Recently, sponsored by the Science Popularization Department of the China Anti Cancer Association, jointly organized by the Rehabilitation Branch of the China Anti Cancer Association and the Mijian Digital Cancer Patient Course Management Platform, and co-organized by the Science Popularization Special Committee of the China Anti Cancer Association, The "2022 White Paper on the Quality of Life of Chinese Lung Cancer Patients" has been officially released (herein after referred to as the "White Paper"), which mainly elaborates on the basic situation of Chinese lung cancer patients and the medical, social, and economic impacts caused by the disease. This article interprets the White Paper in order to help the public understand the real situation of lung cancer patients and provide important empirical evidence and valuable insights for the diagnosis, treatment, and rehabilitation of lung cancer in China.
Objective To analyze trends in the disease burden of tracheal, bronchial, and lung cancer (TBL) in China and in low, medium, and high socio-demographic index (SDI) countries and regions from 1990 to 2021, with the aim of providing a basis for developing targeted prevention and control strategies. Methods Using the Global Burden of Disease (GBD) 2021 database, we extracted TBL-related data for different genders, age groups, and years from 1990 to 2021. The dominant factors contributing to the disease burden and the relationship between DALYs and SDI were analyzed. Results In 2021, China's overall TBL burden was significantly higher than other groups, with substantially greater increases in the number of cases, deaths, and DALYs compared to other groups. The growth rates of ASPR, ASMR, and ASDR also exceeded the overall levels of other SDI countries.The ASPR for all grouped TBLs showed an overall trend of increasing followed by decreasing with age. However, the ASPR for Chinese and middle-SDI male groups exhibited a downward trend in the age range 80-84 years old. Decomposition analysis revealed that the dominant factors for the increase in disease burden of TBL in each group are different. The growth DALYs in China and middle-SDI countries were primarily driven by population aging, while low-SDI countries were mainly influenced by population growth and high-SDI countries were predominantly affected by epidemiological changes. Global health inequalities in TBL have improved, yet low-SDI countries continue to bear a disproportionately heavy health burden. Conclusion The burden of TBL disease in China has steadily increased from 1990 to 2021, currently ranking among the highest globally. Multiple factors, primarily driven by population aging, continue to exacerbate China's TBL burden. The TBL disease burden is influenced by aging, gender differences, and SDI levels. China and low- middle SDI countries should implement targeted intervention strategies based on epidemiological research, including expanding public health service investments and strengthening healthcare system development, to alleviate the increasingly heavy TBL burden.
ObjectiveTo analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of KOA in China. Methods Based on the 2023 Global Burden of Disease Study (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI. Results The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in females than in males, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95%CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences. ConclusionThe continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.
ObjectiveTo provide reference for the formulation of public health policies through exploring the disease burden of aortic aneurysm (AA) in Chinese young adults. MethodsWe analyzed sex-specific mortality rates and years of life lost (YLLs) among Chinese young adults with AA in Global Burden of Disease (GBD) from 1990 to 2019, and compared with global and young adult AA data stratified by sociodemographic index (SDI). Joinpoint was used to analyze the time trend of AA burden among young males and females in China. The attributable risk factors for AA burden in young adults and its characteristics were analyzed. ResultsAmong young adults (15-39 years old) in China, the total of AA deaths in 2019 was 657 (95%UI 549-791), with an increase of 16.90% compared with 1990. The mortality rate in 2019 was 0.13 per 100 000 (95%UI 0.11-0.16), with an increase of 30.00% compared with 1990. In 2019, a total of 36921 YLLs (95%UI 30 865-44 445) were produced by young adults in China, with an increase of 13.21% compared with 1990. The YLLs rate in 2019 was 7.42 per 100 000 (95%UI 6.20-8.93), with an increase of 24.92% compared with 1990. The male YLLs rate was 11.49 per 100 000 (95%UI 9.22-14.28), with an increase of 35.18%. The female YLLs rate was 3.11 per 100 000 (95%UI 2.36-3.98), with a decrease of 3.12%. Both the AA mortality rate and YLLs rate in male young adults were higher than those in female young adults, and the growth rate from 1990 to 2019 was significantly higher than that in females. ConclusionThe disease burden of AA among young adults in China increases significantly from 1990 to 2019, mainly among males. The time trend of male and female AA YLLs in Chinese young adults is obviously inconsistent. The AA YLLs of Chinese male young adults are positively correlated with economic development and the progress of medical technology, and are in the process of gradual increase. The AA YLLs of Chinese female young adults are much lower than the average level, which is closely related to the low smoking rate.
