1990年与2016年北京市恶性肿瘤疾病负担及其变化趋势

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目的:了解北京市1990年与2016年恶性肿瘤的疾病负担现状及其变化情况。方法:利用2016年全球疾病负担研究结果,对1990年和2016年北京市恶性肿瘤发病情况、死亡情况和疾病负担进行描述。主要指标包括发病数、死亡数、过早死亡损失寿命年(YLL)、伤残损失寿命年(YLD)和伤残调整寿命年(DALY),同时使用2000—2025年世界人口的平均人口作为标准人口,计算标化发病率、标化死亡率、DALY率、YLL率和YLD率。结果:2016年恶性肿瘤标化发病率为250.68/10万,较1990年增加30.03%;标化死亡率为115.83/10万,较1990年降低26.71%。恶性肿瘤DALY、YLL和YLD分别为67.12万人年、65.11万人年和2.01万人年,较1990年分别增加85.83%、82.79%和302.00%;标化DALY率和标化YLL率分别为2 549.00/10万和2 469.84/10万,较1990年分别下降33.22%和34.30%;标化YLD率为79.16/10万,较1990年增加37.17%。2016年男性DALY、YLL和YLD分别为42.88万人年、41.78万人年和1.10万人年;女性分别为24.24万人年、23.33万人年和0.91万人年。2016年不同恶性肿瘤中,DALY和YLL排名前3位的均分别为肺癌、肝癌和结直肠癌;YLD排名前3位分别为肺癌、结直肠癌和乳腺癌。2016年恶性肿瘤DALY负担最高的年龄段为50~69岁,为32.36万人年,占总DALY的48.21%,较1990年增加87.70%。结论:北京市恶性肿瘤疾病负担重,以过早死亡导致的疾病负担为主,伤残疾病负担增长迅速。疾病负担集中在50~69岁,且男性高于女性。肺癌居恶性肿瘤疾病负担首位。结直肠癌疾病负担增加。应从青少年开始培养良好的生活方式,加强肿瘤危险因素的预防与干预,加强高危人群早期筛查,规范患者治疗和康复指导。“,”Objective:To investigate the current status and trend of disease burden of neoplasms in 1990 and 2016 for Beijing people.Methods:The incidence situation, deaths status and disease burden of neoplasms in Beijing were described by using the results of the global burden of diseases study 2016 (GBD 2016). The measurement index included incidence, death, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted years (DALY). Using the average world population from 2000 to 2025 as standard population to calculate the age-standardized incidence rate, mortality rate, DALY rate, YLL rate and YLD rate.Results:The age-standardized incidence rate of neoplasms in 2016 was 250.68 per 100 000, which increased by 30.03% than in 1990. The age-standardized mortality rate was 115.83 per 100 000, which decreased by 26.71% than in 1990. The DALY, YLL and YLD of neoplasms in 2016 were 671.2, 651.1 and 20.1 thousand person-years, respectively, which increased by 85.83%, 82.79% and 302.00% than those in 1990. The age-standardized DALY rate and YLL rate were 2 549.00 and 2 469.84 per 100 000, which decreased by 33.22% and 34.30% than those in 1990. The age-standardized YLD rate was 79.16 per 100 000, which increased by 37.17% than that in 1990. The male DALY, YLL and YLD in 2016 were 428.8, 417.8 and 11.0 thousand person-years, and female were 242.4, 233.3 and 9.1 thousand person-years, respectively.Among different neoplasms, the top three neoplasms of DALY and YLL were lung cancer, liver cancer, colon and rectum cancer, the top three of YLD were lung cancer, colon and rectum cancer, breast cancer. The topped group of disease burden of neoplasms was aged from 50 to 69 years old, the DALY of which was 323.6 thousand person-years, accounted for 48.21% of all DALY, and increased by 87.70% than that in 1990.Conclusions:The disease burden of neoplasms in Beijing is dominated by YLL, and the YLD increases rapidly. The burden is severe in the group of aged from 50 to 69 years old, and the male is severer than female. Lung cancer ranks the first of the disease burden of neoplasms. The DALY of colorectal cancer has increased. Comprehensive strategies should be promoted, including cultivating a good lifestyle and implementing prevention and control of neoplasm risk factors as early as teenage group, early screening of high-risk population, and enhancing the instruction of patients′ treatment and rehabilitation.
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