Article(id=1321170040288826309, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169924697993338, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145196, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1718208000000, receivedDateStr=2024-06-13, revisedDate=1726848000000, revisedDateStr=2024-09-21, acceptedDate=1731945600000, acceptedDateStr=2024-11-19, onlineDate=1792921083757, onlineDateStr=2026-10-25, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921083757, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921083757, creator=13701087609, updateTime=1792921083757, updator=13701087609, issue=Issue{id=1321169924697993338, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='5', pageStart='513', pageEnd='640', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921056198, creator='13701087609', updateTime=1792921056198, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=606, endPage=613, ext={EN=ArticleExt(id=1321170040716645319, articleId=1321170040288826309, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Age-period-cohort analysis of the pancreatic cancer burden among Chinese residents from 1990 to 2021, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the trend in the burden of pancreatic cancer among Chinese residents from 1990 to 2021, providing reference data for the prevention and control of pancreatic cancer in China.

Methods

Data related to the burden of pancreatic cancer among Chinese residents from 1990 to 2021 were collected from the Global Burden of Disease (GBD 2021) database. Standardized incidence rates, standardized mortality rates, and disability-adjusted life years (DALYs) were extracted for descriptive analysis. The Joinpoint regression model was used to analyze trends in the burden of pancreatic cancer, and the age-period-cohort (APC) model was applied to assess the effects of age, period, and birth cohort on the burden of pancreatic cancer.

Results

The age-standardized incidence rate of pancreatic cancer in China′s overall, male, and female populations increased from 4.54/100 000, 5.55/100 000, and 3.64/100 000 in 1990 to 5.64/100 000, 7.29/100 000, and 4.18/100 000 in 2021, respectively. The average annual percentage changes (AAPCs) were 0.72%, 0.89%, and 0.48%, respectively, with statistically significant increasing trends for the overall, male, and female populations (all P < 0.001). The age-standardized mortality rates increased from 4.83/100 000, 5.91/100 000, and 3.90/100 000 in 1990 to 5.72/100 000, 7.37/100 000, and 4.29/100 000 in 2021, respectively, with AAPCs of 0.56%, 0.55%, and 0.33%, respectively. Statistically significant increasing trends were observed for the overall, male, and female populations (all P < 0.001). The age-standardized disability-adjusted life years (DALYs) rates increased from 123.16/100 000, 151.33/100 000, and 95.37/100 000 in 1990 to 137.23/100 000, 179.36/100 000, and 96.89/100 000 in 2021, respectively, with AAPCs of 0.36%, 0.55%, and 0.07%, respectively. Statistically significant increasing trends were observed for the overall and male populations (all P < 0.001). The risk of pancreatic cancer incidence increased with age for both males and females. The age effect coefficients were lowest for the 15 - 19 age group (–3.638 and –3.406, respectively), highest for males in the 85 - 89 age group (1.623), and highest for females in the 80 - 84 age group (1.582). The risk of pancreatic cancer incidence increased over time, with period effect coefficients increasing from –0.477 and –0.388 in 1992 - 1996 to 0.488 and 0.382 in 2017 - 2021 for males and females, respectively. The risk of pancreatic cancer incidence decreased with birth cohort, with the lowest cohort effect coefficients observed in 2002 - 2006 (–1.719 and –1.877 for males and females, respectively) and the highest in 1897 - 1901 (1.374 and 1.504, respectively). The risk of pancreatic cancer mortality generally increased with age for both males and females. The age effect coefficients were lowest for the 15 - 19 age group (–3.658 and –3.428, respectively), highest for males in the 90 - 94 age group (1.751), and highest for females in both the 80 - 84 and 85 - 89 age groups (1.686 for both). The risk of pancreatic cancer mortality increased over time, with period effect coefficients increasing from –0.465 and –0.384 in 1992 - 1996 to 0.477 and 0.366 in 2017 - 2021 for males and females, respectively. The risk of pancreatic cancer mortality decreased with birth cohort, with the lowest cohort effect coefficients in 2002 - 2006 (–1.794 and –1.964 for males and females, respectively) and the highest in 1897 - 1901 (1.456 and 1.594, respectively). The risk of pancreatic cancer burden generally increased with age for both males and females. The age effect coefficients were lowest for the 15 - 19 age group (–3.069 and –2.834, respectively) and highest for the 70 - 74 age group (1.049 and 1.286 for males and females, respectively). The risk increased over time, with period effect coefficients increasing from –0.358 and –0.252 in 1992 - 1996 to 0.364 and 0.260 in 2017 - 2021 for males and females, respectively. The risk of pancreatic cancer burden decreased with birth cohort, with the lowest cohort effect coefficients in 2002 - 2006 (–1.334 and –1.513 for males and females, respectively) and the highest in 1897 - 1901 (1.000 and 1.114, respectively).

Conclusion

From 1990 to 2021, the age-standardized incidence, mortality, and DALY rates of pancreatic cancer in the Chinese population, as well as the age-standardized DALY rate in males, showed an increasing trend. The risk of pancreatic cancer burden increased with age and period but decreased with birth cohort.

, authors=Qinxian LIU, Jiayi LI, Zule NING, Yongrui LING, Meng YANG, Jinlin DU, authorsList=Qinxian LIU, Jiayi LI, Zule NING, Yongrui LING, Meng YANG, Jinlin DU, authorCompany=null, correspAuthors=Jinlin DU, authorNote=null, correspAuthorsNote=
DU Jinlin, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170041257710537, articleId=1321170040288826309, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=1990—2021年中国居民胰腺癌疾病负担趋势年龄–时期–队列分析, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

分析1990—2021年中国居民胰腺癌疾病负担趋势,为我国胰腺癌防治工作提供参考依据。

方法

收集2021年全球疾病负担(GBD 2021)数据库中1990—2021年中国居民胰腺癌疾病负担的相关数据,提取标化发病率、标化死亡率和标化伤残调整寿命年(DALYs)率等指标进行描述性分析,采用Joinpoint回归模型分析胰腺癌疾病负担的变化趋势,并应用年龄–时期–队列(APC)模型分析胰腺癌疾病负担的年龄、时期、出生队列效应。

结果

中国总体、男性和女性居民1990—2021年胰腺癌标化发病率分别从1990年的4.54/10万、5.55/10万和3.64/10万上升至2021年的5.64/10万、7.29/10万和4.18/10万,平均年度变化百分比(AAPC)值分别为0.72%、0.89%和0.48%,总体、男性和女性居民上升趋势均有统计学意义(均P<0.001);胰腺癌标化死亡率分别从1990年的4.83/10万、5.91/10万和3.90/10万上升至2021年的5.72/10万、7.37/10万和4.29/10万,AAPC值分别为0.56%、0.55%和0.33%,总体、男性和女性居民上升趋势均有统计学意义(均P<0.001);胰腺癌标化DALYs率分别从1990年的123.16/10万、151.33/10万和95.37/10万上升至2021年的137.23/10万、179.36/10万和96.89/10万,AAPC值分别为0.36%、0.55%和0.07%,总体和男性居民上升趋势均有统计学意义(均P<0.001)。男性和女性居民胰腺癌发病风险均随年龄的增长呈上升趋势,年龄效应系数均在15~19岁为最低(分别为–3.638和–3.406),男性居民在85~89岁为最高(1.623),女性居民在80~84岁为最高(1.582);胰腺癌发病风险随着时期的推移而上升,男性和女性居民的时期效应系数分别由1992—1996年的–0.477和–0.388上升至2017—2021年的0.488和0.382;胰腺癌发病风险随着出生年份的推移呈下降趋势,男性和女性居民的最低出生队列效应系数均在2002—2006年,分别为–1.719和–1.877,最高出生队列效应系数分别为1897—1901年的1.374和1.504。男性和女性居民胰腺癌死亡风险均随着年龄的增长大体呈上升趋势,年龄效应系数均在15~19岁为最低(分别为–3.658和–3.428),男性居民在90~94岁为最高(1.751),女性居民在80~84岁和85~89岁均为最高(均1.686);胰腺癌死亡风险随着时期的推移而上升,男性和女性居民的时期效应系数分别由1992—1996年的–0.465和–0.384上升至2017—2021年的0.477和0.366;胰腺癌死亡风险随着出生年份的推移呈下降趋势,男性和女性居民的最低出生队列效应系数均在2002—2006年,分别为–1.794和–1.964,最高出生队列效应系数分别为1897—1901年的1.456和1.594。男性和女性居民胰腺癌疾病负担风险均随年龄增长大体呈上升趋势,年龄效应系数均在15~19岁为最低(分别为–3.069和–2.834),男性和女性居民均在70~74岁为最高(分别为1.049和1.286);随着时期的推移而上升,男性和女性居民的时期效应系数分别由1992—1996年的–0.358和–0.252上升至2017—2021年的0.364和0.260;胰腺癌疾病负担风险随着出生年份的推移呈下降趋势,男性和女性居民的最低出生队列效应系数均在2002—2006年,分别为–1.334和–1.513,最高出生队列效应系数均在1897—1901年,分别为1.000和1.114。