Objective To explore the long-term trends and epidemiological characteristics of the disease burden of tetanus in China over the past 30 years and to predict its disease burden in 2050, in order to comprehensively assess the overall disease burden of tetanus in China. Methods Leveraging the methods and findings of the Global Burden of Disease Study 2021, we provided a detailed description of the disease burden of tetanus in China based on key indicators such as prevalence, incidence, mortality, disability-adjusted life years, years lived with disability, and years of life lost due to premature mortality. Joinpoint regression analysis, age-period-cohort analysis, decomposition analysis, and Bayesian age-period-cohort models were employed to further elucidate the epidemiological characteristics of tetanus and predict its disease burden in China by 2050. Results From 1990 to 2021, the overall disease burden of tetanus in China exhibited a significant year-by-year decline. The primary demographic group bearing the burden of tetanus in China had gradually shifted from newborns to middle-aged and elderly individuals, with males being more affected than females. Decomposition analysis indicated that epidemiological change was a significant factor contributing to tetanus in China, while the impacts of population and aging were relatively minor. According to predictions from the Bayesian age-period-cohort model, by 2050, only the prevalence rate was expected to slightly increase, while all other indicators were projected to decline and remain at low levels. Conclusion The disease burden of tetanus in China decreased from 1990 to 2021. In subsequent prevention efforts, newborns and middle-aged and elderly individuals should be prioritized as targets for prevention and control to maintain the disease burden of tetanus at a low level.
ObjectiveTo analyze the gender-specific distribution patterns of the disease burden of tracheal, bronchial, and lung cancer (hereinafter referred to as lung cancer) attributed to tobacco from 1990 to 2021 globally and in China and the United States (US), and to predict the trend of disease burden changes from 2022 to 2031, aiming to provide multi-dimensional evidence-based support for optimizing tobacco control strategies and precise lung cancer prevention and control systems. MethodsData on the disease burden of lung cancer attributed to tobacco from 1990 to 2021 globally and in China and the US were extracted and integrated from the Global Burden of Disease (GBD) 2021 database. The Joinpoint 4.9.1.0 software was used to analyze the corresponding trends in disease burden. The Bayesian age-period-cohort (BAPC) prediction model was employed to forecast the disease burden of lung cancer from 2022 to 2031. ResultsIn 2021, China had the highest number of deaths and disability-adjusted life years (DALYs) due to lung cancer attributed to tobacco, followed by the US. The top three risk factors for lung cancer globally and in China and the US from 1990 to 2021 were tobacco, air pollution, and occupational risks. The disease burden of lung cancer patients attributed to tobacco has been decreasing year by year in the global and US populations [the average annual percentage change (AAPC) values of age-standardized mortality rate and DALYs rate were: globally: ?0.96%, ?1.28%; US: ?2.33%, ?2.72%], while it has been increasing in China (the AAPC values of age-standardized mortality rate and DALYs rate were 0.28% and ?0.02%, respectively). From a gender perspective, the disease burden of male patients with lung cancer attributed to tobacco was much higher than that of female patients from 1990 to 2021. Compared to the global average, the disease burden of lung cancer attributed to tobacco in China and the US from 1990 to 2021 was still heavy, with China’s burden being higher than that of the US. The elderly population aged ≥65 years in the global context and in China and the US was the primary group affected by the disease burden of lung cancer attributed to tobacco. The BAPC prediction model indicated that from 2022 to 2031, the age-standardized rates of lung cancer attributed to tobacco in the global context and in China and the US would show a declining trend. ConclusionFrom 1990 to 2021, the disease burden of lung cancer attributed to tobacco in China and the US was still heavy compared to the global average, with China’s burden being significantly higher than that of the US. The focus on prevention and control for both countries remains among the middle-aged and elderly population (especially males), which is a key challenge for tobacco-related lung cancer prevention and treatment work in the next 10 years.
