估算 2015-2030 年中国女性乳腺癌的残疾调整寿命年数和筛查的影响:应用地方权重的基于患病率的探索性分析。

IF 3.2 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Xin-Xin Yan, Juan Zhu, Yan-Jie Li, Meng-Di Cao, Xin Wang, Hong Wang, Cheng-Cheng Liu, Jing Wang, Yang Li, Ju-Fang Shi
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引用次数: 0

摘要

背景:世界上大多数癌症残疾调整生命年(DALY)研究都采用了宽泛、通用的残疾权重(DWs);然而,不同人群和癌症类型之间存在差异。本研究以乳腺癌为例,旨在估算中国女性的人口残疾调整生命年、筛查的影响以及当地残疾权重:方法:利用多源数据,构建了一个基于患病率的模型。(方法:利用多源数据,构建了一个基于患病率的模型:(1) 使用患病病例数、特定阶段比例和当地乳腺癌残疾年数估算总体残疾年数(YLDs)。女性和新发乳腺癌病例数以及当地存活率用于计算患病病例数。(2) 根据乳腺癌死亡率、女性人数和标准预期寿命估算出生命损失年数(YLLs)。(3) 采用 Joinpoint 回归法预测 2020 年至 2030 年乳腺癌的发病率和死亡率以及相关的 DALYs。(4)筛查预测的假设条件包括扩大覆盖面、降低乳腺癌死亡率和提高乳腺癌早期比例:如果筛查覆盖率(25.7%)保持不变,预计 2030 年(2852.8 万)中国女性乳腺癌 DALYs 将增加 26.7%(≥ 65 岁人群为 60.3%)。但是,如果到 2030 年筛查覆盖率能达到 40.7%(根据 "健康中国行动 "推断),则筛查年龄组的残疾调整寿命年数将减少 1.5%。敏感性分析发现,使用当地的残疾调整率将使基线值改变约 10%:结论:中国因乳腺癌导致的残疾调整生命年估计值(青壮年残疾调整生命年比例较高)低于全球疾病负担研究的数字(25.27 万,8.2% 为青壮年残疾调整生命年),这表明应用特定人群的 DWs 非常重要。如果筛查覆盖率保持不变,乳腺癌导致的残疾调整寿命年数将继续增加,尤其是在老年人中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Estimating disability-adjusted life years for breast cancer and the impact of screening in female populations in China, 2015-2030: an exploratory prevalence-based analysis applying local weights.

Estimating disability-adjusted life years for breast cancer and the impact of screening in female populations in China, 2015-2030: an exploratory prevalence-based analysis applying local weights.

Estimating disability-adjusted life years for breast cancer and the impact of screening in female populations in China, 2015-2030: an exploratory prevalence-based analysis applying local weights.

Estimating disability-adjusted life years for breast cancer and the impact of screening in female populations in China, 2015-2030: an exploratory prevalence-based analysis applying local weights.

Background: Most cancer disability-adjusted life year (DALY) studies worldwide have used broad, generic disability weights (DWs); however, differences exist among populations and types of cancers. Using breast cancer as example, this study aimed to estimate the population-level DALYs in females in China and the impact of screening as well as applying local DWs.

Methods: Using multisource data, a prevalence-based model was constructed. (1) Overall years lived with disability (YLDs) were estimated by using numbers of prevalence cases, stage-specific proportions, and local DWs for breast cancer. Numbers of females and new breast cancer cases as well as local survival rates were used to calculate the number of prevalence cases. (2) Years of life lost (YLLs) were estimated using breast cancer mortality rates, female numbers and standard life expectancies. (3) The prevalence of and mortality due to breast cancer and associated DALYs from 2020 to 2030 were predicted using Joinpoint regression. (4) Assumptions considered for screening predictions included expanding coverage, reducing mortality due to breast cancer and improving early-stage proportion for breast cancer.

Results: In Chinese females, the estimated number of breast cancer DALYs was 2251.5 thousand (of 17.3% were YLDs) in 2015, which is predicted to increase by 26.7% (60.3% among those aged ≥ 65 years) in 2030 (2852.8 thousand) if the screening coverage (25.7%) stays unchanged. However, if the coverage can be achieved to 40.7% in 2030 (deduced from the "Healthy China Initiative"), DALYs would decrease by 1.5% among the screened age groups. Sensitivity analyses found that using local DWs would change the base-case values by ~ 10%.

Conclusion: Estimates of DALYs due to breast cancer in China were lower (with a higher proportion of YLDs) than Global Burden of Disease Study numbers (2527.0 thousand, 8.2% were YLDs), suggesting the importance of the application of population-specific DWs. If the screening coverage remains unchanged, breast cancer-caused DALYs would continue to increase, especially among elderly individuals.

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来源期刊
Population Health Metrics
Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.50
自引率
0.00%
发文量
21
审稿时长
29 weeks
期刊介绍: Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.
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