结论

1990—2021年中国居民胰腺癌的标化发病率、标化死亡率和男性居民标化DALYs率均呈上升趋势,其胰腺癌疾病负担风险随年龄增长和时期推移而升高,随队列延伸而降低。

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刘沁娴(2000—),硕士在读,研究方向:疾病预防与控制

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杜进林,E-mail:
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刘沁娴(2000—),硕士在读,研究方向:疾病预防与控制

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Trends in the burden of pancreatic cancer among Chinese residents from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份标化发病率/(1/10万)标化死亡率/(1/10万)标化DALYs率/(1/10万)
总体居民男性居民女性居民总体居民男性居民女性居民总体居民男性居民女性居民
19904.545.553.644.835.913.90123.16151.3395.37
19914.575.593.644.865.953.90123.62152.3195.28
19924.585.603.654.875.963.92123.44152.0495.18
19934.595.593.684.885.953.95123.17151.0295.70
19944.595.563.724.885.913.98122.59149.4296.16
19954.625.623.724.915.983.99122.96150.5795.78
19964.655.643.764.946.004.03123.27150.6596.31
19974.665.663.764.956.014.03123.24150.8296.06
19984.705.713.805.006.074.06123.99151.7796.64
19994.785.803.865.086.164.13125.33153.2797.91
20004.895.983.925.196.354.19127.36156.7498.63
20014.936.053.935.246.434.20127.63157.7798.29
20024.926.073.895.226.444.16127.14158.1097.01
20034.956.173.885.256.554.15127.17159.2896.14
20045.036.293.925.336.664.18128.23161.4796.11
20055.076.373.935.356.724.18128.37162.3295.65
20065.016.313.865.266.624.09126.61160.7393.71
20075.046.393.865.276.694.07126.84161.9493.17
20085.106.493.875.326.774.08127.78164.0392.89
20095.166.623.875.386.894.07128.87166.6392.49
20105.266.793.905.467.044.09130.87170.4292.73
20115.336.913.925.527.154.10132.00172.8092.66
20125.316.963.845.487.174.00131.43173.6790.77
20135.266.923.775.407.103.92129.87172.3689.04
20145.206.843.745.337.003.86128.34170.3488.05
20155.216.863.765.347.033.88128.25170.1588.23
20165.276.903.835.407.073.96129.22170.7789.59
20175.336.933.915.457.074.03130.87172.0491.48
20185.427.024.005.527.144.11132.71173.9693.20
20195.527.144.085.627.254.20134.76176.5294.80
20205.607.244.165.697.334.27136.51178.4896.31
20215.647.294.18 5.727.374.29 137.23179.3696.89
AAPC/%0.720.890.480.560.550.330.360.550.07
t值6.388.373.699.204.334.536.895.890.71
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.0010.48
), ArticleFig(id=1321170045695284220, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170040288826309, language=CN, label=表1, caption=

中国居民1990—2021年胰腺癌疾病负担变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年份标化发病率/(1/10万)标化死亡率/(1/10万)标化DALYs率/(1/10万)
总体居民男性居民女性居民总体居民男性居民女性居民总体居民男性居民女性居民
19904.545.553.644.835.913.90123.16151.3395.37
19914.575.593.644.865.953.90123.62152.3195.28
19924.585.603.654.875.963.92123.44152.0495.18
19934.595.593.684.885.953.95123.17151.0295.70
19944.595.563.724.885.913.98122.59149.4296.16
19954.625.623.724.915.983.99122.96150.5795.78
19964.655.643.764.946.004.03123.27150.6596.31
19974.665.663.764.956.014.03123.24150.8296.06
19984.705.713.805.006.074.06123.99151.7796.64
19994.785.803.865.086.164.13125.33153.2797.91
20004.895.983.925.196.354.19127.36156.7498.63
20014.936.053.935.246.434.20127.63157.7798.29
20024.926.073.895.226.444.16127.14158.1097.01
20034.956.173.885.256.554.15127.17159.2896.14
20045.036.293.925.336.664.18128.23161.4796.11
20055.076.373.935.356.724.18128.37162.3295.65
20065.016.313.865.266.624.09126.61160.7393.71
20075.046.393.865.276.694.07126.84161.9493.17
20085.106.493.875.326.774.08127.78164.0392.89
20095.166.623.875.386.894.07128.87166.6392.49
20105.266.793.905.467.044.09130.87170.4292.73
20115.336.913.925.527.154.10132.00172.8092.66
20125.316.963.845.487.174.00131.43173.6790.77
20135.266.923.775.407.103.92129.87172.3689.04
20145.206.843.745.337.003.86128.34170.3488.05
20155.216.863.765.347.033.88128.25170.1588.23
20165.276.903.835.407.073.96129.22170.7789.59
20175.336.933.915.457.074.03130.87172.0491.48
20185.427.024.005.527.144.11132.71173.9693.20
20195.527.144.085.627.254.20134.76176.5294.80
20205.607.244.165.697.334.27136.51178.4896.31
20215.647.294.18 5.727.374.29 137.23179.3696.89
AAPC/%0.720.890.480.560.550.330.360.550.07
t值6.388.373.699.204.334.536.895.890.71
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.0010.48
), ArticleFig(id=1321170045779170301, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170040288826309, language=EN, label=Tab.2, caption=