Objective To integrate and analyze the disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019, along with the differences between genders, and predict the trends in disease burden changes from 2020 to 2029 to improve prevention and treatment strategies. Methods The disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019 was extracted and integrated from the 2019 Global Burden of Disease (GBD) database, and the corresponding trend was analyzed using the Joinpoint regression model with Joinpoint 4.9.1.0 software. The gray prediction model [GM (1, 1) ] was used to forecast the disease burden of alcohol-related esophageal cancer in China from 2020 to 2029. Results In 2019, the leading causes of esophageal cancer in China were tobacco, alcohol, high body mass index, and insufficient fruit and vegetable intake, accounting for the first to fifth positions in esophageal cancer deaths. From a gender perspective, in 2019, the death number and standardized mortality rate for males were 18.97 times and 20.00 times higher than for females, respectively. The disability-adjusted life years (DALYs) and standardized DALYs rate for males were 33.08 times and 24.78 times higher than those for females, respectively, indicating a heavier disease burden of alcohol-related esophageal cancer among Chinese males. From 1990 to 2019, the average annual percentage change (AAPC) in deaths and DALYs due to alcohol-related esophageal cancer in China was 2.08% and 1.63%, respectively, showing a continuous upward trend with statistical significance (P<0.05). The AAPC values for standardized mortality rate and standardized DALYs rate from 1990 to 2019 were –0.92% and –1.23%, respectively, showing a continuous downward trend with statistical significance (P<0.05). The population aged ≥55 years was the main group bearing the disease burden among all age groups from 1990 to 2019. The gray prediction model predicted that by 2029, the overall standardized mortality rate and standardized DALYs rate would decrease to 2.94/100 000and 67.94/100 000, with a greater decline in females than in males. Conclusion Over the past 30 years, the disease burden of alcohol-related esophageal cancer in China has slightly decreased. However, the reduction in disease burden is still lower compared to the overall decline in esophageal cancer burden, and the disease burden for males is significantly higher than for females. Focusing on prevention and treatment for males and the elderly population remains a major issue in addressing alcohol-related esophageal cancer in China.
ObjectiveTo systematically analyze the temporal trends of pancreatic cancer burden in globally and China from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021) database and predict disease burden changes over the next 15 years. MethodsThe data of the incidence, death, disability-adjusted life years (DALYs) and age-standardized rate data of pancreatic cancer in GBD 2021 were extracted to analyze the epidemic status. Joinpoint regression models were employed to calculate average annual percentage changes (AAPC) and identify trend transitions. An auto-regressive integrated moving average (ARIMA) model was utilized to predict disease burden from 2022 to 2036. ResultsIn 2021, the global age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) for pancreatic cancer were 5.96 (per 100 000), 5.95 (per 100 000), and 130.33 (per 100 000). Corresponding rates in China were 5.64 (per 100 000), 5.72 (per 100 000), and 137.23 (per 100 000). From 1990 to 2021, the average annual growth rate of ASIR (AAPC=0.72%), ASMR (AAPC=0.56%) and ASDR (AAPC=0.36%) were significantly higher than the global rate (ASIR: AAPC=0.27%; ASMR: AAPC=0.16%; ASDR: AAPC=0.02%). Age-specific analysis showed that the crude incidence, mortality, and DALYs rates for the population aged ≥60 years old in China (AAPC: 0.37%–1.55%) were all increasing at a higher rate than the same age group globally (AAPC: –0.02%–0.77%). Sex differences were significant, with greater disease burden in men than in women. ARIMA model predicted that Chinese and global ASIR and ASMR will continue to rise by 2036, with persistently steeper increases in males than females. ConclusionThe disease burden of pancreatic cancer in China is growing faster than that of the world, so early screening and prevention of pancreatic cancer should be strengthened.
