关键词: 胰腺肿瘤, 中国, 发病率, 死亡率

Abstract:

Objective To analyze the incidence and mortality of pancreatic cancer in China from 1992 to 2021，and to explore the effects of age，period，and cohort on pancreatic cancer incidence and mortality. Methods Data from the Global Burden of Disease Study （GBD） 2021 database were used to analyze the incidence and mortality of pancreatic cancer in China from 1992 to 2021. The Joinpoint software was applied to analyze the time trends of standardized incidence and mortality rates，and to calculate the average annual percentage change. An age-period-cohort model was constructed to analyze the effects of age，period，and birth cohort on the trends of pancreatic cancer incidence and mortality. The disease burden of pancreatic cancer deaths attributed to risk factors such as hyperglycemia and smoking was analyzed. Results In 2021，the incidence of pancreatic cancer in China was 8.34/100 000，and the mortality rate was 8.41/100 000，representing increases of 150.45% and 145.19%，respectively，compared to 1992 （3.33/100 000 and 3.43/100 000）. By sex，the incidence （9.93/100 000） and mortality （9.91/100 000） rates in males in 2021 were higher than those in females （6.68/100 000 and 6.83/100 000）. From 1992 to 2021，the standardized incidence and mortality rates of pancreatic cancer in China showed upward trends，with average annual increases of 0.80% and 0.62%，respectively，both of which were statistically significant （both P<0.001）. Age effect results indicated a general increasing trend in pancreatic cancer incidence，with a steady rise in the 15-49 age group，a sharp increase after the age of 50，and a peak in the over 85 age group at 68.64/100 000. The mortality rate showed a slow increase in the 15-79 age group，with a marked rise and peak in the 80-84 age group at 196.51/100 000. Period effect results showed an overall upward trend in the period relative risk （RR） for pancreatic cancer incidence，with the highest risk in 2017-2021 （RR=1.09，95%CI：1.05-1.13，P=0.012），compared to the reference period 2002-2006 （RR=1）. The RR for pancreatic cancer mortality showed a fluctuating trend，with the highest risk in 2012-2016 （RR=1.60，95%CI：1.07-2.38，P=0.021），compared to the reference period 2002-2006 （RR=1）. The results of cohort effect showed that the incidence and mortality risk of pancreatic cancer in China generally increased with the increase of years. With the 1952-1956 birth cohort as the reference cohort （RR=1），the incidence （RR=1.18，95%CI：0.99-1.40，P=0.032） and mortality （RR=1.63，95%CI：0.12-11.53，P=0.042） risk of pancreatic cancer were the highest in the 1987-1991 birth cohort, and showed decreasing trends after the 1992-1996 birth cohort. The proportion of pancreatic cancer deaths attributable to high blood glucose showed an increasing trend，while those attributable to smoking showed a decreasing trend. Conclusions From 1992 to 2021，the standardized incidence and mortality rates of pancreatic cancer in China have continued to rise，with males having higher incidence and mortality rates than females. Age，period，and cohort all significantly influence the trends in pancreatic cancer incidence and mortality. The trend in pancreatic cancer deaths attributable to high blood glucose is increasing.

Key words: Pancreatic neoplasms, China, Incidence, Mortality