基于GBD数据库的胰腺癌疾病负担横断面分析及前瞻性预测

Cross-sectional analysis and prospective prediction of pancreatic cancer disease burden based on the GBD database

摘要:

背景与目的 胰腺癌是一种恶性程度极高的肿瘤，在中国及全球范围内均构成沉重的疾病负担，不仅显著增加卫生经济支出，还深刻影响卫生政策的制定。本研究旨在系统评估过去30年间中国及全球胰腺癌的疾病负担，并基于前瞻性预测模型分析未来趋势，为科学制定防控策略提供依据。方法 利用全球疾病负担（GBD）数据库，提取1990—2021年中国及全球范围内不同性别、全年龄段及年龄标准化的胰腺癌发病率、患病率、病死率及伤残调整生命年（DALY）数据进行分析，并采用自回归积分滑动平均（ARIMA）模型预测未来15年胰腺癌的疾病负担趋势。结果 研究结果显示，1990—2021年间，中国及全球的胰腺癌发病率、患病率、病死率及DALY均呈上升趋势；其中，男性的发病率和病死率显著高于女性，且增长速度更快。经济发达地区（如北美和欧洲）的胰腺癌发病率和病死率最高，而非洲及南亚等经济欠发达地区相对较低。然而，随着经济发展和生活方式的转变，低发病地区的胰腺癌负担亦逐步加重。从时间趋势来看，中国的胰腺癌发病率和病死率增长速度高于全球平均水平，且在人口老龄化的背景下，未来胰腺癌负担预计将进一步加重。结论 胰腺癌的疾病负担在性别及地域上存在显著差异。应加强高危人群的健康教育与早期筛查，优化个体化治疗策略，并加大对胰腺癌基础研究的投入，以有效缓解日益加重的疾病负担。本研究为胰腺癌防控策略的制定提供了重要科学依据，助力改善患者预后并减轻社会经济负担。

Abstract:

Background and Aims Pancreatic cancer is a highly aggressive malignancy that imposes a significant disease burden both in China and globally. It not only substantially increases healthcare expenditures but also profoundly influences health policy decisions. This study aims to systematically assess the disease burden of pancreatic cancer in China and worldwide over the past 30 years and to analyze future trends using a prospective predictive model, providing a scientific basis for the development of effective prevention and control strategies.Methods Data on incidence, prevalence, mortality, and disability-adjusted life years (DALY) of pancreatic cancer, stratified by sex and standardized for age, were extracted from the Global Burden of Disease (GBD) database for the period 1990—2021. The autoregressive integrated moving average (ARIMA) model was used to predict the disease burden trends of pancreatic cancer for the next 15 years.Results The results showed that from 1990 to 2021, the incidence, prevalence, mortality, and DALY rates of pancreatic cancer exhibited an increasing trend in both China and worldwide. Males had significantly higher incidence and mortality rates than females, with a faster growth rate. The highest incidence and mortality rates were observed in economically developed regions such as North America and Europe, while lower rates were noted in less developed regions such as Africa and South Asia. However, with economic development and lifestyle changes, the pancreatic cancer burden in these low-incidence regions is also gradually increasing. Over time, the growth rate of pancreatic cancer incidence and mortality in China has surpassed the global average, and with an aging population, the disease burden is expected to rise further in the future.Conclusion There are significant variations in the pancreatic cancer burden across genders and regions. Strengthening health education and early screening for high-risk populations, optimizing personalized treatment strategies, and increasing investment in basic research on pancreatic cancer are essential to mitigating the growing disease burden. This study provides crucial scientific evidence for the formulation of pancreatic cancer prevention and control strategies, contributing to improved patient outcomes and reduced socioeconomic burden.