Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study.
Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study.
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DOI：
10.1001/jamaoncol.2016.5688
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发表时间：
2017-04-01
期刊：
影响因子：
28.4
通讯作者：
Naghavi M
中科院分区：
文献类型：
--
作者：
Global Burden of Disease Cancer Collaboration;Fitzmaurice C;Allen C;Barber RM;Barregard L;Bhutta ZA;Brenner H;Dicker DJ;Chimed-Orchir O;Dandona R;Dandona L;Fleming T;Forouzanfar MH;Hancock J;Hay RJ;Hunter-Merrill R;Huynh C;Hosgood HD;Johnson CO;Jonas JB;Khubchandani J;Kumar GA;Kutz M;Lan Q;Larson HJ;Liang X;Lim SS;Lopez AD;MacIntyre MF;Marczak L;Marquez N;Mokdad AH;Pinho C;Pourmalek F;Salomon JA;Sanabria JR;Sandar L;Sartorius B;Schwartz SM;Shackelford KA;Shibuya K;Stanaway J;Steiner C;Sun J;Takahashi K;Vollset SE;Vos T;Wagner JA;Wang H;Westerman R;Zeeb H;Zoeckler L;Abd-Allah F;Ahmed MB;Alabed S;Alam NK;Aldhahri SF;Alem G;Alemayohu MA;Ali R;Al-Raddadi R;Amare A;Amoako Y;Artaman A;Asayesh H;Atnafu N;Awasthi A;Saleem HB;Barac A;Bedi N;Bensenor I;Berhane A;Bernabé E;Betsu B;Binagwaho A;Boneya D;Campos-Nonato I;Castañeda-Orjuela C;Catalá-López F;Chiang P;Chibueze C;Chitheer A;Choi JY;Cowie B;Damtew S;das Neves J;Dey S;Dharmaratne S;Dhillon P;Ding E;Driscoll T;Ekwueme D;Endries AY;Farvid M;Farzadfar F;Fernandes J;Fischer F;G/Hiwot TT;Gebru A;Gopalani S;Hailu A;Horino M;Horita N;Husseini A;Huybrechts I;Inoue M;Islami F;Jakovljevic M;James S;Javanbakht M;Jee SH;Kasaeian A;Kedir MS;Khader YS;Khang YH;Kim D;Leigh J;Linn S;Lunevicius R;El Razek HMA;Malekzadeh R;Malta DC;Marcenes W;Markos D;Melaku YA;Meles KG;Mendoza W;Mengiste DT;Meretoja TJ;Miller TR;Mohammad KA;Mohammadi A;Mohammed S;Moradi-Lakeh M;Nagel G;Nand D;Le Nguyen Q;Nolte S;Ogbo FA;Oladimeji KE;Oren E;Pa M;Park EK;Pereira DM;Plass D;Qorbani M;Radfar A;Rafay A;Rahman M;Rana SM;Søreide K;Satpathy M;Sawhney M;Sepanlou SG;Shaikh MA;She J;Shiue I;Shore HR;Shrime MG;So S;Soneji S;Stathopoulou V;Stroumpoulis K;Sufiyan MB;Sykes BL;Tabarés-Seisdedos R;Tadese F;Tedla BA;Tessema GA;Thakur JS;Tran BX;Ukwaja KN;Uzochukwu BSC;Vlassov VV;Weiderpass E;Wubshet Terefe M;Yebyo HG;Yimam HH;Yonemoto N;Younis MZ;Yu C;Zaidi Z;Zaki MES;Zenebe ZM;Murray CJL;Naghavi M
癌症是全球第二大死因。癌症控制规划需要对癌症负担进行当前的评估。
估算1990年至2015年195个国家和地区32种癌症的死亡率、发病率、伤残调整生命年（YLDs）、因过早死亡损失的寿命年（YLLs）和伤残调整生命年（DALYs）。
癌症死亡率通过生命登记系统数据、癌症登记处发病率数据（利用单独估算的死亡率与发病率[MI]比值转换为死亡率估算值）以及死因推断数据进行估算。癌症发病率通过死亡率估算值除以模拟的MI比值来计算。为计算癌症患病率，利用MI比值对生存率进行建模。为计算YLDs，将患病率估算值乘以伤残权重。YLLs通过将特定年龄的癌症死亡人数乘以参考预期寿命来估算。DALYs估算为YLDs和YLLs之和。根据人均收入、教育程度和生育率为每个地区创建了一个社会人口学指数（SDI）。按SDI五分位数对国家进行分类以总结结果。
2015年，全球有1750万癌症病例和870万例死亡。2005年至2015年期间，癌症病例增加了33%，其中人口老龄化的贡献率为16%，人口增长的贡献率为13%，特定年龄发病率的变化贡献率为4%。对于男性，全球最常见的癌症是前列腺癌（160万例）。气管、支气管和肺癌是男性癌症死亡和DALYs的首要原因（120万例死亡和2590万DALYs）。对于女性，最常见的癌症是乳腺癌（240万例）。乳腺癌也是女性癌症死亡和DALYs的首要原因（52.3万例死亡和1510万DALYs）。总体而言，2015年全球男女合计因癌症导致2.083亿DALYs。2005年至2015年期间，在195个国家或地区中的174个，所有癌症合计的年龄标准化发病率有所上升。在195个国家或地区中的140个，所有癌症合计的年龄标准化死亡率（ASDRs）在该时间段内有所下降。所有癌症的ASDR上升的国家主要位于非洲大陆。在所有癌症中，2005年至2015年期间霍奇金淋巴瘤的死亡人数显著下降（−6.1%[95%不确定区间（UI），−10.6%至−1.3%]）。食管癌、胃癌和慢性髓细胞性白血病的死亡人数也有所下降，尽管这些结果没有统计学意义。
作为流行病学转变的一部分，预计未来癌症发病率将会上升，这将进一步使有限的医疗资源紧张。为癌症预防、早期诊断以及治疗和姑息治疗合理分配资源需要详细了解当地的癌症负担。2015年全球疾病负担研究结果表明，在抗癌战争中取得进展是可能的。然而，主要研究结果也凸显了对癌症预防工作尚未满足的需求，包括烟草控制、疫苗接种以及促进体育活动和健康饮食。
Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (−6.1% [95% uncertainty interval (UI), −10.6% to −1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.
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