1990-2023年中国膀胱癌疾病负担与伤残损失寿命年趋势研究

Trends in disease burden and years lived with disability of bladder cancer in China，1990-2023

摘要

目的 基于2023年全球疾病负担研究（GBD 2023）数据，分析1990-2023年中国膀胱癌的疾病负担及伤残损失寿命年（YLD）的变化趋势。方法 运用GBD 2023数据库里中国膀胱癌的流行病学数据，计算年龄标准化患病率（ASPR）、YLD 以及风险因素归因比例等指标，并采用估计年度百分比变化率（EAPC） 评估时间趋势，采用Joinpoint回归模型计算年度变化百分比和平均年度变化百分比并分析趋势。结果 从1990年至2023年期间，需要康复服务的膀胱癌患者数量从213 568例增至587 191例，增长了175.0%；YLD 人年数从22 158增至56 620，增长了155.6%；ASPR从22.6/10万上升至25.7/10万（EAPC=0.06），趋势基本稳定；年龄标准化 YLD 率（ASYR）保持在2.5/10万（EAPC=-0.32），呈现下降趋势。疾病负担存在十分突出的性别差异，2023年男性患者数和YLD 分别是女性的4.63倍和4.25倍。风险因素归因分析，吸烟以及高空腹血糖是膀胱癌的主要风险因素，其中归因于高空腹血糖的 ASYR 在男性中呈上升趋势（EAPC=0.13），但在女性中呈下降趋势（EAPC=-1.41）。结论 中国膀胱癌康复需求和疾病负担增长明显，男性与老年人群负担更为沉重。急需制定针对性的干预措施，加强烟草控制、职业防护以及体质量管理，并且建立整合性康复服务体系，以此来应对膀胱癌带来的日益加重的疾病负担。

Abstract

Objective Based on data from the Global Burden of Disease Study 2023（GBD 2023），this study analyzes the trends in disease burden and years lived with disability（YLD）of bladder cancer in China from 1990 to 2023. Methods Epidemiological data on bladder cancer in China were obtained from the GBD 2023 database.The age-standardized prevalence rate（ASPR），YLD and population attributable fraction（PAF）of risk factors were calculated.Temporal trends were evaluated using the estimated annual percentage change（EAPC），and Joinpoint regression was applied to compute the annual percent change（APC）and average annual percent change（AAPC）for trend analysis. Results Between 1990 and 2023，the number of bladder cancer patients requiring rehabilitation services increased from 213 568 cases to 587 191 cases，representing a 175.0% increase.The YLD rose from 22 158 to 56 620，marking a 155.6% growth.The ASPR increased from 22.6/100 000 to 25.7/100 000（EAPC=0.06），indicating a stable trend.The age-standardized YLD rate（ASYR）remained at 2.5/100 000（EAPC=-0.32）， indicating a downward trend.Notably，gender disparities in disease burden were evident，with male patients and YLD being 4.63 times and 4.25 times higher than their female counterparts，respectively.Risk factor analysis showed that smoking and high fasting plasma glucose were the main risk factors for bladder cancer.The ASYR attributable to high fasting plasma glucose showed an increasing trend in males（EAPC=0.13）but a decreasing trend in females（EAPC= -1.41）. Conclusion The demand for rehabilitation and disease burden of bladder cancer in China have significantly increased，with particularly heavy burdens among males and the elderly population.It is urgent to formulate targeted interventions，strengthen tobacco control，occupational protection，and weight management，and establish an integrated rehabilitation service system to address the increasingly severe disease burden caused by bladder cancer.

关键词

膀胱癌 / 伤残损失寿命年 / 风险因素 / 康复需求 / 全球疾病负担

Key words

bladder cancer / years lived with disability / risk factors / rehabilitation needs / Global Burden of Disease Study

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基金资助

新乡市灾后重建专项资助项目(21CJ002)