| 刘威,王黎君,齐金蕾,刘江美,由金玲,林琳,殷鹏,周脉耕.1990-2017年中国女性乳腺癌疾病负担分析[J].Chinese journal of Epidemiology,2021,42(7):1225-1230 |
| 1990-2017年中国女性乳腺癌疾病负担分析 |
| Disease burden of breast cancer in women in China, 1990-2017 |
| Received:September 08, 2020 |
| DOI：10.3760/cma.j.cn112338-20200908-01139 |
| KeyWord: 乳腺肿瘤 发病率 死亡率 疾病负担 伤残调整寿命年 |
| English Key Word: Neoplasm, Breast Incidence Mortality Burden of disease Disability-adjusted life years |
| FundProject:国家重点研发计划（2018YFC1315301） |
| Author Name | Affiliation | E-mail | | Liu Wei | Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Wang Lijun | Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Qi Jinlei | Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Liu Jiangmei | Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | You Jinling | Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Lin Lin | Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Yin Peng | Division of Vital Registration and Death Cause Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | yinpeng@ncncd.chinacdc.cn | | Zhou Maigeng | National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | |
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| Abstract: |
| 目的 分析1990-2017年我国女性乳腺癌发病、死亡及其疾病负担的变化趋势。方法 利用2017年全球疾病负担（GBD）中国分省研究结果，采用GBD2017世界标准人口对发病率、死亡率、伤残调整寿命年（DALY）率、过早死亡损失寿命年（YLL）率和伤残损失寿命年（YLD）率进行标化，采用归因负担公式来估计饮酒、高BMI、高FPG、低体力活动和吸烟这5个乳腺癌危险因素的归因死亡数。分析1990-2017年我国女性乳腺癌发病、死亡及其造成的疾病负担及归因死亡数的变化情况。结果 2017年中国女性乳腺癌发病人数、死亡人数和标化发病率分别为35.76万、8.48万和35.62/10万，较1990年分别增长了286.18%、114.14%和88.77%。标化死亡率从1990年的8.57/10万逐年降至2007年的7.84/10万然后又逐年升至2015年的8.71/10万，而后又下降至2017年的8.47/10万。1990年与2017年中国女性乳腺癌的死亡率随年龄增加而上升，≥ 80岁最高。1990-2017年DALY标化率和YLL标化率的变化趋势与标化死亡率相同，而YLD标化率及YLD占DALY比例则是逐年递增。2017年乳腺癌DALY标化率、YLL标化率和YLD标化率分别为253.00/10万、228.96/10万和24.05/10万，与1990年相比各自变化率分别为-6.88%、-11.73%和95.85%。与1990年相比，2017年我国可归因于高BMI的乳腺癌死亡比例增加了165.76%，从5.49%增至14.59%；可归因于饮酒和高FPG的乳腺癌死亡比例有所增加；可归因于低体力活动和吸烟的乳腺癌死亡比例基本保持稳定。2017年我国女性乳腺癌标化死亡率最高的3个省份分别为香港特别行政区（9.93/10万）、广西壮族自治区（9.52/10万）和辽宁省（9.49/10万）；与1990年相比有19个省份的标化死亡率出现下降，降低率最高的3个省份为北京市（-27.17%）、澳门特别行政区（-26.06%）和吉林省（-23.89%）；增长率最高的2个省份是河北省（28.85%）和河南省（24.34%）。结论 我国女性乳腺癌的疾病负担在1990-2017年间不断加重，需要不断加强乳腺癌的防治工作。 |
| English Abstract: |
| Objective To analyze the trend of the incidence, mortality and disease burden of breast cancer in women in China during 1990-2017. Methods Based on the estimation of data in China from the Global Burden of Disease 2017 (GBD2017), the incidence,mortality, disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) on breast cancer for women in China during 1990-2017 were standardized by the world standard population used for GBD2017. The GBD study applied the attributable burden formula to estimate the attributable deaths by five risk factors of breast cancer, including alcohol use, high body mass index (BMI), high fasting plasma glucose, low physical activity and tobacco smoking. The incidence, mortality, attributable deaths and the disease burden due to breast cancer in women in China were analyzed. Results In 2017, a total of 357.6 thousand female breast cancer cases, including 84.8 thousand deaths, were reported in China, with the age-standardized incidence rate of 35.62/100 000, which increased by 286.18%, 114.14% and 88.77% respectively compared with 1990. The age-standardized mortality rate decreased from 8.57/100 000 in 1990 to 7.84/100 000 in 2007, then increased to 8.71/100 000 in 2015, and then decreased to 8.47/100 000 in 2017. The mortality of breast cancer increased with age in 1990 and 2017. From 1990 to 2017, the trend of standardized DALY rate and standardized YLL rate were the same as that of standardized mortality, while the standardized YLD rate and the proportion of YLD in DALY increased year by year. In 2017, the standardized DALY rate, standardized YLL rate and standardized YLD rate of breast cancer were 253.00/100 000, 228.96/100 000, and 24.05/100 000, respectively. Compared with 1990, the change rates were -6.88% and -11.73% and 95.85% respectively. The proportion of breast cancer deaths attributable to high BMI increased significantly by 165.76%, from 5.49% in 1990 to 14.59% in 2017. The proportion of breast cancer deaths attributable to alcohol use and high fasting blood glucose increased; and the proportion of breast cancer deaths attributed to low physical activity and smoking remained stable. In 2017, the three provinces with the highest age-standardized mortality rate of female breast cancer were Hongkong (9.93/100 000), Guangxi (9.52/100 000) and Liaoning (9.49/100 000). Compared with 1990, the age-standardized mortality of 19 provinces decreased, and Beijing (-27.17%), Macao (-26.06%) and Jilin (-23.89%) had the fastest decrease. The two provinces with the highest growth rates were Hebei (28.85%) and Henan (24.34%). Conclusions The disease burden of female breast cancer in China increased during 1990-2017. Therefore it is necessary to strengthen the prevention and treatment of breast cancer. |
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