2019, the crude incidence of prostate cancer in China increased from 4.33 per 100, 000 to 21.17 per 100, 000. China's crude death rate has increased from 3.34 per 100, 000 to 7.50 per 100, 000. The crude disability adjusted life year (DALY) rate of prostate cancer in China has increased from 66.06/100, 000 to 138.32/100, 000. The Joinpoint results showed that standardized incidence tended to increase and standardized mortality tended to decrease. The results from the Age-Period-Cohort model show that the risk of incidence and mortality increases with age. The risk of incidence rises with the passage of time, while the risk of mortality decreases over time. The risk of incidence increases with successive cohorts, whereas the risk of mortality increases with later cohorts.Conclusion From 1990 to 2019, the incidence and mortality of prostate cancer in China showed an increasing trend, and the risk of morbidity and mortality increased with age. The risk of morbidity was highest in people over 85 years old, suggesting that the elderly over 85 years old should be the focus of prostate cancer prevention and treatment.-
Key words:
- prostate cancer /
- incidence /
- mortality /
- age-period-cohort model /
- disease burden
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表 1 1990年和2019年PCa发病和死亡情况
1/10万 年份 发病率 标化发病率 死亡率 标化死亡率 DALY率 标化DALY率 YLL率 标化YLL率 1990年 4.33 8.88 3.34 8.22 66.06 125.93 63.81 121.83 2019年 21.17 17.33 7.50 7.79 138.32 118.94 124.68 108.19 变化率/% 388.91 95.16 124.55 -5.23 109.39 -5.55 95.39 -11.20 
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表 2 1990—2019年中国PCa标化发病死亡趋势分析
指标 年份 APC(95%CI) t P值 趋势1 标化发病率 1990—1999 1.8(1.6~1.9) 2.63 ＜0.05 标化死亡率 1990—1997 0.3(0.1~0.5) 1.06 ＜0.05 趋势2 标化发病率 1999—2007 2.8(2.6~3.0) 3.67 ＜0.05 标化死亡率 1997—2007 -0.6(-0.7~-0.4) -1.02 ＜0.05 趋势3 标化发病率 2007—2010 4.3(2.3~6.3) 5.26 ＜0.05 标化死亡率 2007—2015 0.2(0~0.4) 1.01 ＜0.05 趋势4 标化发病率 2010—2019 1.7(2.1~19.0) 2.43 ＜0.05 标化死亡率 2015—2019 -0.9(-1.4~-0.3) -1.23 ＜0.05 总体趋势 标化发病率 1990—2019 2.3(2.1~2.6) 3.23 ＜0.05 标化死亡率 1990—2019 -0.2(-0.1~-0.3) -1.02 ＜0.05
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表 3 1990—2019年中国与全球及不同SDI地区PCa发病及死亡率情况
1/10万 地区 发病率 死亡率 1990年 2019年 变化率/% 1990年 2019年 变化率/% 中国 4.33 21.17 388.91 3.34 7.50 124.55 全球 19.46 36.34 86.74 8.65 12.54 44.97 高SDI地区 80.75 137.68 70.50 24.69 31.24 26.53 中高SDI地区 17.65 44.56 152.46 9.64 15.99 65.87 中SDI地区 6.13 20.68 237.36 4.47 9.31 108.28 中低SDI地区 4.80 11.81 146.04 4.22 7.52 78.20 低SDI地区 5.51 7.16 29.95 5.41 6.22 14.97
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