Age-period-cohort model analysis of pancreatic cancer incidence in Chinese residents from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类总体居民男性居民女性居民
效应系数95%CI效应系数95%CI效应系数95%CI
年龄效应/岁15~19–3.585–5.289~–1.881–3.638–5.186~–2.090–3.406–5.346~–1.466
20~24–3.041–4.187~–1.894–3.117–4.167~–2.067–2.845–4.130~–1.561
25~29–2.398–3.223~–1.573–2.423–3.162~–1.684–2.314–3.272~–1.356
30~34–1.473–2.041~–0.905–1.357–1.849~–0.866–1.729–2.454~–1.003
35~39–0.689–1.130~–0.248–0.537–0.922~–0.152–1.085–1.645~–0.524
40~44–0.197–0.570~0.176–0.075–0.404~0.254–0.525–0.984~–0.067
45~490.076–0.247~0.3980.166–0.119~0.452–0.190–0.581~0.201
50~540.4770.208~0.7470.4980.258~0.7390.3590.039~0.679
55~590.7850.562~1.0090.7660.566~0.9660.7360.473~0.999
60~640.9820.798~1.1650.9260.761~1.0900.9970.783~1.211
65~691.1470.996~1.2971.0640.929~1.1991.2121.037~1.387
70~741.3531.225~1.4811.2351.121~1.3501.4741.324~1.624
75~791.3981.272~1.5241.2561.145~1.3681.5571.407~1.707
80~841.4121.270~1.5531.2891.165~1.4141.5821.409~1.754
85~891.5271.357~1.6981.6231.475~1.7721.5571.347~1.767
90~941.3711.162~1.5791.5671.386~1.7491.4591.202~1.715
≥950.8560.603~1.1090.7550.533~0.9771.1620.852~1.472
时期效应/年份1992—1996–0.455–0.586~–0.323–0.477–0.594~–0.361–0.388–0.545~–0.231
1997—2001–0.254–0.340~–0.168–0.304–0.380~–0.227–0.198–0.299~–0.097
2002—2006–0.061–0.112~–0.010–0.101–0.146~–0.056–0.035–0.093~0.023
2007—20110.0960.045~0.1470.1010.057~0.1460.0770.018~0.135
2012—20160.2350.150~0.3200.2920.218~0.3670.1620.061~0.264
2017—20210.4390.312~0.5660.4880.376~0.6000.3820.229~0.535
出生队列效应/年份1897—19011.5201.155~1.8851.3741.045~1.7041.5041.077~1.932
1902—19061.3201.010~1.6311.2540.978~1.5301.3170.949~1.685
1907—19111.1520.881~1.4231.1260.885~1.3671.1740.851~1.498
1912—19161.0010.760~1.2421.0530.839~1.2661.0160.728~1.304
1917—19210.8890.670~1.1091.0070.813~1.2010.8840.621~1.147
1922—19260.8090.602~1.0160.8810.697~1.0640.8270.578~1.076
1927—19310.7060.497~0.9140.7130.529~0.8970.7570.505~1.009
1932—19360.5900.368~0.8120.6060.410~0.8020.6460.377~0.915
1937—19410.4510.206~0.6970.4670.250~0.6840.5130.216~0.810
1942—19460.2980.022~0.5730.3010.057~0.5450.3730.038~0.707
1947—19510.171–0.140~0.4820.171–0.104~0.4460.249–0.129~0.626
1952—1956–0.002–0.353~0.349–0.004–0.314~0.3060.080–0.347~0.507
1957—1961–0.163–0.557~0.230–0.171–0.518~0.176–0.086–0.566~0.393
1962—1966–0.383–0.824~0.058–0.391–0.779~–0.003–0.314–0.852~0.225
1967—1971–0.522–1.014~–0.031–0.529–0.960~–0.097–0.480–1.085~0.125
1972—1976–0.706–1.257~–0.155–0.731–1.213~–0.248–0.666–1.351~0.020
1977—1981–0.826–1.442~–0.210–0.847–1.384~–0.310–0.833–1.612~–0.055
1982—1986–0.928–1.654~–0.201–0.940–1.566~–0.314–0.997–1.947~–0.047
1987—1991–1.037–1.992~–0.081–1.024–1.839~–0.209–1.170–2.424~0.085
1992—1996–1.214–2.658~0.231–1.199–2.466~0.068–1.346–3.105~0.414
1997—2001–1.412–3.655~0.831–1.400–3.388~0.589–1.571–4.263~1.121
2002—2006–1.716–6.247~2.816–1.719–5.738~2.300–1.877–7.347~3.594
), ArticleFig(id=1321170045879833598, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170040288826309, language=CN, label=表2, caption=

中国居民1990—2021年胰腺癌发病率的APC模型分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类总体居民男性居民女性居民
效应系数95%CI效应系数95%CI效应系数95%CI
年龄效应/岁15~19–3.585–5.289~–1.881–3.638–5.186~–2.090–3.406–5.346~–1.466
20~24–3.041–4.187~–1.894–3.117–4.167~–2.067–2.845–4.130~–1.561
25~29–2.398–3.223~–1.573–2.423–3.162~–1.684–2.314–3.272~–1.356
30~34–1.473–2.041~–0.905–1.357–1.849~–0.866–1.729–2.454~–1.003
35~39–0.689–1.130~–0.248–0.537–0.922~–0.152–1.085–1.645~–0.524
40~44–0.197–0.570~0.176–0.075–0.404~0.254–0.525–0.984~–0.067
45~490.076–0.247~0.3980.166–0.119~0.452–0.190–0.581~0.201
50~540.4770.208~0.7470.4980.258~0.7390.3590.039~0.679
55~590.7850.562~1.0090.7660.566~0.9660.7360.473~0.999
60~640.9820.798~1.1650.9260.761~1.0900.9970.783~1.211
65~691.1470.996~1.2971.0640.929~1.1991.2121.037~1.387
70~741.3531.225~1.4811.2351.121~1.3501.4741.324~1.624
75~791.3981.272~1.5241.2561.145~1.3681.5571.407~1.707
80~841.4121.270~1.5531.2891.165~1.4141.5821.409~1.754
85~891.5271.357~1.6981.6231.475~1.7721.5571.347~1.767
90~941.3711.162~1.5791.5671.386~1.7491.4591.202~1.715
≥950.8560.603~1.1090.7550.533~0.9771.1620.852~1.472
时期效应/年份1992—1996–0.455–0.586~–0.323–0.477–0.594~–0.361–0.388–0.545~–0.231
1997—2001–0.254–0.340~–0.168–0.304–0.380~–0.227–0.198–0.299~–0.097
2002—2006–0.061–0.112~–0.010–0.101–0.146~–0.056–0.035–0.093~0.023
2007—20110.0960.045~0.1470.1010.057~0.1460.0770.018~0.135
2012—20160.2350.150~0.3200.2920.218~0.3670.1620.061~0.264
2017—20210.4390.312~0.5660.4880.376~0.6000.3820.229~0.535
出生队列效应/年份1897—19011.5201.155~1.8851.3741.045~1.7041.5041.077~1.932
1902—19061.3201.010~1.6311.2540.978~1.5301.3170.949~1.685
1907—19111.1520.881~1.4231.1260.885~1.3671.1740.851~1.498
1912—19161.0010.760~1.2421.0530.839~1.2661.0160.728~1.304
1917—19210.8890.670~1.1091.0070.813~1.2010.8840.621~1.147
1922—19260.8090.602~1.0160.8810.697~1.0640.8270.578~1.076
1927—19310.7060.497~0.9140.7130.529~0.8970.7570.505~1.009
1932—19360.5900.368~0.8120.6060.410~0.8020.6460.377~0.915
1937—19410.4510.206~0.6970.4670.250~0.6840.5130.216~0.810
1942—19460.2980.022~0.5730.3010.057~0.5450.3730.038~0.707
1947—19510.171–0.140~0.4820.171–0.104~0.4460.249–0.129~0.626
1952—1956–0.002–0.353~0.349–0.004–0.314~0.3060.080–0.347~0.507
1957—1961–0.163–0.557~0.230–0.171–0.518~0.176–0.086–0.566~0.393
1962—1966–0.383–0.824~0.058–0.391–0.779~–0.003–0.314–0.852~0.225
1967—1971–0.522–1.014~–0.031–0.529–0.960~–0.097–0.480–1.085~0.125
1972—1976–0.706–1.257~–0.155–0.731–1.213~–0.248–0.666–1.351~0.020
1977—1981–0.826–1.442~–0.210–0.847–1.384~–0.310–0.833–1.612~–0.055
1982—1986–0.928–1.654~–0.201–0.940–1.566~–0.314–0.997–1.947~–0.047
1987—1991–1.037–1.992~–0.081–1.024–1.839~–0.209–1.170–2.424~0.085
1992—1996–1.214–2.658~0.231–1.199–2.466~0.068–1.346–3.105~0.414
1997—2001–1.412–3.655~0.831–1.400–3.388~0.589–1.571–4.263~1.121
2002—2006–1.716–6.247~2.816–1.719–5.738~2.300–1.877–7.347~3.594
), ArticleFig(id=1321170045972108287, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170040288826309, language=EN, label=Tab.3, caption=

