中国全科医学 ›› 2025, Vol. 28 ›› Issue (26): 3314-3320.DOI: 10.12114/j.issn.1007-9572.2024.0595

• 论著·流行病学研究 • 上一篇    下一篇

1990—2021年中国宫颈癌疾病负担趋势分析及2022—2035年预测研究

尚忠华1, 蒋芝月1, 黄朝晖2, 杨星3, 刘海燕1, 张丽1,*()   

  1. 1.561113 贵州省贵阳市,贵州医科大学公共卫生与健康学院环境污染与疾病监控教育部重点实验室
    2.550004 贵州省贵阳市,贵州医科大学附属医院
    3.561113 贵州省贵阳市,贵州医科大学医药卫生管理学院
  • 收稿日期:2024-10-13 修回日期:2025-02-09 出版日期:2025-09-15 发布日期:2025-07-22
  • 通讯作者: 张丽

  • 作者贡献:

    尚忠华负责研究设计与构思,数据处理、统计分析及结果可视化分析,撰写论文初稿;蒋芝月、刘海燕负责研究统计学方法的设计、实施与结果解读;杨星、黄朝晖参与研究设计讨论,提供领域专业知识指导;张丽负责论文的全面修订、审阅与最终定稿,监督研究质量与过程控制,并提供资金支持。

  • 基金资助:
    贵州医科大学高层次人才科研启动基金项目(校博合J字[2023-001]号)

Trends in Cervical Cancer Burden in China from 1990 to 2021 and Prediction for 2022 to 2035

SHANG Zhonghua1, JIANG Zhiyue1, HUANG Zhaohui2, YANG Xing3, LIU Haiyan1, ZHANG Li1,*()   

  1. 1. School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 561113, China
    2. The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
    3. School of Medicine and Health Management, Guizhou Medical University, Guiyang 561113, China
  • Received:2024-10-13 Revised:2025-02-09 Published:2025-09-15 Online:2025-07-22
  • Contact: ZHANG Li

摘要: 背景 宫颈癌是全球女性第四大常见癌症,给世界各国造成了巨大的疾病负担,是当前全球尤其是发展中国家所面临的一个重要公共卫生问题。 目的 分析1990—2021年中国宫颈癌疾病负担的趋势,并预测2022—2035年宫颈癌疾病负担情况,为制订和调整防控策略提供科学依据。 方法 利用2021年全球疾病负担数据,采用年估计变化百分比(EAPC)对1990—2021年中国宫颈癌的标化发病率、标化死亡率及标化伤残调整寿命年(DALYs)率的时间趋势进行分析,并与英国、美国和澳大利亚等国家进行比较。基于贝叶斯年龄-时期-队列模型(BAPC),对2022—2035年中国宫颈癌疾病负担进行预测。 结果 中国宫颈癌标化发病率由1990年的11.80/10万增至2021年的13.37/10万(EAPC=0.88,95%CI=0.70~1.07);标化死亡率由1990年的6.98/10万降至2021年的4.64/10万(EAPC=-1.05,95%CI=-1.20~-0.89);标化DALYs率由1990年的228.2/10万降至2021年的149.8/10万(EAPC=-1.07,95%CI=-1.22~-0.92)。35岁及以上女性宫颈癌发病数占总病例数的比例从1990年的86.41%升至2021年的92.12%,DALYs数占总DALYs数的比例从1990年的88.48%升至2021年的95.07%;40岁及以上女性宫颈癌死亡数占总死亡数的比例从1990年的86.42%升至2021年的95.54%。25~54岁组宫颈癌标化发病率上升趋势明显,其中,45~49岁年龄组上升幅度最大(EAPC=1.49,95%CI=1.20~1.78);45~49岁组宫颈癌标化死亡率和标化DALYs率在<60岁人群中下降幅度最小。预测2035年,中国宫颈癌标化发病率、标化死亡率以及标化DALYs率将分别降至11.8/10万、3.4/10万和112.8/10万。 结论 1990—2021年,中国宫颈癌标化发病率呈缓慢上升趋势,而标化死亡率与标化DALYs率则呈缓慢下降趋势。预测至2035年,中国宫颈癌的发病、死亡及DALYs负担将呈下降态势。35岁以上人群构成了宫颈癌疾病负担的主体,是防控策略的核心目标人群。基于现有防控经验,建议加速推进9~14岁女童HPV疫苗全国接种的全覆盖策略;精准提升35~44岁人群的宫颈癌筛查覆盖率。通过构建覆盖全生命周期的综合防控体系,以期有效降低中国宫颈癌的疾病负担。

关键词: 宫颈癌, 疾病负担, 发病率, 死亡率, 伤残调整寿命年, 趋势分析

Abstract:

Background

Cervical cancer is the fourth most common cancer in women worldwide, causing a huge burden of disease in countries around the world, and is currently an important public health problem facing the world, especially in developing countries.

Objective

To examine the trends in cervical cancer burden in China from 1990 to 2021 and to project the burden from 2022 to 2035, providing a scientific basis for formulating and adjusting prevention and control strategies.

Methods

Utilizing data from the 2021 Global Burden of Disease (GBD) study, we analyzed the temporal trends in cervical cancer age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (DALYs) rate in China between 1990 and 2021 using the estimated annual percentage change (EAPC). These trends were compared with those in developed countries such as the United Kingdom. Additionally, the Bayesian age-period-cohort (BAPC) model was used to predict cervical cancer burden in China from 2022 to 2035.

Results

The ASIR of cervical cancer in China increased from 11.80 per 100 000 in 1990 to 13.37 per 100 000 in 2021 (EAPC=0.88, 95%CI=0.70-1.07). The ASMR decreased from 6.98 per 100 000 in 1990 to 4.64 per 100 000 in 2021 (EAPC=-1.05, 95%CI=-1.20 to -0.89), and the age-standardized DALYs rate decreased from 228.2 per 100 000 in 1990 to 149.8 per 100 000 in 2021 (EAPC=-1.07, 95%CI=-1.22 to -0.92). Between 1990 and 2021, the proportion of cervical cancer cases in women aged 35 and older increased from 86.41% to 92.12%, while the proportion of DALYs in this group rose from 88.48% to 95.07%. Furthermore, the proportion of deaths in women aged 40 and older increased from 86.42% in 1990 to 95.54% in 2021. A notable upward trend in cervical cancer incidence was observed in women aged 25-54, with the most pronounced increase in the 45-49 age group (EAPC=1.49, 95%CI=1.20-1.78). Among women under 60, the 45-49 age group showed the smallest decline in mortality and DALYs rates. By 2035, the projected age-standardized incidence, mortality, and DALYs rates for cervical cancer in China are expected to decrease to 11.8, 3.4, and 112.8 per 100 000, respectively.

Conclusion

From 1990 to 2021, the standardized incidence rate of cervical cancer in China showed a slow upward trend, while the standardized mortality rate and standardized DALYs rate showed a slow downward trend. It is predicted that the incidence, death and DALYs burden of cervical cancer in China will decrease by 2035. People over 35 years of age constitute the main body of cervical cancer disease burden and are the core target population for prevention and control strategies. Based on existing prevention and control experience, it is recommended to accelerate the national coverage strategy of HPV vaccination for girls aged 9-14 years; and accurately improve the coverage rate of cervical cancer screening for 35-44 years. By constructing a comprehensive prevention and control system covering the whole life cycle, in order to effectively reduce the burden of cervical cancer in China.

Key words: Cervical cancer, Disease burden, Incidence, Mortality, Disability-adjusted life years, Trend analysis

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