吕恒梁, 白峻竹, 李轩, 王龙昊, 张馨, 游姝萌, 张文义, 徐元勇. 1990-2019年中国丙型肝炎病毒感染相关肝癌的发病趋势分析[J]. 疾病监测, 2024, 39(6): 766-770. DOI: 10.3784/jbjc.202312110652
引用本文: 吕恒梁, 白峻竹, 李轩, 王龙昊, 张馨, 游姝萌, 张文义, 徐元勇. 1990-2019年中国丙型肝炎病毒感染相关肝癌的发病趋势分析[J]. 疾病监测, 2024, 39(6): 766-770. DOI: 10.3784/jbjc.202312110652
Lyu Hengliang, Bai Junzhu, Li Xuan, Wang Longhao, Zhang Xin, You Shumeng, Zhang Wenyi, Xu Yuanyong. Incidence trend of liver cancer associated with hepatitis C virus infection in China, 1990−2019[J]. Disease Surveillance, 2024, 39(6): 766-770. DOI: 10.3784/jbjc.202312110652
Citation: Lyu Hengliang, Bai Junzhu, Li Xuan, Wang Longhao, Zhang Xin, You Shumeng, Zhang Wenyi, Xu Yuanyong. Incidence trend of liver cancer associated with hepatitis C virus infection in China, 1990−2019[J]. Disease Surveillance, 2024, 39(6): 766-770. DOI: 10.3784/jbjc.202312110652

1990-2019年中国丙型肝炎病毒感染相关肝癌的发病趋势分析

Incidence trend of liver cancer associated with hepatitis C virus infection in China, 1990−2019

  • 摘要:
    目的 分析1990—2019年我国由丙型肝炎病毒(HCV)感染相关的肝癌在不同的年龄、时期以及出生队列流行情况,为肝癌防控提供参考依据。
    方法 从全球疾病负担2019数据库中提取1990—2019年中国HCV感染相关肝癌的发病数据;使用Joinpoint回归分析肝癌年龄标化发病率的时间变化趋势;使用年龄−时期−队列模型,分析年龄、时期、出生队列因素对我国由HCV感染相关肝癌发病的影响。
    结果 通过Joinpoint回归分析发现,1990—2019年HCV感染相关肝癌的标化发病率由4.54/10万降至1.75/10万,总体呈现下降趋势[年度平均变化百分比(AAPC)=−3.28%,P<0.001],男性(AAPC=−2.58%, P<0.001)标化发病率降低幅度低于女性(AAPC=−3.71%, P<0.001);使用年龄−时期−队列模型分析发现,1990—2019年HCV感染相关肝癌发病风险随年龄的增加而升高,85~89岁年龄组发病风险最高[相对危险度(RR)=7.54,95%置信区间:7.01~8.12];发病风险随时期呈“ N ”形,呈现先增加后降低再增加的趋势;发病风险随出生队列的增长而下降,1949年及以前出生人群发病风险RR值均大于1.00(均P<0.001),1960年及以后出生的人群发病风险RR值均小于1.00(均P<0.050)。
    结论 1990—2019年中国HCV感染相关肝癌的发病率呈下降趋势,但近年来下降趋势不明显,发病情况存在人群差异。 建议加强对重点人群的健康宣教,高危人群筛查,以及对HCV早期感染者及时干预和治疗,从而降低我国未来肝癌的疾病负担。

     

    Abstract:
    Objective To analyze the incidence of liver cancer associated with hepatitis C virus (HCV) infection in different age groups, periods and birth cohorts in China from 1990 to 2019, and provide reference for the prevention and control of liver cancer.
    Methods The incidence data of liver cancer associated with HCV infection in China during this period were extracted from the global burden of disease 2019 database. Joinpoint regression was used to analyze the time trend of age-standardized incidence of liver cancer. Age-period-cohort model was used to analyze the effects of age, period and birth cohort on the incidence of liver cancer associated with HCV infection in China.
    Results The results of Joinpoint regression analysis indicated that the standardized incidence rate of liver cancer associated with HCV infection decreased from 4.54/100 000 in 1990 to 1.75/100 000 in 2019, indicating a general downward trend (AAPC=−3.28%, P<0.001). However, the reduction in the standardized incidence rate in men (AAPC=−2.58%, P<0.001) was lower than that in women (AAPC=−3.71%, P<0.001). The analysis with age-period-cohort model found that the risk for liver cancer associated with HCV infection increased with age, the highest risk was observed in people aged 85-89 years (RR=7.54, 95%CI: 7.0–8.12). The curve of incidence risk also showed a “N” shape: increase, then decrease, and increase again. Moreover, the incidence risk decreased in later birth cohort, the all RR values in individuals born in 1949 or earlier were >1.00 (all P<0.001) and all RR values in individuals born in 1960 or later were <1.00 (all P<0.050).
    Conclusion From 1990 to 2019, the incidence of HCV infection-related liver cancer in China showed a downward trend, but the decline was less obvious in recent years, and there were differences in the incidence of HCV infection-related liver cancer among different populations. It is suggested to strengthen health education in key populations, implement high-risk group screening, and provide timely intervention and treatment for early-stage HCV infections to reduce the burden of liver cancer in the future in China.

     

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