Objective To assess the burden of hypertensive nephropathy in China and the world from 1990 to 2021 and predict future trends. Methods Based on the Global Burden of Disease Database 2021, standardized prevalence, standardized mortality and standardized disability adjusted life year (DALY) rates were used to describe the burden of hypertensive nephropathy in China and the world from 1990 to 2021. Estimated annual percentage change (EAPC) and autoregressive integrated moving average model were used to reveal the trend of disease burden. Results From 1990 to 2021, the EAPCs of standardized prevalence, standardized mortality and standardized DALY rates of hypertensive nephropathy in China were ?0.61% (?0.73%, ?0.50%), ?0.77% (?0.85%, ?0.69%), and ?1.00% (?1.09%, ?0.91%), respectively. The global EAPCs for standardized prevalence, standardized mortality, and standardized DALY rates of hypertensive nephropathy were ?0.16% (?0.18%, ?0.13%), 0.97% (0.91%, 1.03%), and 0.63% (0.58%, 0.67%), respectively. The standardized prevalence rate, standardized mortality rate and standardized DALY rate of hypertensive nephropathy in China all showed a downward trend, and the global standardized prevalence rate also showed a downward trend, while the global standardized mortality rate and standardized DALY rate showed an upward trend, and the indicators of disease burden in China were lower than the global level. The standardized mortality rate and the standardized DALY rate of hypertensive nephropathy were higher in males than in females. With the increase of age, the disease burden indicators of hypertensive nephropathy in China and the world were on the rise, and the age of disease and death were concentrated in the age group over 65 years old. Renal dysfunction and hypertension were important risk factors for death in hypertensive nephropathy patients. It was estimated that from 2022 to 2040, the standardized prevalence rate and mortality rate of hypertensive nephropathy would be on the rise in China and the world, and the standardized DALY rate would be on the rise in the world, while in China it would be on the decline. Conclusions The burden of hypertensive nephropathy is heavy in China and the world from 1990 to 2021, and the control of hypertension and prevention of renal dysfunction should be strengthened. It is estimated that the standardized prevalence and mortality of hypertensive nephropathy will increase in China and the world from 2022 to 2040, and the disease burden will remain heavy.
ObjectiveTo analyze and compare the disease burden, trends, and influencing factors of lung cancer in adolescents and young adults (AYAs) in China and globally from 1990 to 2021, providing a reference for the prevention and treatment of lung cancer in China. MethodsIndicators of lung cancer disease burden in different genders and age groups in 204 countries or regions from 1990 to 2021 were retrieved and standardized from GBD 2021 database. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) of the standardized rates of lung cancer in AYAs in China and globally from 1990 to 2021; changes in incidence, mortality, and disability-adjusted life years (DALYs) rates due to population growth, aging, and epidemiological changes were analyzed; differences in lung cancer disease burden in AYAs in different socio-demographic index (SDI) regions were analyzed; and the influencing factors of lung cancer in AYAs in China and globally were explored. ResultsFrom 1990 to 2021, the age-standardized incidence rate (ASIR) (AAPC=?0.18%, P<0.001), age-standardized mortality rate (ASMR) (AAPC=?0.62%, P<0.001), and age-standardized DALYs rate (AAPC=?0.62%, P<0.001) of lung cancer in AYAs in China showed a downward trend, consistent with the global trend, but the decline in China was relatively small. During this period, the age-standardized rates of various indicators of lung cancer in males in China and globally were higher than those in females, and the burden of lung cancer in Chinese males was heavier. However, due to the significant downward trend in males, the gap in lung cancer burden between males and females was narrowing. At the same time, from 2013 to 2021, the ASIR [annual percent change (APC)=2.01%, P<0.001], ASMR (APC=1.46%, P<0.001), and standardized DALYs rate (APC=1.46%, P<0.001) in China showed an upward trend. From 1990 to 2021, among the main influencing factors for the incidence, mortality, and DALYs rates of lung cancer in Chinese AYAs, the contribution of aging was upward-pushing, while the increase in global indicators was mainly attributed to population growth. The global burden of lung cancer in AYAs was overly concentrated in high SDI regions. Although the gap in lung cancer burden between high SDI and low SDI regions was narrowing, it remained widespread. Globally, smoking, environmental PM2.5, insufficient fruit intake, second-hand smoke, and indoor air pollution were prominent risk factors. ConclusionFrom 1990 to 2021, the global and Chinese AYAs lung cancer incidence and mortality rates generally show a downward trend, but the female lung cancer burden relatively increases, especially in young women without a history of smoking. Continued efforts are needed to reduce the burden of lung cancer in AYAs, especially the specific risk for young women.