中国、日本和韩国肺癌负担的分化轨迹：来自1990-2021年全球疾病负担研究的比较风险评估
Diverging Trajectories of Lung Cancer Burden in China, Japan, and South Korea: A Comparative Risk Assessment from the Global Burden of Disease Study 1990-2021.
作者
作者单位
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
- Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
摘要
中文
肺癌在东亚构成重大公共卫生挑战。本研究旨在比较1990年至2021年中国、日本和韩国这三个具有不同社会经济和公共卫生概况的邻国的肺癌负担及关键危险因素的演变。利用2021年全球疾病负担研究的数据，我们应用了一个综合分析框架，包括Joinpoint回归识别趋势转变、年龄-时期-队列模型解开人口学效应，以及ARIMA时间序列模型进行预测。风险归因和聚类分析评估了行为、环境、职业和代谢因素的贡献。观察到显著差异。中国的年龄标准化死亡率（ASMR）增加（估计年变化百分比，EAPC=+0.25%），而日本（EAPC=-0.91%）和韩国（EAPC=-1.02%）则下降。吸烟仍是主要危险因素（归因评分10/10），但风险特征出现分化：环境空气污染对中国负担贡献为9/10，职业石棉在日本占主导（评分8/10），代谢风险（高空腹血糖）在韩国急剧上升（自1990年以来+18.4%）。负担在65-79岁年龄组达到峰值，男性死亡率是女性的3-8倍。预测显示，中国将趋于稳定（至2050年ASMR约30.5），日本持续下降（约12.0），而韩国到2050年可能出现反弹风险。肺癌负担反映了由社会经济发展和公共卫生政策塑造的不同流行病学转变。精准预防策略至关重要，中国应优先控制烟草和空气质量，日本关注职业风险，韩国重视代谢因素，并辅以区域合作。
English
Lung cancer poses a major public health challenge in East Asia. This study aimed to compare the evolving burden of lung cancer and key risk factors from 1990 to 2021 in China, Japan, and South Korea, three neighboring countries with distinct socioeconomic and public health profiles. Using data from Global Burden of Disease Study 2021, we applied an integrated analytical framework. This included Joinpoint regression to identify trend transitions, an Age-Period-Cohort model to disentangle demographic effects, and ARIMA time-series modeling for forecasting. Risk attribution and cluster analysis assessed contributions of behavioral, environmental, occupational, and metabolic factors. Marked disparities were observed. China's age-standardized mortality rate (ASMR) increased (Estimated Annual Percentage Change, EAPC = +0.25%), while Japan (EAPC = -0.91%) and South Korea (EAPC = -1.02%) experienced declines. Smoking remained the predominant risk factor (Attribution score: 10/10), but risk profiles diverged: ambient air pollution contributed 9/10 to China's burden, occupational asbestos dominated in Japan (Score: 8/10), and metabolic risks (high fasting plasma glucose) rose sharply in South Korea (+18.4% since 1990). The burden peaked in the 65-79 age group, with male mortality 3-8 times higher than females. Projections suggest stabilization in China (ASMR ~30.5 by 2050), continued decline in Japan (~12.0), and a potential rebound risk in South Korea by 2050. Lung cancer burden reflects divergent epidemiological transitions, shaped by socioeconomic development and public health policies. Precision prevention strategies are essential, prioritizing tobacco control and air quality in China, occupational risks in Japan, and metabolic factors in South Korea, supported by regional collaboration.
分类与指标
- 研究类型
- 临床研究
- 病种
- 肺癌
- JCR 分区
- Q2
- 影响因子
- 2.6
- 新锐分区
- 4区