1990~2021年中国早发性膀胱癌疾病负担变化及2022~2031年预测分析

Temporal Change in the Disease Burden of Early-Onset Bladder Cancer in China from 1990 to 2021 and Predictive Analysis for 2022 to 2031

摘要: 目的：分析1990~2021年中国早发性膀胱癌的疾病负担状况，预测2022~2031年中国早发性膀胱癌的变化趋势。方法：基于2021年全球疾病负担(Global Burden of Disease, GBD)数据库，提取15至49岁膀胱癌的发病、死亡及伤残调整寿命年(disability Adjusted Life Years, DALYs)(数/率)数据，计算年龄标准化率(Age-Standardized Rate, ASR)，利用Joinpoint回归模型分析疾病负担指标变化的显著节点，计算年度变化百分比(Annual Percentage Change, APC)和平均年度变化百分比(Average Annual Percentage Change, AAPC)，并结合自回归差分移动平均模型(Auto-Regressive Integrated Moving Average, ARIMA)预测2022~2031年中国早发性膀胱癌的疾病负担。结果：1990至2021年中国早发性膀胱癌的年龄标化发病率(ASIR)从0.92/10万增长至1.10/10万，AAPC为0.57%；年龄标化死亡率(ASMR)从0.35/10万减少至0.19/10万，AAPC为−1.99%；年龄标化DALYs率(ASDR)从17.61/10万减少至10/10万，AAPC为−1.83%。据ARIMA预测，中国早发性膀胱癌的ASIR将从2022年的1.12/10万升至2031年的1.32/10万，ASMR预计从2022年的0.19/10万升至2031年的0.20/10万，ASDR预计2022年为10.04/10万，2031年为10.40/10万。结论：1990~2021年中国早发性膀胱癌的整体负担形势依旧严峻，ASIR呈持续上升趋势，并预测未来10年将继续上升。ASMR、ASDR过去30年总体呈下降趋势，预计未来10年将趋于平稳。未来需进一步优化防治策略，提高大众认知，以有效减轻中国早发性膀胱癌的整体负担。

Abstract: Objective: To analyze the disease burden of early-onset bladder cancer in China from 1990 to 2021 and predict its changing trends from 2022 to 2031. Methods: Based on the 2021 Global Burden of Disease (GBD) database, data on the incidence, mortality, and Disability-Adjusted Life Years (DALYs) (number/rate) of bladder cancer among individuals aged 15 to 49 were extracted. Age-standardized rates (ASRs) were calculated. The Joinpoint regression model was used to identify significant inflection points in the changes of disease burden indicators, and the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC) were computed. Additionally, the Auto-Regressive Integrated Moving Average (ARIMA) model was applied to forecast the disease burden of early-onset bladder cancer in China from 2022 to 2031. Results: From 1990 to 2021, the Age-Standardized Incidence Rate (ASIR) of early-onset bladder cancer in China increased from 0.92 per 100,000 to 1.10 per 100,000, with an AAPC of 0.57%. The Age-Standardized Mortality Rate (ASMR) decreased from 0.35 per 100,000 to 0.19 per 100,000, with an AAPC of −1.99%. The Age-Standardized DALYs Rate (ASDR) declined from 17.61 per 100,000 to 10.00 per 100,000, with an AAPC of −1.83%. According to ARIMA predictions, the ASIR of early-onset bladder cancer in China is projected to increase from 1.12 per 100,000 in 2022 to 1.32 per 100,000 in 2031. The ASMR is forecast to increase from 0.19 per 100,000 in 2022 to 0.20 per 100,000 in 2031, while the ASDR is predicted to be 10.04 per 100,000 in 2022 and 10.40 per 100,000 in 2031. Conclusions: The overall burden of early-onset bladder cancer in China remained severe from 1990 to 2021, with ASIR showing continuous upward trends that are projected to persist over the next decade. Although ASMR and ASDR generally declined over the past 30 years, they are expected to stabilize in the next 10 years. Further optimization of prevention and control strategies, along with enhanced public awareness, is necessary to effectively reduce the overall burden of early-onset bladder cancer in China.