Age-period-cohort model analysis of pancreatic cancer mortality rates in Chinese residents from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类总体居民男性居民女性居民
效应系数95%CI效应系数95%CI效应系数95%CI
年龄效应/岁15~19–3.609–5.351~–1.867–3.658–5.235~–2.080–3.428–5.421~–1.434
20~24–3.039–4.195~–1.882–3.110–4.166~–2.054–2.843–4.146~–1.541
25~29–2.495–3.360~–1.630–2.516–3.288~–1.743–2.414–3.424~–1.404
30~34–1.590–2.185~–0.996–1.472–1.984~–0.960–1.853–2.619~–1.087
35~39–0.866–1.330~–0.402–0.711–1.114~–0.309–1.271–1.869~–0.674
40~44–0.338–0.726~0.051–0.213–0.553~0.127–0.676–1.158~–0.195
45~49–0.032–0.366~0.3030.060–0.234~0.354–0.302–0.711~0.106
50~540.3890.111~0.6680.4100.163~0.6570.268–0.064~0.601
55~590.7290.499~0.9590.7100.505~0.9140.6780.405~0.950
60~640.9490.761~1.1370.8930.725~1.0610.9640.743~1.185
65~691.1460.992~1.2991.0630.926~1.2001.2111.032~1.391
70~741.3871.257~1.5171.2681.152~1.3841.5091.356~1.663
75~791.4711.343~1.5991.3231.210~1.4361.6361.482~1.790
80~841.5091.364~1.6541.3811.254~1.5081.6861.508~1.865
85~891.6471.471~1.8221.7371.585~1.8901.6861.467~1.905
90~941.5561.340~1.7711.7511.565~1.9381.6511.383~1.919
≥951.1860.925~1.4461.0830.855~1.3101.4991.176~1.822
时期效应/年份1992—1996–0.451–0.586~–0.316–0.465–0.584~–0.346–0.384–0.547~–0.222
1997—2001–0.243–0.330~–0.156–0.292–0.369~–0.215–0.188–0.291~–0.084
2002—2006–0.048–0.096~0.000–0.095–0.137~–0.052–0.020–0.075~0.034
2007—20110.0940.045~0.1440.0940.052~0.1370.0770.020~0.133
2012—20160.2230.136~0.3090.2800.204~0.3560.1500.046~0.253
2017—20210.4250.294~0.5560.4770.362~0.5920.3660.207~0.525
出生队列效应/年份1897—19011.6101.243~1.9761.4561.129~1.7841.5941.157~2.030
1902—19061.4151.098~1.7311.3391.059~1.6191.4111.031~1.791
1907—19111.2370.959~1.5151.2050.959~1.4511.2580.923~1.593
1912—19161.0670.819~1.3151.1190.901~1.3381.0830.784~1.382
1917—19210.9340.709~1.1601.0600.861~1.2590.9280.655~1.202
1922—19260.8390.625~1.0530.9160.728~1.1050.8570.597~1.117
1927—19310.7120.496~0.9280.7170.528~0.9070.7660.503~1.030
1932—19360.5870.358~0.8170.6020.400~0.8040.6480.366~0.929
1937—19410.4470.193~0.7010.4630.240~0.6870.5130.203~0.824
1942—19460.2930.007~0.5790.2970.045~0.5480.3730.023~0.723
1947—19510.164–0.159~0.4870.164–0.119~0.4480.247–0.148~0.643
1952—1956–0.009–0.374~0.355–0.011–0.331~0.3090.079–0.368~0.526
1957—1961–0.172–0.581~0.237–0.179–0.538~0.179–0.088–0.591~0.414
1962—1966–0.395–0.853~0.063–0.403–0.804~–0.001–0.320–0.885~0.246
1967—1971–0.539–1.051~–0.027–0.545–0.992~–0.098–0.492–1.127~0.144
1972—1976–0.729–1.305~–0.154–0.752–1.253~–0.251–0.688–1.410~0.035
1977—1981–0.859–1.505~–0.212–0.878–1.438~–0.318–0.871–1.697~–0.045
1982—1986–0.970–1.739~–0.202–0.982–1.640~–0.323–1.045–2.062~–0.028
1987—1991–1.089–2.098~–0.081–1.075–1.931~–0.218–1.230–2.565~0.106
1992—1996–1.275–2.792~0.241–1.259–2.585~0.066–1.415–3.276~0.446
1997—2001–1.475–3.777~0.826–1.462–3.493~0.569–1.647–4.434~1.141
2002—2006–1.790–6.506~2.926–1.794–5.958~2.370–1.964–7.711~3.782
), ArticleFig(id=1321170046055994368, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170040288826309, language=CN, label=表3, caption=

中国居民1990—2021年胰腺癌死亡率的APC模型分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类总体居民男性居民女性居民
效应系数95%CI效应系数95%CI效应系数95%CI
年龄效应/岁15~19–3.609–5.351~–1.867–3.658–5.235~–2.080–3.428–5.421~–1.434
20~24–3.039–4.195~–1.882–3.110–4.166~–2.054–2.843–4.146~–1.541
25~29–2.495–3.360~–1.630–2.516–3.288~–1.743–2.414–3.424~–1.404
30~34–1.590–2.185~–0.996–1.472–1.984~–0.960–1.853–2.619~–1.087
35~39–0.866–1.330~–0.402–0.711–1.114~–0.309–1.271–1.869~–0.674
40~44–0.338–0.726~0.051–0.213–0.553~0.127–0.676–1.158~–0.195
45~49–0.032–0.366~0.3030.060–0.234~0.354–0.302–0.711~0.106
50~540.3890.111~0.6680.4100.163~0.6570.268–0.064~0.601
55~590.7290.499~0.9590.7100.505~0.9140.6780.405~0.950
60~640.9490.761~1.1370.8930.725~1.0610.9640.743~1.185
65~691.1460.992~1.2991.0630.926~1.2001.2111.032~1.391
70~741.3871.257~1.5171.2681.152~1.3841.5091.356~1.663
75~791.4711.343~1.5991.3231.210~1.4361.6361.482~1.790
80~841.5091.364~1.6541.3811.254~1.5081.6861.508~1.865
85~891.6471.471~1.8221.7371.585~1.8901.6861.467~1.905
90~941.5561.340~1.7711.7511.565~1.9381.6511.383~1.919
≥951.1860.925~1.4461.0830.855~1.3101.4991.176~1.822
时期效应/年份1992—1996–0.451–0.586~–0.316–0.465–0.584~–0.346–0.384–0.547~–0.222
1997—2001–0.243–0.330~–0.156–0.292–0.369~–0.215–0.188–0.291~–0.084
2002—2006–0.048–0.096~0.000–0.095–0.137~–0.052–0.020–0.075~0.034
2007—20110.0940.045~0.1440.0940.052~0.1370.0770.020~0.133
2012—20160.2230.136~0.3090.2800.204~0.3560.1500.046~0.253
2017—20210.4250.294~0.5560.4770.362~0.5920.3660.207~0.525
出生队列效应/年份1897—19011.6101.243~1.9761.4561.129~1.7841.5941.157~2.030
1902—19061.4151.098~1.7311.3391.059~1.6191.4111.031~1.791
1907—19111.2370.959~1.5151.2050.959~1.4511.2580.923~1.593
1912—19161.0670.819~1.3151.1190.901~1.3381.0830.784~1.382
1917—19210.9340.709~1.1601.0600.861~1.2590.9280.655~1.202
1922—19260.8390.625~1.0530.9160.728~1.1050.8570.597~1.117
1927—19310.7120.496~0.9280.7170.528~0.9070.7660.503~1.030
1932—19360.5870.358~0.8170.6020.400~0.8040.6480.366~0.929
1937—19410.4470.193~0.7010.4630.240~0.6870.5130.203~0.824
1942—19460.2930.007~0.5790.2970.045~0.5480.3730.023~0.723
1947—19510.164–0.159~0.4870.164–0.119~0.4480.247–0.148~0.643
1952—1956–0.009–0.374~0.355–0.011–0.331~0.3090.079–0.368~0.526
1957—1961–0.172–0.581~0.237–0.179–0.538~0.179–0.088–0.591~0.414
1962—1966–0.395–0.853~0.063–0.403–0.804~–0.001–0.320–0.885~0.246
1967—1971–0.539–1.051~–0.027–0.545–0.992~–0.098–0.492–1.127~0.144
1972—1976–0.729–1.305~–0.154–0.752–1.253~–0.251–0.688–1.410~0.035
1977—1981–0.859–1.505~–0.212–0.878–1.438~–0.318–0.871–1.697~–0.045
1982—1986–0.970–1.739~–0.202–0.982–1.640~–0.323–1.045–2.062~–0.028
1987—1991–1.089–2.098~–0.081–1.075–1.931~–0.218–1.230–2.565~0.106
1992—1996–1.275–2.792~0.241–1.259–2.585~0.066–1.415–3.276~0.446
1997—2001–1.475–3.777~0.826–1.462–3.493~0.569–1.647–4.434~1.141
2002—2006–1.790–6.506~2.926–1.794–5.958~2.370–1.964–7.711~3.782
), ArticleFig(id=1321170046160850944, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170040288826309, language=EN, label=Tab.4, caption=

