背景:肥胖模式的改变对食管癌(EC)的流行病学产生了重大影响。
目的:本研究旨在调查不同地域和社会人口指数(SDI)地区与高体重指数(BMI)相关的EC的具体负担。使用2019年全球疾病负担研究的数据。
方法:死亡率,年龄标准化死亡率(ASDR),分析了204个国家和地区1990年至2019年的残疾调整寿命年(DALYs)。分解分析,边境和健康不平等分析,和年龄-时期-队列模型被用于检查驱动疾病负担的因素并预测未来趋势.
结果:高BMI导致89,903.9[95%不确定度区间(UI):27,878.9-171,254.6]与EC相关的死亡,每10万人的ASDR为1.1(95%UI0.3-2.1),和2019年2,202,314.1(681,901.4-4,173,080.3)DALYs。在29年期间,这些数字呈上升趋势。SDI中部地区(31,023.8,95%UI9,180.4-62,631.5)和东亚(36,939.9,95%UI9,620.5-81,495)的EC相关死亡负担最高。全球所有年龄组和性别的疾病负担都在增加。人口增长是导致所有SDI五分之一人口EC死亡的主要因素。在所有发展水平的国家中都观察到疾病负担的差异。预测模型表明,在未来十年中,与EC相关的死亡人数将继续增加。
结论:该研究全面了解了过去几十年来与高BMI相关的全球EC负担。存在通过有针对性的干预措施和政策在所有SDI级别减轻这一负担的机会。
BACKGROUND: The changing patterns of obesity have had a significant impact on the epidemiology of esophageal cancer (EC).
OBJECTIVE: This
study aimed to investigate the specific burden of EC associated with high body mass index (BMI) across different geographical and Sociodemographic Index (SDI) regions, using data from the Global Burden of Disease
Study 2019.
METHODS: Mortality, age-standardized death rates (ASDR), and disability-adjusted life-years (DALYs) from 1990 to 2019 were analyzed for 204 countries and territories. Decomposition analysis, frontier and health inequality analyses, and age-period-cohort models were employed to examine the factors driving disease burden and to predict future trends.
RESULTS: High BMI contributed to 89,903.9 [95% uncertainty interval (UI): 27,878.9-171,254.6] EC-related deaths, an ASDR of 1.1 (95% UI 0.3-2.1) per 100,000 population, and 2,202,314.1 (681,901.4-4,173,080.3) DALYs in 2019. There was an increasing trend in these figures over the 29-year period. The middle SDI region (31,023.8, 95% UI 9,180.4-62,631.5) and East Asia (36,939.9, 95% UI 9,620.5-81,495) carried the highest burden of EC-related deaths. Disease burden increased across all age groups and genders globally. Population growth was a major factor driving EC deaths across all SDI quintiles. Disparities in disease burden were observed across countries at all development levels. Predictive models indicated a continued increase in EC-related deaths in the next decade.
CONCLUSIONS: The
study provided a comprehensive understanding of the global burden of EC associated with high BMI over the past decades. Opportunities exist to reduce this burden at all SDI levels through targeted interventions and policies.