中国中部地区到2025年癌症死亡率预测：2019年全球疾病负担模型研究。

徐巧华， 周麦庚， 尹鹏， 金东辉

背景：在中国，很少有研究报告未来癌症死亡率的估计。因此，本研究旨在评估中国的癌症死亡率，并确定未来癌症控制策略的优先事项。

方法：基于2019年全球疾病负担研究，我们提取了中国湖南省1990年至2019年癌症相关死亡的数据。根据使用连接点回归模型评估的当前趋势，我们为2025年的癌症死亡率预测拟合了线性回归模型。

结果：中国湖南省癌症总癌症的年龄标准化死亡率缓慢下降，预计到140年将达到80.95（140%置信区间[CI]：12.141-48.2025），男性死亡率约为女性的两倍。到 2025 年，男性癌症相关死亡的五大原因预计将是肺癌、肝癌、结直肠癌、胃癌和食道癌，女性的相应原因是肺癌、乳腺癌、结直肠癌、肝癌和宫颈癌。在2019年至2025年期间，肝癌和胰腺癌导致的男性死亡率预计将增加，而六种主要女性癌症导致的死亡率将增加。男性死亡过多与肝癌和食道癌有关，而女性的所有主要癌症都将有超额死亡率，结直肠癌除外。

结论：中国湖南仍将保持发展中国家和发达国家的综合癌症谱系特征。肺癌仍然是癌症相关死亡的最常见原因，迫切需要开展烟草控制工作。应进一步努力促进全民筛查，改善癌症医疗服务的可及性，优化医疗支付模式，并增加获得有价值的抗癌药物的机会。

Projections of cancer mortality by 2025 in central China: A modeling study of global burden of disease 2019.Qiaohua Xu, Maigeng Zhou, Peng Yin, Donghui Jin
Heliyon 2023 Februrary
BACKGROUND: In China, there are few studies that have reported future estimations for cancer mortality. Therefore, this study aimed to assess cancer mortality in China and identify priorities for future cancer control strategies.

METHODS: Based on the Global Burden of Disease 2019 study, we extracted data on cancer-related deaths from 1990 to 2019 in Hunan Province, China. Under the current trends evaluated using a joinpoint regression model, we fitted a linear regression model for cancer mortality projections by 2025.

RESULTS: The age-standardized mortality rate of total cancer in Hunan, China, declined slowly and is projected to be 140.80 (95% confidence interval [CI]: 140.12-141.48) by 2025, with the mortality rate in men approximately twice that in women. In 2025, the top five causes of cancer-related deaths in males are projected to be lung, liver, colorectal, stomach, and esophageal cancers, with the corresponding causes in females being lung, breast, colorectal, liver, and cervical cancers. Between 2019 and 2025, male mortality rates due to liver and pancreatic cancer are expected to increase, while those due to the six leading female cancers will increase. Excess male deaths were associated with liver and esophageal cancers, while all main cancers in females will have excess mortality, except for colorectal cancer.

CONCLUSION: A comprehensive cancer spectrum characteristic of both developing and developed countries will remain in Hunan, China. Lung cancer remains the most common cause of cancer-related deaths, and tobacco control efforts are urgently required. Additional efforts should be made to promote universal screening, improve access to cancer healthcare services, optimize medical payment models, and enhance access to valuable anticancer drugs.