Age-period-cohort model analysis of pancreatic cancer DALY rates in Chinese residents from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类总体居民男性居民女性居民
效应系数95%CI效应系数95%CI效应系数95%CI
年龄效应/岁15~19–3.015–3.220~–2.810–3.069–3.255~–2.883–2.834–3.069~–2.600
20~24–2.472–2.612~–2.331–2.546–2.675~–2.418–2.276–2.435~–2.118
25~29–1.962–2.070~–1.854–1.985–2.082~–1.888–1.880–2.007~–1.754
30~34–1.099–1.175~–1.023–0.982–1.048~–0.917–1.360–1.459~–1.262
35~39–0.422–0.482~–0.362–0.268–0.319~–0.216–0.825–0.903~–0.747
40~440.0530.002~0.1030.1770.133~0.222–0.283–0.347~–0.220
45~490.2950.250~0.3390.3870.348~0.4260.025–0.030~0.080
50~540.6410.603~0.6780.6620.629~0.6950.5210.476~0.566
55~590.8930.861~0.9250.8750.847~0.9030.8420.804~0.879
60~641.0080.981~1.0350.9530.929~0.9771.0220.990~1.053
65~691.0751.052~1.0980.9930.972~1.0131.1391.112~1.166
70~741.1661.146~1.1861.0491.030~1.0671.2861.263~1.310
75~791.0711.051~1.0910.9290.911~0.9471.2331.210~1.256
80~840.9120.890~0.9340.7880.769~0.8081.0871.061~1.113
85~890.8650.840~0.8910.9570.935~0.9780.9050.874~0.936
90~940.6840.654~0.7140.8810.856~0.9070.7780.741~0.815
≥950.3070.271~0.3430.2000.168~0.2320.6220.578~0.666
时期效应/年份1992—1996–0.323–0.342~–0.304–0.358–0.375~–0.341–0.252–0.274~–0.229
1997—2001–0.180–0.194~–0.166–0.229–0.241~–0.216–0.121–0.137~–0.104
2002—2006–0.042–0.053~–0.031–0.073–0.082~–0.063–0.018–0.030~–0.005
2007—20110.0670.056~0.0780.0780.068~0.0880.0430.030~0.055
2012—20160.1620.148~0.1760.2180.206~0.2300.0870.070~0.103
2017—20210.3160.298~0.3340.3640.348~0.3790.2600.239~0.282
出生队列效应/年份1897—19011.1351.076~1.1941.0000.945~1.0551.1141.048~1.181
1902—19060.9900.944~1.0360.9250.884~0.9660.9840.930~1.038
1907—19110.8630.824~0.9020.8350.800~0.8690.8840.838~0.930
1912—19160.7430.709~0.7780.7930.763~0.8240.7570.716~0.797
1917—19210.6540.623~0.6850.7650.738~0.7920.6520.615~0.688
1922—19260.5980.569~0.6260.6650.640~0.6900.6190.585~0.653
1927—19310.5230.494~0.5520.5320.507~0.5580.5760.542~0.611
1932—19360.4430.412~0.4740.4560.429~0.4830.5060.469~0.543
1937—19410.3450.312~0.3790.3540.325~0.3840.4160.376~0.457
1942—19460.2370.199~0.2740.2370.204~0.2700.3180.272~0.363
1947—19510.1480.106~0.1900.1460.109~0.1830.2330.181~0.284
1952—19560.015–0.032~0.0630.011–0.030~0.0530.1030.046~0.161
1957—1961–0.108–0.160~–0.055–0.117–0.163~–0.071–0.026–0.091~0.039
1962—1966–0.277–0.336~–0.218–0.287–0.338~–0.235–0.203–0.276~–0.130
1967—1971–0.383–0.448~–0.317–0.391–0.448~–0.334–0.338–0.420~–0.256
1972—1976–0.533–0.607~–0.459–0.557–0.621~–0.493–0.495–0.588~–0.401
1977—1981–0.619–0.702~–0.537–0.639–0.710~–0.568–0.632–0.738~–0.526
1982—1986–0.685–0.783~–0.587–0.695–0.779~–0.612–0.759–0.889~–0.629
1987—1991–0.765–0.893~–0.638–0.748–0.856~–0.640–0.904–1.072~–0.736
1992—1996–0.915–1.102~–0.727–0.897–1.061~–0.733–1.052–1.281~–0.822
1997—2001–1.071–1.348~–0.795–1.053–1.297~–0.809–1.241–1.576~–0.906
2002—2006–1.338–1.891~–0.785–1.334–1.823~–0.846–1.513–2.187~–0.839
), ArticleFig(id=1321170046248931329, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170040288826309, language=CN, label=表4, caption=

