全球疾病负担研究 2017 年：气管、支气管和肺癌全球负担的严重程度、时间趋势和不平等。
Magnitude, temporal trends and inequality in global burden of tracheal, bronchus and lung cancer: findings from the Global Burden of Disease Study 2017.
机构信息
Department of Thoracic Surgery, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, China.
Department of Respiratory, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, China.
出版信息
BMJ Glob Health. 2020 Oct;5(10). doi: 10.1136/bmjgh-2020-002788.
INTRODUCTION
We aimed to assess the magnitude, temporal trends and socioeconomic disparity in the global burden of tracheal, bronchus and lung (TBL) from 1990 to 2017, using data extracted from the Global Burden of Diseases study (GBD 2017).
METHODS
We extracted data from the GBD 2017 study. A series of comparative and descriptive analyses of the disease burden between females and males and countries with different socioeconomic development statuses (Social Demographic Index, SDI). We also analysed the temporal trends of age-standardised disability-adjusted life year rates (ASDR) of TBL cancer at the global and super-regional level by means of joinpoint regression. Finally, we also calculated Concentration Index to explore trends of between-country inequality in cancer burden from 1990 to 2017.
RESULTS
During the past 27 years, the global incidence of TBL cancer cases and death cases has increased by 100% and 82.3% respectively, but the increase number was mainly influenced by population growth and ageing. After adjustment, from 1990 to 2017, the ASDR of TBL has increased by 3% and the age-standardised death rate has decreased by 7%. The global TBL cancer burden fell by 15.3%. The joinpoint analysis revealed that the overall trend of age-standardised TBL cancer burden for both females and males significantly changed twice between 1990 and 2017, and it varied across countries with different SDI values and was also different between females and males. Age-standardised TBL cancer burden was more concentrated in higher socioeconomic development countries, but the development of healthy inequality showed a downward trend in males while showing an upward trend in females.
CONCLUSION
The magnitude and temporal trends of TBL cancer burden varied across countries and sex. This study highlighted the importance of crafting health policy to adapt to local conditions to manage the global burden of TBL cancers.
简介
本研究旨在利用全球疾病负担研究（GBD 2017）的数据，评估 1990 年至 2017 年全球气管、支气管和肺（TBL）疾病负担的规模、时间趋势和社会经济差异。
方法
我们从 GBD 2017 研究中提取数据。通过比较和描述分析，研究了女性和男性以及不同社会经济发展水平国家（社会人口指数，SDI）之间的疾病负担差异。我们还通过联合回归分析了全球和超区域层面 TBL 癌症的年龄标准化残疾调整生命年率（ASDR）的时间趋势。最后，我们还计算了集中指数，以探索 1990 年至 2017 年癌症负担在国家间不平等的趋势。
结果
在过去的 27 年中，全球 TBL 癌症发病率和死亡率分别增加了 100%和 82.3%，但增加的数量主要受人口增长和老龄化的影响。调整后，1990 年至 2017 年，TBL 的 ASDR 增加了 3%，年龄标准化死亡率下降了 7%。全球 TBL 癌症负担下降了 15.3%。联合回归分析显示，1990 年至 2017 年期间，女性和男性的 TBL 癌症负担的总体趋势发生了两次显著变化，而且在不同 SDI 值的国家之间也存在差异，在女性和男性之间也存在差异。年龄标准化 TBL 癌症负担在社会经济发展水平较高的国家更为集中，但健康不平等的发展在男性中呈下降趋势，而在女性中则呈上升趋势。
结论
TBL 癌症负担的规模和时间趋势在国家和性别之间存在差异。本研究强调了制定适合当地情况的卫生政策以管理全球 TBL 癌症负担的重要性。
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