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2010 年至 2019 年 29 种癌症的发病率、死亡率、生命损失年数、失能生存年数和伤残调整生命年:2019 年全球疾病负担研究的系统分析。

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

机构信息

Institute for Health Metrics and Evaluation, University of Washington, Seattle.

Department of Global Health, Boston University, Boston, Massachusetts.

出版信息

JAMA Oncol. 2022 Mar 1;8(3):420-444. doi: 10.1001/jamaoncol.2021.6987.

Abstract

IMPORTANCE

The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden.

OBJECTIVE

To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019.

EVIDENCE REVIEW

The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).

FINDINGS

In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles.

CONCLUSIONS AND RELEVANCE

The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

摘要

重要性

2019 年全球疾病、伤害和危险因素研究(GBD 2019)系统地估计了发病率、发病率和死亡率,为降低癌症负担的地方和国际努力提供了信息。

目的

估计 204 个国家和地区以及按社会人口指数(SDI)五分位数的癌症负担和趋势,时间范围为 2010 年至 2019 年。

证据综述

使用 GBD 2019 估计方法来描述 2019 年及过去十年的癌症发病率、死亡率、残疾生活年数、生命损失年数和伤残调整生命年(DALY)。估计值还按 SDI 的五分位数提供,SDI 是一个综合指标,衡量 25 岁以下人群的教育程度、人均收入和总生育率。估计数包括 95%的置信区间(UI)。

发现

2019 年,全球估计有 2360 万(95% UI,2220-2490 万)例新癌症病例(不包括非黑色素瘤皮肤癌时为 1720 万)和 1000 万(95% UI,936-1060 万)例癌症死亡病例,全球因癌症导致的 DALY 估计数为 2.5 亿(2.35-2.64 亿)。自 2010 年以来,新病例增加了 26.3%(95% UI,20.3%-32.3%),死亡人数增加了 20.9%(95% UI,14.2%-27.6%),DALY 增加了 16.0%(95% UI,9.3%-22.8%)。在 GBD 2019 研究的 22 组疾病和伤害中,2019 年癌症在全球死亡人数、生命损失年数和 DALY 方面仅次于心血管疾病。癌症负担因 SDI 而异。对 DALY 有贡献的残疾生活年数的比例随着 SDI 的增加而增加,从低 SDI 五分位数的 1.4%(1.1%-1.8%)到高 SDI 五分位数的 5.7%(4.2%-7.1%)。虽然高 SDI 五分位数在 2019 年有最多的新病例,但中 SDI 五分位数有最多的癌症死亡和 DALY。从 2010 年到 2019 年,病例和死亡人数的最大百分比增长发生在低和中低 SDI 五分位数。

结论和相关性

这项系统分析的结果表明,癌症的全球负担是巨大的,而且还在不断增加,负担因 SDI 而异。这些结果提供了全面和可比的估计,可能为全球公平控制癌症的努力提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82e6/8719276/7c5507492709/jamaoncol-e216987-g001.jpg

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