中国居民1990—2021年胰腺癌DALYs率的APC模型分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类总体居民男性居民女性居民
效应系数95%CI效应系数95%CI效应系数95%CI
年龄效应/岁15~19–3.015–3.220~–2.810–3.069–3.255~–2.883–2.834–3.069~–2.600
20~24–2.472–2.612~–2.331–2.546–2.675~–2.418–2.276–2.435~–2.118
25~29–1.962–2.070~–1.854–1.985–2.082~–1.888–1.880–2.007~–1.754
30~34–1.099–1.175~–1.023–0.982–1.048~–0.917–1.360–1.459~–1.262
35~39–0.422–0.482~–0.362–0.268–0.319~–0.216–0.825–0.903~–0.747
40~440.0530.002~0.1030.1770.133~0.222–0.283–0.347~–0.220
45~490.2950.250~0.3390.3870.348~0.4260.025–0.030~0.080
50~540.6410.603~0.6780.6620.629~0.6950.5210.476~0.566
55~590.8930.861~0.9250.8750.847~0.9030.8420.804~0.879
60~641.0080.981~1.0350.9530.929~0.9771.0220.990~1.053
65~691.0751.052~1.0980.9930.972~1.0131.1391.112~1.166
70~741.1661.146~1.1861.0491.030~1.0671.2861.263~1.310
75~791.0711.051~1.0910.9290.911~0.9471.2331.210~1.256
80~840.9120.890~0.9340.7880.769~0.8081.0871.061~1.113
85~890.8650.840~0.8910.9570.935~0.9780.9050.874~0.936
90~940.6840.654~0.7140.8810.856~0.9070.7780.741~0.815
≥950.3070.271~0.3430.2000.168~0.2320.6220.578~0.666
时期效应/年份1992—1996–0.323–0.342~–0.304–0.358–0.375~–0.341–0.252–0.274~–0.229
1997—2001–0.180–0.194~–0.166–0.229–0.241~–0.216–0.121–0.137~–0.104
2002—2006–0.042–0.053~–0.031–0.073–0.082~–0.063–0.018–0.030~–0.005
2007—20110.0670.056~0.0780.0780.068~0.0880.0430.030~0.055
2012—20160.1620.148~0.1760.2180.206~0.2300.0870.070~0.103
2017—20210.3160.298~0.3340.3640.348~0.3790.2600.239~0.282
出生队列效应/年份1897—19011.1351.076~1.1941.0000.945~1.0551.1141.048~1.181
1902—19060.9900.944~1.0360.9250.884~0.9660.9840.930~1.038
1907—19110.8630.824~0.9020.8350.800~0.8690.8840.838~0.930
1912—19160.7430.709~0.7780.7930.763~0.8240.7570.716~0.797
1917—19210.6540.623~0.6850.7650.738~0.7920.6520.615~0.688
1922—19260.5980.569~0.6260.6650.640~0.6900.6190.585~0.653
1927—19310.5230.494~0.5520.5320.507~0.5580.5760.542~0.611
1932—19360.4430.412~0.4740.4560.429~0.4830.5060.469~0.543
1937—19410.3450.312~0.3790.3540.325~0.3840.4160.376~0.457
1942—19460.2370.199~0.2740.2370.204~0.2700.3180.272~0.363
1947—19510.1480.106~0.1900.1460.109~0.1830.2330.181~0.284
1952—19560.015–0.032~0.0630.011–0.030~0.0530.1030.046~0.161
1957—1961–0.108–0.160~–0.055–0.117–0.163~–0.071–0.026–0.091~0.039
1962—1966–0.277–0.336~–0.218–0.287–0.338~–0.235–0.203–0.276~–0.130
1967—1971–0.383–0.448~–0.317–0.391–0.448~–0.334–0.338–0.420~–0.256
1972—1976–0.533–0.607~–0.459–0.557–0.621~–0.493–0.495–0.588~–0.401
1977—1981–0.619–0.702~–0.537–0.639–0.710~–0.568–0.632–0.738~–0.526
1982—1986–0.685–0.783~–0.587–0.695–0.779~–0.612–0.759–0.889~–0.629
1987—1991–0.765–0.893~–0.638–0.748–0.856~–0.640–0.904–1.072~–0.736
1992—1996–0.915–1.102~–0.727–0.897–1.061~–0.733–1.052–1.281~–0.822
1997—2001–1.071–1.348~–0.795–1.053–1.297~–0.809–1.241–1.576~–0.906
2002—2006–1.338–1.891~–0.785–1.334–1.823~–0.846–1.513–2.187~–0.839
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1990—2021年中国居民胰腺癌疾病负担趋势年龄–时期–队列分析
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刘沁娴 , 李嘉怡 , 宁祖乐 , 凌永睿 , 杨萌 , 杜进林 *, *
中国公共卫生 | 调查报告与分析 2025,41(5): 606-613
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中国公共卫生 |调查报告与分析 2025 , 41 (5) : 606 -613
1990—2021年中国居民胰腺癌疾病负担趋势年龄–时期–队列分析
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刘沁娴, 李嘉怡, 宁祖乐, 凌永睿, 杨萌, 杜进林*, *
作者信息
  • 广东医科大学公共卫生学院,东莞 523808
通讯作者:
杜进林,E-mail:
作者简介:

刘沁娴(2000—),硕士在读,研究方向:疾病预防与控制

Age-period-cohort analysis of the pancreatic cancer burden among Chinese residents from 1990 to 2021
Qinxian LIU, Jiayi LI, Zule NING, Yongrui LING, Meng YANG, Jinlin DU
Affiliations
  • School of Public Health, Guangdong Medical University, Dongguan Guangdong 523808, China
  • Corresponding Author:
    DU Jinlin, E-mail:
出版时间: 2025-05-10 doi: 10.11847/zgggws1145196
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目的

分析1990—2021年中国居民胰腺癌疾病负担趋势,为我国胰腺癌防治工作提供参考依据。

方法

收集2021年全球疾病负担(GBD 2021)数据库中1990—2021年中国居民胰腺癌疾病负担的相关数据,提取标化发病率、标化死亡率和标化伤残调整寿命年(DALYs)率等指标进行描述性分析,采用Joinpoint回归模型分析胰腺癌疾病负担的变化趋势,并应用年龄–时期–队列(APC)模型分析胰腺癌疾病负担的年龄、时期、出生队列效应。

结果

中国总体、男性和女性居民1990—2021年胰腺癌标化发病率分别从1990年的4.54/10万、5.55/10万和3.64/10万上升至2021年的5.64/10万、7.29/10万和4.18/10万,平均年度变化百分比(AAPC)值分别为0.72%、0.89%和0.48%,总体、男性和女性居民上升趋势均有统计学意义(均P<0.001);胰腺癌标化死亡率分别从1990年的4.83/10万、5.91/10万和3.90/10万上升至2021年的5.72/10万、7.37/10万和4.29/10万,AAPC值分别为0.56%、0.55%和0.33%,总体、男性和女性居民上升趋势均有统计学意义(均P<0.001);胰腺癌标化DALYs率分别从1990年的123.16/10万、151.33/10万和95.37/10万上升至2021年的137.23/10万、179.36/10万和96.89/10万,AAPC值分别为0.36%、0.55%和0.07%,总体和男性居民上升趋势均有统计学意义(均P<0.001)。男性和女性居民胰腺癌发病风险均随年龄的增长呈上升趋势,年龄效应系数均在15~19岁为最低(分别为–3.638和–3.406),男性居民在85~89岁为最高(1.623),女性居民在80~84岁为最高(1.582);胰腺癌发病风险随着时期的推移而上升,男性和女性居民的时期效应系数分别由1992—1996年的–0.477和–0.388上升至2017—2021年的0.488和0.382;胰腺癌发病风险随着出生年份的推移呈下降趋势,男性和女性居民的最低出生队列效应系数均在2002—2006年,分别为–1.719和–1.877,最高出生队列效应系数分别为1897—1901年的1.374和1.504。男性和女性居民胰腺癌死亡风险均随着年龄的增长大体呈上升趋势,年龄效应系数均在15~19岁为最低(分别为–3.658和–3.428),男性居民在90~94岁为最高(1.751),女性居民在80~84岁和85~89岁均为最高(均1.686);胰腺癌死亡风险随着时期的推移而上升,男性和女性居民的时期效应系数分别由1992—1996年的–0.465和–0.384上升至2017—2021年的0.477和0.366;胰腺癌死亡风险随着出生年份的推移呈下降趋势,男性和女性居民的最低出生队列效应系数均在2002—2006年,分别为–1.794和–1.964,最高出生队列效应系数分别为1897—1901年的1.456和1.594。男性和女性居民胰腺癌疾病负担风险均随年龄增长大体呈上升趋势,年龄效应系数均在15~19岁为最低(分别为–3.069和–2.834),男性和女性居民均在70~74岁为最高(分别为1.049和1.286);随着时期的推移而上升,男性和女性居民的时期效应系数分别由1992—1996年的–0.358和–0.252上升至2017—2021年的0.364和0.260;胰腺癌疾病负担风险随着出生年份的推移呈下降趋势,男性和女性居民的最低出生队列效应系数均在2002—2006年,分别为–1.334和–1.513,最高出生队列效应系数均在1897—1901年,分别为1.000和1.114。

