文章摘要
赵清雅,张彩霞.1990-2019年中国归因于饮食危险因素的结直肠癌疾病负担分析[J].中华流行病学杂志,2024,45(2):200-206
1990-2019年中国归因于饮食危险因素的结直肠癌疾病负担分析
Disease burden of colorectal cancer attributable to dietary risk factors from 1990 to 2019 in China
收稿日期:2023-09-19  出版日期:2024-02-20
DOI:10.3760/cma.j.cn112338-20230919-00168
中文关键词: 结直肠肿瘤  全球疾病负担  饮食危险因素  年龄-时期-队列模型
英文关键词: Colorectal neoplasms  Global burden of disease  Dietary risk factors  Age-period-cohort model
基金项目:国家自然科学基金(81973020);广东省自然科学基金(2021A1515011751)
作者单位E-mail
赵清雅 中山大学公共卫生学院, 广州 510080
中山大学公共卫生学院(深圳), 深圳 518107 
 
张彩霞 中山大学公共卫生学院, 广州 510080 zhangcx3@mail.sysu.edu.cn 
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中文摘要:
      目的 分析1990-2019年中国归因于饮食危险因素的结直肠癌的死亡率和伤残调整寿命年(DALY)的变化趋势。方法 基于2019全球疾病负担(GBD2019)中归因于饮食危险因素(加工肉制品摄入过量、红肉摄入过量、钙摄入不足、纤维摄入不足、牛奶摄入不足、全谷物摄入不足和总饮食危险因素)的中国结直肠癌死亡率和DALY率数据,利用Joinpoint回归模型描述变化趋势,应用年龄-时期-队列模型分析年龄、时期、队列效应。结果 Joinpoint回归分析结果显示,1990-2019年,归因于加工肉制品摄入过量、红肉摄入过量、牛奶摄入不足、全谷物摄入不足和总饮食危险因素的结直肠癌标化死亡率和标化DALY率整体呈上升趋势(P<0.05),归因于钙摄入不足和纤维摄入不足的结直肠癌标化死亡率和标化DALY率整体呈下降趋势(P<0.05)。65~79岁各年龄组归因于加工肉制品摄入过量、红肉摄入过量、牛奶摄入不足、全谷物摄入不足以及总饮食危险因素的结直肠癌死亡率和DALY率较25~64岁各年龄组上升速度更快,65~79岁各年龄组归因于钙摄入不足和纤维摄入不足较25~64岁各年龄组下降速度更慢。控制时期和队列效应后,归因于加工肉制品摄入过量、红肉摄入过量、钙摄入不足、纤维摄入不足、牛奶摄入不足、全谷物摄入不足和总饮食危险因素的结直肠癌死亡率和DALY率均随年龄增长呈上升趋势(P<0.05)。归因于加工肉制品摄入过量、红肉摄入过量、钙摄入不足、牛奶摄入不足、全谷物摄入不足、总饮食危险因素的结直肠癌死亡率和DALY率随时期、队列变化整体呈上升趋势,归因于纤维摄入不足随时期、队列变化整体呈下降趋势。各饮食危险因素的时期效应和队列效应均有统计学意义(P<0.001)。结论 归因于饮食危险因素的中国结直肠癌疾病负担总体呈上升趋势,老年人为高危人群,在结直肠癌防治工作中需加强饮食危险因素的科普教育。
英文摘要:
      Objective To analyze the trend of mortality rate and disability-adjusted life year (DALY) of colorectal cancer attributable to dietary risk factors from 1990 to 2019 in China. Methods Mortality rate and DALY rate of colorectal cancer attributable to dietary risk factors (diet high in processed meat, diet high in red meat, diet low in calcium, diet in low in fiber, diet low in milk, diet low in whole grains, dietary risks) were collected from the Global Burden of Disease study 2019 (GBD2019). Joinpoint regression model was selected to analyze the trend and an age-period-cohort model was used to estimate the effects of age, period and birth cohort. Results Joinpoint regression analysis showed that the age-standardized mortality rate and age-standardized DALY rate of colorectal cancer attributable to diet high in processed meat, diet high in red meat, diet low in milk, diet low in whole grains and dietary risks showed an upward trend (P<0.05) from 1990 to 2019, while those attributable to diet low in calcium and diet low in fiber showed a downward trend (P<0.05). The mortality rate and DALY rate of colorectal cancer attributable to diet high in processed meat, diet high in red meat, diet low in milk, diet low in whole grains and dietary risks in age groups from 65 to 79 years showed a quicker upward trend than those in age groups from 25 to 64 years. The mortality rate and DALY rate attributable to diet low in calcium and diet low in fiber in age groups from 65 to 79 years showed a slower downward trend than those in age groups from 25 to 64 years. The mortality rate and DALY rate of colorectal cancer attributable to diet high in processed meat, diet high in red meat, diet low in calcium, diet low in fiber, diet low in milk, diet low in whole grains, and dietary risks increased with age after adjusting for period effect and cohort effect (P<0.05). The mortality rate and DALY rate attributable to diet high in processed meat, diet high in red meat, diet low in calcium, diet low in milk, diet low in whole grains and dietary risks increased with period or cohort, while those attributable to diet low in fiber decreased with period or cohort. Period and cohort effect of dietary risk factors in this study were statistically significant (P<0.001). Conclusions Disease burden of colorectal cancer attributable to dietary risk factors in China showed an upward trend in general. Elderly population is high at risk and more attention should be paid to science popularization and education on dietary risk factors in prevention and treatment of colorectal cancer.
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