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.
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.
Objective?To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures (fragility fractures) among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. Methods? Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. Results?From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=?0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a “W-shaped” manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=?0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). ConclusionSince 1990, the LBMD attributable fracture burden in China’s older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
Objective To analyze the trends in the disease burden of tracheal, bronchus, and lung cancer (TBL) in China and in low-, middle-, and high-socio-demographic index (SDI) countries and regions from 1990 to 2021, with the aim of providing evidence for the formulation of targeted prevention and control strategies. Methods Utilizing data from the Global Burden of Disease (GBD) Study 2021, we extracted TBL-related data from 1990 to 2021, stratified by sex, age group, and year. We assessed the disease burden and trends of TBL across different groups, conducted a decomposition analysis to identify the leading contributors to the change in disease burden, and examined the relationship between disability-adjusted life years (DALYs) and SDI. Results In 2021, the overall burden of TBL in China was substantially higher than that in other groups. The fold-increase in the number of prevalent cases, deaths, and DALYs was significantly greater in China. Moreover, the growth rates of the age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) in China were higher than the overall levels in other SDI countries. In all groups, the ASPR of TBL generally followed a pattern of increasing and then decreasing with age; however, for males in China and middle-SDI countries, the ASPR exhibited a decline in the 80-84 age group. Decomposition analysis revealed that the primary drivers of the increasing TBL burden varied among groups: the rise in DALYs in China and middle-SDI countries was mainly driven by population aging, in low-SDI countries by population growth, and in high-SDI countries by epidemiological transition. While global health inequality in TBL showed some improvement, low-SDI countries continued to bear a disproportionately heavy health burden. Conclusion The disease burden of TBL in China has progressively increased from 1990 to 2021, now ranking among the highest globally. Multiple factors, predominantly driven by population aging, are exacerbating this burden. The burden of TBL is influenced by advancing age, sex differences, and SDI levels. China, along with low- and middle-SDI countries, should implement targeted intervention strategies based on epidemiological findings, including expanding investment in public health services and strengthening healthcare systems, to mitigate the growing burden of TBL.
Objective To analyze the current status and temporal trends of the disease burden of spinal fractures in China from 1990 to 2021 based on data from the Global Burden of Disease Study 2021 (GBD 2021), aiming to provide evidence for developing prevention and treatment strategies. Methods Epidemiological data on spinal fractures in China, the United States of America (USA), and globally were extracted from the GBD 2021 database. Joinpoint regression models were applied to analyze temporal trends. Age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rates were calculated, with comparisons of gender- and age-group disparities. Results In 2021, the number of incident cases, prevalent cases, and DALYs of spinal fractures in China increased by 52.28%, 113.68%, and 106.98%, respectively, compared to 1990. The age-standardized incidence, prevalence, and DALYs rates rose by 11.80%, 16.11%, and 14.79%, respectively. The disease burden escalated significantly with age, peaking in individuals aged ≥75 years. Males exhibited higher age-standardized incidence and DALYs rates than females. Comparative analysis revealed that the age-standardized DALYs rate in China (4.19/100 000) was lower than that in globally (6.62/100 000) and USA (15.92/100 000). However, China showed an upward trend [annual average percentage change (AAPC)=0.19%], contrasting with a declining trend in the USA (AAPC=–0.08%). ConclusionThe escalating disease burden of spinal fractures in China is closely linked to population aging, gender disparities, and insufficient targeted prevention policies. Future strategies should integrate age- and gender-specific interventions, including strengthened osteoporosis prevention, trauma risk control, and big data-driven precision measures, to mitigate this burden.
ObjectiveTo analyze the disease burden and evolving trends for gastric cancer in China and worldwide from 1990 to 2021. MethodsBased on the 2021 Global Burden of Disease (GBD) database, we analyzed the burden of gastric cancer using indicators such as incidence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lost due to disability (YLDs). Joinpoint regression analysis was used to calculate the average annual percentage change (AAPC) of these indicators to show trends over time. ResultsIn 2021, the standardized incidence rate of gastric cancer was 14.33 (per 100 000) worldwide and 29.05 (per 100 000) in China, with corresponding standardized mortality rates of 11.20 (per 100 000) and 21.51 (per 100 000). The standardized incidence rate of gastric cancer in China trended downward during 1990–2021 (AAPC=–1.61%, P<0.05), but was lower than the global decline (AAPC=–1.77%, P<0.05). During 1990-2021 in China, the rates of standardized DALYs (AAPC=–2.76%, P<0.05), standardized YLLs (AAPC=–2.78%, P<0.05) and standardized YLDs (AAPC= –1.25%, P<0.05) all showed a significant decrease. The global rates of standardized DALYs (AAPC=–2.42%, P<0.05), standardized YLLs (AAPC=–2.44%, P<0.05) and standardized YLDs (AAPC=–1.56%, P<0.05) all showed a significant decrease. These AAPC values above indicated a general attenuation in the gastric cancer burden across all age groups, both in China and worldwide. ConclusionsDespite these signs of a decline in disease burden indicators for gastric cancer in China and worldwide, the number of cases and deaths in gastric cancer remains substantial coupled with the heavy burden on the healthcare system. Therefore, increased efforts in early detection and prevention strategies are of utmost importance to further reduce the impact of this malignant disease.
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.
Objective To analyze the disease burden and trends of tracheal, bronchus, and lung cancer (TBL) attributable to occupational carcinogens in China from 1990 to 2021, in order to provide reference for the prevention and control of TBL in China. Methods Based on the Global Burden of Disease database 2021, with occupational carcinogens as relevant risk factors and tracheal, bronchus, and lung cancer as the study diseases, data on mortality and disability-adjusted life years (DALYs) attributable to occupational carcinogens in China from 1990 to 2021 were extracted and age-standardized. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC). Hiplot was used to visualize the distribution of disease burden by gender and age. The grey model GM (1, 1) was used to predict the disease burden and trends of TBL attributable to occupational carcinogens in China from 2022 to 2031. Results From 1990 to 2021, the overall mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China increased from 1.85/100 000,53.93/100 000, 2.64/100 000, and 69.50/100 000 in 1990 to 5.22/100 000, 129.29/100 000, 3.49/100 000, and 83.80/100 000in 2021, respectively. The growth rates were 182.16%, 139.74%, 32.20%, and 20.58%, respectively. Joinpoint regression analysis showed that the AAPC values of overall mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China from 1990 to 2021 were 3.41%, 2.87%, 0.92%, and 0.62%, respectively (all P<0.001), showing an overall upward trend, with higher values in females than in males. In 2021, the overall mortality rate of TBL attributable to occupational carcinogens in China gradually increased with age, with high mortality rates mainly concentrated in those aged ≥65 years, and higher rates in males than in females. The overall DALYs rate showed a trend of increasing first and then slowly decreasing with age, peaking at 65-69 years old, with higher rates in males than in females. The grey prediction model GM (1, 1) showed that the predicted values of mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China from 2022 to 2031 all showed an upward trend. By 2031, the predicted values of mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate will reach 7.19/100 000, 175.63/100 000, 4.16/100 000, and 93.64/100 000, respectively. Conclusion From 1990 to 2021, the mortality rate, DALYs rate, age-standardized mortality rate, and age-standardized DALYs rate of TBL attributable to occupational carcinogens in China all showed an upward trend. Males and the elderly are the main populations affected by the disease burden of TBL attributable to occupational carcinogens in China. It is necessary to strengthen the prevention and control of occupational carcinogens and promote health education.
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.