结论

1990—2021年中国居民胰腺癌的标化发病率、标化死亡率和男性居民标化DALYs率均呈上升趋势,其胰腺癌疾病负担风险随年龄增长和时期推移而升高,随队列延伸而降低。

胰腺癌  /  疾病负担  /  趋势  /  年龄–时期–队列(APC)模型  /  中国居民
Objective

To analyze the trend in the burden of pancreatic cancer among Chinese residents from 1990 to 2021, providing reference data for the prevention and control of pancreatic cancer in China.

Methods

Data related to the burden of pancreatic cancer among Chinese residents from 1990 to 2021 were collected from the Global Burden of Disease (GBD 2021) database. Standardized incidence rates, standardized mortality rates, and disability-adjusted life years (DALYs) were extracted for descriptive analysis. The Joinpoint regression model was used to analyze trends in the burden of pancreatic cancer, and the age-period-cohort (APC) model was applied to assess the effects of age, period, and birth cohort on the burden of pancreatic cancer.

Results

The age-standardized incidence rate of pancreatic cancer in China′s overall, male, and female populations increased from 4.54/100 000, 5.55/100 000, and 3.64/100 000 in 1990 to 5.64/100 000, 7.29/100 000, and 4.18/100 000 in 2021, respectively. The average annual percentage changes (AAPCs) were 0.72%, 0.89%, and 0.48%, respectively, with statistically significant increasing trends for the overall, male, and female populations (all P < 0.001). The age-standardized mortality rates increased from 4.83/100 000, 5.91/100 000, and 3.90/100 000 in 1990 to 5.72/100 000, 7.37/100 000, and 4.29/100 000 in 2021, respectively, with AAPCs of 0.56%, 0.55%, and 0.33%, respectively. Statistically significant increasing trends were observed for the overall, male, and female populations (all P < 0.001). The age-standardized disability-adjusted life years (DALYs) rates increased from 123.16/100 000, 151.33/100 000, and 95.37/100 000 in 1990 to 137.23/100 000, 179.36/100 000, and 96.89/100 000 in 2021, respectively, with AAPCs of 0.36%, 0.55%, and 0.07%, respectively. Statistically significant increasing trends were observed for the overall and male populations (all P < 0.001). The risk of pancreatic cancer incidence increased with age for both males and females. The age effect coefficients were lowest for the 15 - 19 age group (–3.638 and –3.406, respectively), highest for males in the 85 - 89 age group (1.623), and highest for females in the 80 - 84 age group (1.582). The risk of pancreatic cancer incidence increased over time, with period effect coefficients increasing from –0.477 and –0.388 in 1992 - 1996 to 0.488 and 0.382 in 2017 - 2021 for males and females, respectively. The risk of pancreatic cancer incidence decreased with birth cohort, with the lowest cohort effect coefficients observed in 2002 - 2006 (–1.719 and –1.877 for males and females, respectively) and the highest in 1897 - 1901 (1.374 and 1.504, respectively). The risk of pancreatic cancer mortality generally increased with age for both males and females. The age effect coefficients were lowest for the 15 - 19 age group (–3.658 and –3.428, respectively), highest for males in the 90 - 94 age group (1.751), and highest for females in both the 80 - 84 and 85 - 89 age groups (1.686 for both). The risk of pancreatic cancer mortality increased over time, with period effect coefficients increasing from –0.465 and –0.384 in 1992 - 1996 to 0.477 and 0.366 in 2017 - 2021 for males and females, respectively. The risk of pancreatic cancer mortality decreased with birth cohort, with the lowest cohort effect coefficients in 2002 - 2006 (–1.794 and –1.964 for males and females, respectively) and the highest in 1897 - 1901 (1.456 and 1.594, respectively). The risk of pancreatic cancer burden generally increased with age for both males and females. The age effect coefficients were lowest for the 15 - 19 age group (–3.069 and –2.834, respectively) and highest for the 70 - 74 age group (1.049 and 1.286 for males and females, respectively). The risk increased over time, with period effect coefficients increasing from –0.358 and –0.252 in 1992 - 1996 to 0.364 and 0.260 in 2017 - 2021 for males and females, respectively. The risk of pancreatic cancer burden decreased with birth cohort, with the lowest cohort effect coefficients in 2002 - 2006 (–1.334 and –1.513 for males and females, respectively) and the highest in 1897 - 1901 (1.000 and 1.114, respectively).

Conclusion

From 1990 to 2021, the age-standardized incidence, mortality, and DALY rates of pancreatic cancer in the Chinese population, as well as the age-standardized DALY rate in males, showed an increasing trend. The risk of pancreatic cancer burden increased with age and period but decreased with birth cohort.

