中国60岁及以上人群结直肠癌疾病负担趋势分析与预测

Trend Analysis and Prediction of Colorectal Cancer Disease Burden in the Chinese Population Aged 60 Years and Older

摘要: 目的：分析1990~2021年中国60岁及以上老年人群结直肠癌的疾病负担变化趋势，并预测2022~2036年的标化负担水平。方法：利用全球疾病负担研究(Global Burden of Disease Study, GBD) 2021数据，计算各年龄组(60~64岁至85岁及以上)的发病率、死亡率及伤残调整生命年(Disability-Adjusted Life Years, DALYs)率，描述其时间变化；并采用贝叶斯层次模型(Bayesian Hierarchical Model)估计未来年龄标准化率(Age-Standardized Rate, ASR)。结果：1990~2021年，各年龄组发病率均持续上升，男性高于女性，75~79岁和80~84岁组在2000年后上升明显加快；死亡率与DALYs率总体呈先升后降或波动趋稳，男性高龄组(≥80岁)降幅小于女性。预测显示，2022~2036年标化发病率、死亡率及DALYs率均呈上升趋势，其中发病率增幅约35%，远期不确定性增大。结论：中国老年人群结直肠癌发病负担持续加重，死亡率虽趋稳但仍处高位，未来标化负担预期上升，需针对性加强高龄男性人群防控。

Abstract: Objective: To analyze temporal trends in the colorectal cancer burden among Chinese adults aged 60 years and older from 1990 to 2021, and project age-standardized burden metrics for 2022~2036. Methods: Global Burden of Disease Study 2021 (GBD 2021) data were used to calculate incidence rates, mortality rates, and disability-adjusted life year (DALY) rates across age subgroups (60~64 years to ≥85 years). Temporal trends were described, and a Bayesian hierarchical model was employed to estimate future age-standardized rates (ASRs). Results: Between 1990 and 2021, incidence rates rose consistently across all age subgroups, with higher rates in males than females. In the 75~79 and 80~84 age groups, incidence growth accelerated markedly after 2000. Mortality and DALY rates generally exhibited an initial increase followed by a decline or stable fluctuation; the magnitude of decline was smaller in males aged ≥ 80 years relative to females. Projections showed that age-standardized incidence, mortality, and DALY rates would all increase from 2022 to 2036, with incidence rates rising by approximately 35% and greater uncertainty observed in long-term forecasts. Conclusion: The incidence burden of colorectal cancer continues to worsen among China’s older population. While mortality rates have plateaued, they remain elevated. Standardized disease burden is expected to rise in the coming decades, highlighting the need for targeted prevention and control interventions focused on older men at advanced ages.