1990~2021年中国60岁及以上人群肾癌疾病负担趋势分析

Trend Analysis of Kidney Cancer Disease Burden in Chinese Population Aged 60 Years and Older from 1990 to 2021

摘要: 目的：分析1990~2021年中国60岁及以上人群肾癌发病数、死亡数和伤残调整生命年(Disability-Adjusted Life Years, DALYs)的变化趋势，并预测2022~2035年各年龄组的变化态势，为老年肾癌防控提供依据。方法：基于全球疾病负担研究(Global Burden of Disease Study, GBD) 2021研究数据，描述1990~2021年各年龄组(60~64、65~69、70~74、75~79、80~84、≥85岁)肾癌发病数、死亡数及DALYs变化；采用自回归积分移动平均(Autoregressive Integrated Moving Average, ARIMA)模型预测2022~2035年相应指标。结果：1990~2021年，各年龄组发病、死亡及DALYs均呈不同程度上升。1990年发病数最高为60~64岁组，死亡数最高为70~74岁组，DALYs最高为60~64岁组；2021年发病数最高为65~69岁组，死亡数最高为70~74岁组，DALYs最高为65~69岁组。ARIMA点预测显示，2022~2035年60~64岁组发病数可能呈轻度下降，而死亡数和DALYs可能继续增加；其余年龄组的发病数、死亡数和DALYs总体呈上升态势，其中65~69岁组的绝对增加较为明显。随着预测期限延长，各指标的95%预测区间逐渐扩大，提示远期预测仍存在较大不确定性。结论：1990~2021年中国60岁及以上人群肾癌的绝对疾病负担总体增加。在既往变化趋势延续的情景下，ARIMA模型提示未来多数年龄组的发病数、死亡数和DALYs仍可能增加，其中65~69岁组的绝对负担增长值得重点关注。预测结果主要用于提示潜在变化方向，仍需结合后续实际监测数据进行动态验证。

Abstract: Objective: To analyze the trends in the numbers of incident cases, deaths, and Disability-Adjusted Life Years (DALYs) due to kidney cancer among Chinese adults aged 60 years and older from 1990 to 2021, and to project the corresponding changes across age groups from 2022 to 2035, thereby providing evidence for the prevention and control of kidney cancer in older adults. Methods: Data were obtained from the Global Burden of Disease Study (GBD) 2021. Changes in the numbers of incident cases, deaths, and DALYs due to kidney cancer from 1990 to 2021 were described for six age groups: 60~64, 65~69, 70~74, 75~79, 80~84, and ≥85 years. Autoregressive Integrated Moving Average (ARIMA) models were used to project the corresponding indicators from 2022 to 2035. Results: From 1990 to 2021, the numbers of incident cases, deaths, and DALYs increased to varying degrees across all age groups. In 1990, the highest number of incident cases occurred in the 60~64-year age group, the highest number of deaths in the 70~74-year age group, and the highest number of DALYs in the 60~64-year age group. In 2021, the highest numbers of incident cases and DALYs were observed in the 65~69-year age group, whereas the highest number of deaths remained in the 70~74-year age group. ARIMA point forecasts suggested that, from 2022 to 2035, the number of incident cases in the 60~64-year age group may decline slightly, whereas the numbers of deaths and DALYs may continue to increase. The numbers of incident cases, deaths, and DALYs were generally projected to increase in the remaining age groups, with relatively pronounced absolute increases in the 65~69-year age group. The 95% prediction intervals widened progressively over the forecast horizon, indicating considerable uncertainty in the longer-term projections. Conclusion: From 1990 to 2021, the absolute burden of kidney cancer among Chinese adults aged 60 years and older generally increased. Under a scenario in which historical trends continue, the ARIMA models suggest that the numbers of incident cases, deaths, and DALYs may continue to increase in most age groups, with the growing absolute burden in the 65~69-year age group warranting particular attention. These projections primarily indicate possible future trends and should be dynamically updated and validated using subsequent observed data.