pancreatic cancer  /  disease burden  /  trend  /  Age-period-cohort (APC) model  /  Chinese residents
刘沁娴, 李嘉怡, 宁祖乐, 凌永睿, 杨萌, 杜进林. 1990—2021年中国居民胰腺癌疾病负担趋势年龄–时期–队列分析. 中国公共卫生, 2025 , 41 (5) : 606 -613 . DOI: 10.11847/zgggws1145196
Qinxian LIU, Jiayi LI, Zule NING, Yongrui LING, Meng YANG, Jinlin DU. Age-period-cohort analysis of the pancreatic cancer burden among Chinese residents from 1990 to 2021[J]. Chinese Journal of Public Health, 2025 , 41 (5) : 606 -613 . DOI: 10.11847/zgggws1145196
胰腺癌是死亡率极高的恶性肿瘤,由于大部分患者在早期无明显症状,早诊困难,因此患病晚期才被发现,从而导致患者面临着较低的生存率和有限的治疗选择[1]。近年来,中国居民的胰腺癌发病率和死亡率均呈上升趋势[2],2019年我国已成为全球胰腺癌发病率、死亡率和伤残调整寿命年(disability adjusted life years, DALYs)较高的国家[3],预计到2030年胰腺癌的发病和死亡人数将分别增至21.879万和22.297万[4],这将对我国居民的生命健康构成重大威胁。为分析1990—2021年中国居民胰腺癌疾病负担趋势,为我国胰腺癌防治工作提供参考依据,本研究收集2021年全球疾病负担(Global Burden of Disease Study, GBD 2021)数据库中1990—2021年中国居民胰腺癌疾病负担的相关数据,提取标化发病率、标化死亡率和标化DALYs率等指标进行描述性分析,采用Joinpoint回归模型分析胰腺癌疾病负担的变化趋势,并应用年龄–时期–队列(age-period-cohort, APC)模型分析胰腺癌疾病负担的年龄、时期、出生队列效应。结果报告如下。
资料来源于GBD 2021公开数据库(https://ghdx.healthdata.org/gbd-2021),该数据库来自美国华盛顿大学健康指标和评估研究所(Institute for Health Metrics and Evaluation, IHME)所牵头的2021年全球疾病负担项目,包含204个国家和地区的371种疾病和伤害的疾病负担的估算数据。本研究提取其中1990—2021年中国居民胰腺癌标化发病率、标化死亡率和标化DALYs率等指标进行分析,各标化率均采用 GBD 2021全球标准人口年龄构成[5]进行计算。GBD 2021采用《疾病和有关健康问题的国际统计分类》第十次修订本(International Classification of Diseases, Tenth Revision, ICD-10)[6]编码对胰腺癌进行分类,编码为C25.0~C25.9。
采用Excel 2019软件建立数据库,应用Joinpoint Regression Program 5.1.0.0软件通过计算平均年度变化百分比(average annual percent change,AAPC)对中国居民1990—2021年胰腺癌标化发病率、标化死亡率和标化DALYs率的时间变化趋势进行分析;应用Stata 17.0软件进行APC模型拟合,将1990—2021年中国居民胰腺癌标化发病率、标化死亡率和标化DALYs率按年龄、时期和出生队列进行分层汇总,通过效应系数描述中国居民胰腺癌的疾病负担风险及其变化,效应系数为正值表示疾病负担风险增加,效应系数为负值表示疾病负担风险减少[7]。检验水准为双侧检验α=0.05。
中国总体、男性和女性居民1990—2021年胰腺癌标化发病率分别从1990年的4.54/10万、5.55/10万和3.64/10万上升至2021年的5.64/10万、7.29/10万和4.18/10万,AAPC值分别为0.72%、0.89%和0.48%,总体、男性和女性居民上升趋势均有统计学意义(均P<0.001);胰腺癌标化死亡率分别从1990年的4.83/10万、5.91/10万和3.90/10万上升至2021年的5.72/10万、7.37/10万和4.29/10万,AAPC值分别为0.56%、0.55%和0.33%,总体、男性和女性居民上升趋势均有统计学意义(均P<0.001);胰腺癌标化DALYs率分别从1990年的123.16/10万、151.33/10万和95.37/10万上升至2021年的137.23/10万、179.36/10万和96.89/10万,AAPC值分别为0.36%、0.55%和0.07%,总体和男性居民上升趋势均有统计学意义(均P<0.001)。
中国总体、男性和女性居民胰腺癌发病风险均随年龄的增长总体呈上升趋势,年龄效应系数均在15~19岁为最低,总体和男性居民均在85~89岁为最高,女性居民在80~84岁为最高;中国总体、男性和女性居民胰腺癌发病风险均随着时期的推移而上升,总体、男性和女性居民的时期效应系数均在1992—1996年为最低,在2017—2021年为最高;中国总体、男性和女性居民胰腺癌发病风险均随着出生年份的推移呈下降趋势,总体、男性和女性居民的最低出生队列效应系数均在2002—2006年,最高出生队列效应系数均在1897—1901年。
中国总体、男性和女性居民胰腺癌死亡风险均随年龄的增长总体呈上升趋势,年龄效应系数均在15~19岁为最低,总体居民在85~89岁为最高,男性居民在90~94岁为最高,女性居民在80~84岁和85~89岁均为最高;中国总体、男性和女性居民胰腺癌死亡风险均随着时期的推移而上升,总体、男性和女性居民的时期效应系数均在1992—1996年为最低,在2017—2021年为最高;中国总体、男性和女性居民胰腺癌死亡风险均随着出生年份的推移总体呈下降趋势,总体、男性和女性居民的最低出生队列效应系数均在2002—2006年,最高出生队列效应系数均在1897—1901年。
中国总体、男性和女性居民胰腺癌疾病负担风险均随年龄的增长总体呈上升趋势,年龄效应系数均在15~19岁为最低,在70~74岁为最高;中国总体、男性和女性居民胰腺癌疾病负担风险均随着时期的推移而上升,总体、男性和女性居民的时期效应系数均在1992—1996年为最低,在2017—2021年为最高;中国总体、男性和女性居民胰腺癌疾病负担风险均随着出生年份的推移总体呈下降趋势,总体、男性和女性居民的最低队列效应系数均在2002—2006年,最高队列效应系数均在1897—1901年。
胰腺癌是一种预后不良的恶性肿瘤,由于发现时约80%的患者已处于局部进展期或晚期[8],失去了进行根治性手术的机会,因此其5年生存率仅为10%[9]。本研究结果显示,中国居民1990—2021年胰腺癌疾病负担呈上升趋势,标化发病率、标化死亡率和标化DALYs率分别从1990年的4.54/10万、4.83/10万和123.16/10万上升至2021年的5.64/10万、5.72/10万和137.23/10万,AAPC值分别为0.72%、0.56%和0.36%(均P<0.001),与国内外相关研究[10–12]结果一致,胰腺癌的防治已成为一个不容忽视的公共卫生问题。
本研究结果还显示,中国居民1990—2021年胰腺癌疾病负担存在明显的性别差异,男性居民胰腺癌的标化发病率、标化死亡率和标化DALYs率均高于女性居民,与既往研究[12–13]结果一致,表明男性居民可能是胰腺癌的高发人群。有研究表明,患胰腺癌的危险因素包括家族史、肥胖、2 型糖尿病和吸烟[14],我国男性居民的吸烟率[15]和肥胖率[16]均高于女性居民,不良的生活习惯可能是男性居民胰腺癌高发的原因。因此,今后应加大对男性居民的健康教育力度,宣传健康知识,控制吸烟行为,改善不良生活方式和饮食习惯,以减轻胰腺癌的发病率。
APC模型分析结果显示,男性和女性居民胰腺癌的发病风险、死亡风险和疾病负担风险均随年龄的增长总体呈上升趋势,这提示胰腺癌更常见于老年人群,今后需特别关注老年人群的胰腺癌疾病负担并采取有效的预防措施。男性和女性居民胰腺癌的发病风险、死亡风险和疾病负担风险均随时期的推移呈增长趋势,这可能是由于人口老龄化和生活方式的改变所导致[17–18]。随着人口老龄化的加剧,老年人口比例明显上升,与此同时,中国社会亦面临着由不良生活方式转变所带来的挑战[19],这些因素共同增加了胰腺癌的发病风险、死亡风险和疾病负担风险,因此应提高公众的健康意识,倡导其进行健康的生活方式,并对高风险人群进行定期的健康检查和监测,早诊早治,从而降低胰腺癌的发病率和死亡率[20]。男性和女性居民胰腺癌的发病风险、死亡风险和疾病负担风险均随出生队列的推移呈下降趋势,这可能与我国教育水平的上升[21]使得较晚出生的人群拥有更高的教育背景,从而有助于其获取和理解健康知识有关。此外, 医疗条件的改善和居民生活水平的提升[22]亦可能激发了较晚出生人群对疾病预防和健康维护的重视,进而有效地减轻了胰腺癌的疾病负担。
综上所述,中国居民1990—2021年胰腺癌的疾病负担总体呈上升趋势,特别是老年和男性群体,其疾病负担尤为严重。随着人口老龄化的加速以及生活方式的变迁,预计我国胰腺癌的防控形势将变得更加严峻,而早诊早治是胰腺癌防治的有效手段,因此需要政府和卫生部门制定和实施公共卫生政策,重点关注老年和男性群体,通过普及健康知识、加强疾病预防知识宣传、有序开展筛查等干预措施降低我国居民胰腺癌的发病率和死亡率并减轻其疾病负担。

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2025年第41卷第5期
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doi: 10.11847/zgggws1145196
  • 接收时间:2024-06-13
  • 首发时间:2026-10-25
  • 出版时间:2025-05-10
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  • 收稿日期:2024-06-13
  • 修回日期:2024-09-21
  • 录用日期:2024-11-19
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    广东医科大学公共卫生学院,东莞 523808

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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