Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.
Int J Cancer. 2021 Sep 1;149(5):993-1001. doi: 10.1002/ijc.33617. Epub 2021 May 18.
Projecting the burden of pancreatic cancer over time provides essential information to effectively plan measures for its management and prevention. Here, we obtained data from the Global Burden of Disease (GBD) Study between 1990 and 2019, to model how pancreatic cancer will affect the 27 countries of the European Union (EU) plus the United Kingdom (the pre-Brexit EU-28) until 2039 by conducting the Bayesian age-period-cohort analysis. The number of new pancreatic cancer cases in the EU-28 was 59 000 in 1990, 109 000 in 2019 and projected to be 147 000 in 2039. This corresponded to 60 000, 109 000 and 155 000 for deaths, and a loss of 1.3 million, 2.0 million and 2.7 million for disability-adjusted life years (DALYs), respectively. The most pronounced increase of the crude incidence rate was observed and projected to be in the population older than 80 years. The age-standardized rate (ASR) of incidence, however, increased from 8.6 to 10.1 per 100 000 person-years during 1990-2019 but was projected to remain stable during 2019-2039. At the same time, our models only predicted a mild increase in the ASR of mortality until 2039. The fraction of pancreatic cancer mortality attributable to tobacco consumption decreased during 1990-2019, but we found upward trends for the attributable fractions for high fasting plasma glucose and high body mass index. In conclusion, a substantial increase in counts of incidence, mortality and DALYs lost of pancreatic cancer in the EU-28 is projected over the next two decades, which indicates the need for future health policies and interventions.
预测胰腺癌的疾病负担随时间的变化,可为有效规划其管理和预防措施提供重要信息。在这里,我们利用全球疾病负担研究(GBD)1990 年至 2019 年的数据,通过贝叶斯年龄-时期-队列分析模型,预测在未来 20 年内,27 个欧盟成员国(EU)加上英国(脱欧前的欧盟 28 国)的胰腺癌发病情况。1990 年,欧盟 28 国的新发病例数为 5.9 万例,2019 年为 10.9 万例,预计到 2039 年将达到 14.7 万例。这分别对应 6 万例、10.9 万例和 15.5 万例的死亡病例,以及 130 万例、200 万例和 270 万例的残疾调整生命年(DALY)损失。发病率的粗率预计在 80 岁以上人群中最为显著增加。然而,年龄标准化发病率(ASR)从 1990-2019 年的每 10 万人年 8.6 例增加到 10.1 例,但预计在 2019-2039 年将保持稳定。与此同时,我们的模型仅预测到 2039 年前死亡率的 ASR 会略有上升。1990-2019 年期间,归因于烟草消费的胰腺癌死亡率的比例有所下降,但我们发现高空腹血糖和高身体质量指数的归因比例呈上升趋势。总之,未来二十年欧盟 28 国的胰腺癌发病率、死亡率和 DALY 损失预计将大幅增加,这表明需要制定未来的卫生政策和干预措施。