1990-2021年204个国家和地区的全球、区域和国家泌尿生殖系统癌负担：对2021年全球疾病负担研究的系统分析

IF 7.6 Q1 ONCOLOGY

Journal of the National Cancer Center Pub Date : 2025-06-01 DOI:10.1016/j.jncc.2025.03.001

Zhiyong Zhang , Yingwei Xie , Lei Liu , Yongtao Wang , Shuang Li , Li Chen , Xiangbo Zeng , Yuanchao Zhu , Yishan Zhang , Yongyuan Xiao , Fengjin Zhao , Bihong Xu , Xiaocen Liu , Wenbin Guo , Ganping Wang , Wenlian Xie , Wanlong Tan , Hao Ping , Zaosong Zheng

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引用次数: 0

摘要

背景：泌尿生殖系统癌症是全球癌症负担的重要组成部分，并已成为癌症相关死亡的主要原因。然而，仍然缺乏最新的统计分析，以仔细检查全球和国家的变化，在泌尿生殖系统癌症的流行病学。我们的研究旨在通过分析最近更新的2021年全球疾病负担（GBD）数据库，全面了解泌尿生殖系统癌的全球分布和进展。方法本研究报告了1990年至2021年间按性别、年龄和地点划分的四种泌尿生殖系统癌（膀胱癌、肾癌、前列腺癌和睾丸癌）的发病率、死亡率、残疾调整生命年（DALYs）及其各自的年龄标准化率。对这些数据的估计以其95%的不确定区间（UIs）表示。使用估计年百分比变化（EAPCs）和贝叶斯年龄-时期-队列（BAPC）模型进一步量化生殖泌尿系统癌年龄标准化率（ASRs）的时间动态。根据社会人口指数（SDI）五分位数对国家和领土进行分类。结果：在全球范围内，除了膀胱癌的年龄标准化发病率（asir）持续下降（EAPC = - 0.36%）外，肾癌、前列腺癌和睾丸癌的asir从1990年到2021年呈上升趋势（EAPC分别为0.53%、0.20%和1.43%）。就地理区域而言，高收入的北美地区膀胱癌（13.98 / 10万人[95% UI， 12.96至14.61]）和前列腺癌（47.02 / 10万人[95% UI， 44.47至49.04]）的asir最高。南拉丁美洲的肾癌（13.44 / 10万人[95% UI， 12.27至14.73]）和睾丸癌（4.98 / 10万人[95% UI， 4.33至5.72]）的ASIRs最高。此外，中欧（1.25% [95% CI， 1.12%至1.38%]）、东亚（2.40% [95% CI， 2.21%至2.59%]）、东欧（3.74% [95% CI， 3.55%至3.92%]）和加勒比地区（5.52% [95% CI， 4.32%至6.74%]）分别表现出膀胱癌、肾癌、前列腺癌和睾丸癌的最高EAPCs。与asir不同，年龄标准化死亡率（ASMRs）和年龄标准化DALYs率（ASDRs）在所有类型的泌尿生殖系统癌中随时间呈下降趋势。膀胱癌、肾癌和前列腺癌的疾病负担主要分布在老年男性，而睾丸癌主要发生在年轻男性。吸烟仍然是膀胱癌的主要危险因素。同时，在研究期间，高空腹血糖和高体重指数对膀胱癌和肾癌的影响越来越显著。到2050年的预测表明，全球泌尿生殖系统癌的负担预计将有不同程度的下降。然而，预计泌尿生殖系统癌负担的地区差异将持续存在。结论：尽管结果显示泌尿生殖系统癌引起的asr略有下降，但它们仍然造成了相当大的全球负担，并导致大量死亡。本研究从GBD 2021中获取并分析了泌尿生殖系统癌的最新流行病学数据，为国家卫生保健专业人员和政策制定者优化资源配置、更有效地管理成本、制定切实可行的卫生保健政策提供了有价值的信息。

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Global, regional, and national burden of genitourinary cancers in 204 countries and territories, 1990–2021: a systematic analysis for the global burden of disease study 2021

Background

Genitourinary cancers constitute a significant portion of the global cancer burden and have emerged as a prominent cause of cancer-related mortality. However, there remains a paucity of up-to-date statistical analyses that meticulously examine the global and national shifts in the epidemiology of genitourinary cancers. Our study aimed to provide a comprehensive understanding of the global distribution and progression of genitourinary cancers through analyses of the recently updated 2021 Global Burden of Disease (GBD) database.

Methods

This study presented the incidence, mortality, disability-adjusted life years (DALYs), and their respective age-standardized rates for four genitourinary cancers (bladder, kidney, prostate, and testicular cancers) by sex, age, and location from 1990 to 2021. Estimates for these data were presented with their 95% uncertainty intervals (UIs). Estimated annual percentage changes (EAPCs) and Bayesian Age-Period-Cohort (BAPC) models were utilized to further quantify the temporal dynamics of age-standardized rates (ASRs) in genitourinary cancers. Countries and territories were categorized according to socio-demographic index (SDI) quintiles.

Results

Globally, with the exception of a sustained decline in age-standardized incidence rates (ASIRs) for bladder cancer (EAPC = −0.36%), the ASIRs for kidney, prostate, and testicular cancers demonstrated an upward trend from 1990 to 2021 (EAPC = 0.53%, 0.20%, and 1.43%, respectively). In terms of geographical regions, High-income North America had the highest ASIRs for both bladder (13.98 per 100,000 persons [95% UI, 12.96 to 14.61]) and prostate (47.02 per 100,000 persons [95% UI, 44.47 to 49.04]) cancers. Southern Latin America recorded the highest ASIRs for kidney (13.44 per 100,000 persons [95% UI, 12.27 to 14.73]) and testicular (4.98 per 100,000 persons [95% UI, 4.33 to 5.72]) cancers. Additionally, Central Europe (1.25% [95% CI, 1.12% to 1.38%]), East Asia (2.40% [95% CI, 2.21% to 2.59%]), Eastern Europe (3.74% [95% CI, 3.55% to 3.92%]), and the Caribbean (5.52% [95% CI, 4.32% to 6.74%]) exhibited the highest EAPCs for bladder, kidney, prostate, and testicular cancers, respectively. Unlike the ASIRs, age-standardized mortality rates (ASMRs) and age-standardized DALYs rates (ASDRs) showed a downward trend over time in all types of genitourinary cancers. The disease burdens of bladder, kidney, and prostate cancers were primarily distributed among older men, while testicular cancer mainly occurred in young men. Smoking remained the primary risk factor for bladder cancer. Meanwhile, high fasting plasma glucose and high body-mass index exerted increasingly significant impacts on bladder and kidney cancers, respectively, during the study period. Projections to 2050 suggest that the global burdens of genitourinary cancers are expected to decline to varying degrees. However, regional disparities in genitourinary cancer burdens are projected to persist.

Conclusions

Although the results demonstrate a marginal decline in ASRs caused by genitourinary cancers, they still impose a considerable global burden and result in numerous deaths. Our study obtained and analyzed the latest epidemiological data of genitourinary cancers from the GBD 2021, offering valuable information for national healthcare professionals and policymakers to optimize resource allocation, manage costs more efficiently, and develop practical healthcare policies.

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来源期刊

Journal of the National Cancer Center Oncology

CiteScore

14.20

自引率

0.00%

发文量

审稿时长

70 days