1990 — 2021年中国女性“两癌”疾病负担变化趋势及未来预测

宋林琳; 郭智峰; 吴玉; 郭哲

doi:10.19757/j.cnki.issn1674-7763.2025.02.004

1990 — 2021年中国女性“两癌”疾病负担变化趋势及未来预测

Disease burden of breast cancer and cervical cancer among women in China 1990 — 2021: trends and future projections

摘要

摘要:
目的分析1990 — 2021年中国女性乳腺癌和宫颈癌（以下简称“两癌”）的疾病负担变化趋势并进行预测，为“两癌”预防提供依据。
方法收集2021年全球疾病负担数据库中中国女性“两癌”的发病、死亡和伤残调整寿命年（disability-adjusted life-year，DALY）数据。计算年估计变化百分比（estimated annual percentage change，EAPC）以评估1990 — 2021年中国女性“两癌”的疾病负担变化趋势。采用贝叶斯年龄-时期-队列分析对2022 — 2031年中国女性“两癌”的疾病负担进行预测。
结果 2021年，中国女性乳腺癌的标化发病率、标化死亡率和标化DALY率分别为37.0/10万、8.2/10万和281.5/10万，1990 — 2021年的EAPC分别为2.3%、−0.6%和−0.5%。同期，宫颈癌的标化发病率、标化死亡率和标化DALY率分别为13.4/10万、4.6/10万和149.8/10万， EAPC分别为0.9%、−1.0%和−1.1%。50 ~ 59岁的女性“两癌”疾病负担较重。预测分析结果显示，2022 — 2031年，中国女性乳腺癌标化发病率将持续上升，标化死亡率和标化DALY率趋于稳定。宫颈癌的标化发病率、标化死亡率和标化DALY率呈下降趋势。
结论 1990 — 2021年中国女性“两癌”的发病率有所上升，但其造成的死亡和DALY明显减少，反映了中国在促进“两癌”预防上做出的重大贡献。未来，继续加强“两癌”的病因预防和早发现、早诊断、早治疗的“三早”预防，特别是针对高危人群的“两癌”筛查，仍是妇幼卫生领域的重要议题。

Abstract:
Objective To analyze the trends in disease burden of breast cancer and cervical cancer among Chinese women from 1990 to 2021 and make predictions, so as to provide evidence for prevention of breast cancer and cervical cancer.
Methods Data on the incidence, death, and disability-adjusted life-years (DALYs) of breast cancer and cervical cancer among women in China were collected from the Global Burden of Disease (GBD) 2021 database. The estimated annual percentage change (EAPC) was calculated to assess the trends in disease burden of breast cancer and cervical cancer among women in China from 1990 to 2021. Bayesian age-period-cohort analysis was used to predict the disease burden of breast cancer and cervical cancer among women in China from 2022 to 2031.
Results In 2021, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of breast cancer among women in China were 37.0, 8.2, and 281.5 per 100,000, respectively, with EAPCs of 2.3%, −0.6%, and −0.5% from 1990 to 2021. The ASIR, ASMR, and ASDR of cervical cancer were 13.4, 4.6, and 149.8 per 100 000, respectively, with EAPCs of 0.9%, −1.0%, and −1.1% from 1990 to 2021. The disease burden of breast cancer and cervical cancer was higher among women aged 50 – 59 years. The predictive analysis showed that the ASIR of breast cancer among women in China would continue to increase, while the ASMR and ASDR would remain stable from 2022 to 2031. The ASIR, ASMR, and ASDR of cervical cancer were projected to decline.
Conclusion Despite an increase in the incidence of breast cancer and cervical cancer among women in China, 1990 — 2021, the death and DALYs caused by breast cancer and cervical cancer have significantly decreased, reflecting the substantial contributions made by China in promoting the prevention of breast cancer and cervical cancer. In the future, it remains an important issue in the field of maternal and child health to continue strengthening the etiological prevention and early detection, diagnosis and treatment of breast cancer and cervical cancer, especially screening for these cancers among high-risk populations.

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