| 苗长城,吴轻,杨波,曹瑞,杨倩.中国呼吸道癌症疾病负担的近期上升趋势及未来预测：基于GBD 2023的分析[J].济宁医学院学报,2026,49(5):448-455 |
| 中国呼吸道癌症疾病负担的近期上升趋势及未来预测：基于GBD 2023的分析 |
| Recent trends and future prediction of the burden of respiratory tract cancers in China:an analysis based on GBD 2023 |
| 投稿时间：2026-04-27 |
| DOI：10.3969/j.issn.1000-9760.2026.05.011 |
| 中文关键词: 呼吸道癌症 疾病负担 全球疾病负担 风险归因 年龄-时期-队列模型 趋势分析 |
| 英文关键词: Respiratory tract cancer Disease burden Global burden of disease Risk attribution Age-period-cohort model Trend analysis |
| 基金项目:安徽省教育厅2025年度高等学校科研重点项目（2025AHGXSK30574） |
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| 中文摘要: |
| 目的 系统分析1990—2023年中国呼吸道癌症（喉癌及气管、支气管和肺癌）的疾病负担，比较其在全球不同社会人口学指数（socio-demographic index，SDI）分区中的变化特征，描述长期变化趋势，量化主要风险因素归因，并预测至2040年的远期负担，为制定中国呼吸道癌症精准防控策略提供科学依据。方法 基于全球疾病负担研究2023数据库，使用发病率、死亡率及伤残调整寿命年等指标评估疾病负担并按癌种、年龄、性别和SDI分层。1990—2023年疾病负担的变化趋势采用Joinpoint回归建模。使用贝叶斯年龄-时期-队列模型预测2026—2040年的未来疾病负担。结果 2023年中国呼吸道癌症疾病负担严重，估算发病人数达915 933例，死亡人数达784 128例，伤残调整寿命年达17 821 583人年。其中，50岁及以上男性未来呼吸道癌症疾病负担尤为突出，且发病与死亡高峰集中于70~90岁年龄组。1990—2023年，呼吸道癌症疾病负担总体呈波动下降趋势，但在2020年后呈阶段性上升趋势。喉癌的年龄标准化发病率、死亡率和伤残调整寿命年AAPC分别为 -0.15%（95%CI：-0.42%～0.03%）、-1.88%（95%CI：-2.05%～-1.71%）和-1.80%（95%CI：-1.93%～ -1.68%）；气管、支气管和肺癌相应AAPC分别为0.13%（95%CI:0.03%～0.25%）、-0.26%（95%CI：-0.37%～ -0.13%）和-0.54%（95%CI：-0.67%～-0.36%）。风险因素分析显示，烟草是呼吸道癌症首要风险因素，空气污染、职业暴露和饮酒等亦为重要风险因素。全球SDI分层结果显示，呼吸道癌症疾病负担表现为高SDI分区下降、低SDI分区上升的趋势。预测模型表明，直至2040年，中国呼吸道癌症疾病负担预计将持续增长，70~80岁人群将成为负担最重的人群。需要注意的是，近期的疾病负担阶段性上升可能受筛查及病例发现模式改变影响，且2040年预测区间较宽，远期预测幅度需谨慎解释。结论 中国呼吸道癌症疾病负担仍较为严重，且近期呈阶段性上升趋势。应针对不同人群和区域特征，实施差异化控烟、风险分层筛查与环境治理，推进呼吸道癌症的精准防控。 |
| 英文摘要: |
| Objective To systematically assess the disease burden,temporal trends,and attributable risk factors of respiratory tract cancers (larynx cancer and tracheal,bronchial,and lung cancer) in China,from 1990 to 2023,compare their patterns across global socio-demographic index (SDI) quintiles,quantify the burden attributable to major risk factors,and project the long-term burden through 2040 to inform precision prevention and control.Methods Based on the Global Burden of Disease Study 2023 database,disease burden was evaluated using incidence rates,mortality rates,and disability-adjusted life years,with analyses stratified by cancer type,age,sex,and SDI.Temporal trends from 1990 to 2023 were modeled by Joinpoint regression.The Bayesian age-period-cohort model was applied to project the future disease burden from 2026 to 2040.Results In 2023,the respiratory tract cancer burden in China remained substantial,with an estimated 915933 incident cases,784128 deaths,and 17821583 disability-adjusted life years.The burden was particularly pronounced among men aged 50 years and older,and the peaks in incidence and mortality were observed among population aged 70~90.From 1990 to 2023,the overall burden showed a fluctuating downward trend,followed by a short-term upward trend after 2020.The average annual percent changes in the age-standardized incidence,mortality,and disability adjusted life year rates of larynx cancer were -0.15%（95%CI：-0.42%～0.03%）,-1.88%（95%CI： -2.05%～-1.71%）,and -1.80%（95%CI：-1.93%～ -1.68%）,respectively;the corresponding average annual percent changes for tracheal,bronchial,and lung cancer were 0.13%（95%CI:0.03%～0.25%）,-0.26%（95%CI： -0.37%～-0.13%） and -0.54%（95%CI：-0.67%～-0.36%）,respectively.Risk factor analysis identified tobacco as the leading contributor to respiratory tract cancer,while air pollution,occupational exposures,and alcohol use were also important risk factors.SDI-stratified analyses showed a general pattern of decreasing cancer burden in the high SDI region and increasing burden in the lower SDI region.Finally,projections indicated that this burden would continue to increase rapidly by 2040 and individuals aged 70 to 80 would be the most affected.The recent short-term increase may have been influenced by changes in screening intensity,while the wide prediction intervals for 2040 indicate that the magnitude of the long-term projections should be interpreted cautiously.Conclusions The respiratory tract cancer burden in China remains high and has shown a recent upward trend.Prevention strategies should be tailored to population and regional characteristics through differentiated tobacco-control measures,risk-stratified screening,and environmental governance to advance precision prevention and control of respiratory tract cancers. |
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