Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990-2017: A Joinpoint and Age-Period-Cohort Analysis
Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990-2017: A Joinpoint and Age-Period-Cohort Analysis
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1990-2017年中国肝癌发病率和死亡率的长期趋势：连接点和年龄-时期-队列分析
DOI：
10.3390/ijerph16162878
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发表时间：
2019-08-14
影响因子：
--
通讯作者：
Li, Hao
中科院分区：
文献类型：
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作者：
Wang, Fang;Mubarik, Sumaira;Li, Hao
肝癌（LC）是癌症相关死亡的最常见原因之一：本研究旨在呈现 1990-2017 年中国 LC 发病率和死亡率的长期趋势和年龄组效应。发病率和死亡率数据来自 2017 年全球疾病负担研究。我们使用 Joinpoint 回归确定了年龄标准化发病率 (ASIR) 和死亡率 (ASMR) 的趋势。进行年龄-周期-队列 (APC) 分析，以使用内在估计方法描述长期趋势。 ASMR 在 2013 年之前显着下降，此后又上升，1990 年至 2017 年间，男性的总体平均年百分比变化 (AAPC) 值为 -0.5%（95% 置信区间 (CI)：-0.6%、-0.3%），女性为 -1.3%（-1.6%、-1.0%）。 1990年至2017年间，男性ASIR显着增加0.2%（0.1%、0.3%），女性则显着下降1.1%（-1.2%、-1.0%）。无论性别，LC发病率和死亡率风险均随着年龄的增长而增加。发病率和死亡率的周期效应风险比（RR）在男性中表现出类似的单调增加趋势，在女性中保持稳定。队列效应显示出总体下降趋势，并且两性的发病率和死亡率几乎重叠，并且较晚出生队列的 RR 低于先前出生队列。年龄较大、月经周期较近以及出生于 1923 年之前与肝癌发病率和死亡率较高的风险相关。净年龄和时期效应呈现增加趋势，而队列效应在发病率和死亡风险方面呈现下降趋势。随着中国人口老龄化的加剧以及不健康生活方式的普及，肝癌带来的负担仍将是中国未来的巨大挑战。
Liver cancer (LC) is one of the most common causes of cancer-related deaths: this study aims to present the long-term trends and age-period-cohort effects of the incidence of and mortality from LC in China during 1990-2017. Incidence and mortality data were obtained from the Global Burden of Disease Study 2017. We determined trends in the age-standardized incidence rate (ASIR) and mortality rate (ASMR) using Joinpoint regression. An age-period-cohort (APC) analysis was performed to describe the long-term trends with intrinsic estimator methods. The ASMR decreased markedly before 2013 and increased thereafter, with overall average annual percent change (AAPC) values of -0.5% (95% confidence interval (CI): -0.6%, -0.3%) for men and -1.3% (-1.6%, -1.0%) for women during 1990-2017. The ASIR significantly increased by 0.2% (0.1%, 0.3%) in men and decreased by 1.1% (-1.2%, -1.0%) in women from 1990 to 2017. The risks of LC incidence and mortality increased with age in both genders. The period effect risk ratios (RRs) of incidence and mortality displayed similar monotonic increasing trends in men and remained stable in women. The cohort effect showed an overall downward trend and almost overlapping incidence and mortality in both genders, and later birth cohorts experienced lower RRs than previous birth cohorts. Older age, recent period, and birth before 1923 were associated with a higher risk of liver cancer incidence and mortality. The net age and period effects showed an increasing trend, while the cohort effects presented a decreasing trend in incidence and mortality risk. As China's population aging worsens and with the popularization of unhealthy lifestyles, the burden caused by liver cancer will remain a huge challenge in China's future.