陆军军医大学(第三军医大学)第一附属医院乳腺甲状腺外科,重庆
YANG Ying, E-mail: yang2004@tmmu.edu.cn
Received:23 April 2025,
Revised:31 May 2025,
Published:30 July 2025
移动端阅览
熊丹,苏小君,方燕梅,等.1992-2021年中国甲状腺癌发病率变化趋势:Joinpoint回归及年龄-时期-队列模型分析[J].陆军军医大学学报,2025,47(14):1652-1659.DOI:10.16016/j.2097-0927.202504096.
XIONG D,SU X J,FANG Y M,et al.Trend of thyroid cancer incidence in China, 1992-2021: a Joinpoint regression and age-period-cohort analysis[J].J Army Med Univ,2025,47(14):1652-1659.DOI:10.16016/j.2097-0927.202504096.
熊丹,苏小君,方燕梅,等.1992-2021年中国甲状腺癌发病率变化趋势:Joinpoint回归及年龄-时期-队列模型分析[J].陆军军医大学学报,2025,47(14):1652-1659.DOI:10.16016/j.2097-0927.202504096. DOI:
XIONG D,SU X J,FANG Y M,et al.Trend of thyroid cancer incidence in China, 1992-2021: a Joinpoint regression and age-period-cohort analysis[J].J Army Med Univ,2025,47(14):1652-1659.DOI:10.16016/j.2097-0927.202504096. DOI:
目的
2
分析1992-2021年我国甲状腺癌发病变化趋势,并评估年龄、时期及队列对甲状腺癌发病率的影响。
方法
2
利用2021年全球疾病负担数据,分析1992-2021年我国甲状腺癌年龄标准化发病率(age-standardized incidence rate,ASIR)的变化趋势,使用Joinpoint回归模型及年龄-时期-队列模型进行分析。利用差分自回归移动平均模型(auto regressive integrated moving average,ARIMA)预测未来20年中国甲状腺癌发病情况。
结果
2
1992-2021年,我国男性甲状腺癌ASIR从0.70/10万上升到2.11/10万,平均年度变化百分比(average annual percent change,AAPC)为3.93%(95%
CI
:3.86%~4.00%,
P
<
0.001);女性ASIR从1.91/10万上升到2.87/10万,AAPC为1.43%(95%
CI
:1.36%~1.50%,
P
<
0.001)。年龄效应上,女性ASIR整体波动不大,男性ASIR在≥85岁组达到峰值,为230.51/10万。时期效应上,男性、女性甲状腺癌发病风险随时期变化呈上升趋势,男性发病风险大于女性。以1992-1996年为参照组(
RR
=1),2017-2021年男性、女性(
RR
男性
=2.94,95%
CI
:2.78~3.11;
RR
女性
=1.37,95%
CI
:1.32~1.42)的发病风险最高。队列效应上,男性、女性甲状腺癌发病风险随队列变化呈上升趋势。以1992-1996年为对照组(
RR
=1),同一队列中,1986年前的队列,女性发病风险大于男性,但1996年后的队列,男性发病风险大于女性。男性2012-2016年(
RR
=2.54,95%
CI
:1.80~3.57)发病风险最大,女性在1992-2016年发病风险均大于对照组,但差异无统计学意义。ARIMA模型预测分析发现,2022-2041年中国男性、女性甲状腺癌ASIR持续上升,到2041年,男性甲状腺癌ASIR达到2.79/10万(95%
CI
:1.96~3.61),女性甲状腺癌ASIR达到3.54/10万(95%
CI
:3.02~4.06)。
结论
2
1992-2021年,我国甲状腺癌的ASIR呈上升趋势,女性高于男性,但男性年龄越大、出生越晚,甲状腺癌的发病风险越高。未来20年,中国男性、女性的甲状腺癌发病率将持续上升,防控形式严峻。
Objective To analyze the temporal trend of thyroid cancer incidence in China from 1992 to 2021 and evaluate the impact of age
period and cohort on the incidence.
Methods Based on the Global Burden of Disease 2021
the trend changes of age-standardized incidence rate (ASIR) of thyroid cancer in China from the period were analyzed
and the obtained data were further analyzed with Joinpoint regression and age-period-cohort analysis. Auto regressive integrated moving average (ARIMA) model was applied to predict the incidence of thyroid cancer in China in the next 20 years. Results The ASIR of thyroid cancer among males was increased from 0.70/100 000 to 2.11/100 000 between 1992 and 2021
with an average annual percent change (AAPC) of 3.93% (95%
CI
: 3.86%~4.00%
P
<
0.001); For the females
the ASIR was elevated from 1.91/100 000 to 2.87/100 000 in the time
with an AAPC of 1.43% (95%
CI
: 1.36%~1.50%
P
<
0.001). On the age effect
the overall variation in ASIR among the females was minor
and that in the males reached its peak in the ≥85-years-old group
with a rate of 230.51/100 000. Regarding the period effect
the risk of thyroid cancer incidence in the males and females changed with the period and exhibited a temporal increase
and the incidence risk was consistently higher in the males than the females across different periods. Taking the incidence risk during 1992 and 1996 as a reference (
RR
=1)
the males (
RR
=2.94
95%
CI
: 2.78~3.11) and the females (
RR
=1.37
95%
CI
: 1.32~1.42) had the highest risk of thyroid cancer in the period from 2017 to 2021. On the cohort effect
the risk of thyroid cancer in both sexes showed an increasing trend with cohort change. When taking the cohort during 1992 and 1996 as a reference (
RR
=1)
the females in the pre-1986 cohort exhibited a higher risk of incidence than the males
but in the post-1996 cohort
the males demonstrated a greater risk of incidence than the females. The males in the 2012-2016 cohort had the highest risk of thyroid cancer when compared to the r
eference group (
RR
=2.54
95%
CI
: 1.80~3.57)
and the females in the cohort from 1992 to 2016 had higher risk of thyroid cancer than the reference group
though no statistical differences were observed. The ARIMA model prediction analysis found that the ASIR of thyroid cancer in males and females in China would continue to increase from 2022 to 2041
and the ASIR of thyroid cancer in males would reach 2.79/100 000 (95%
CI
: 1.96~3.61)
and the ASIR of thyroid cancer in females would reach 3.54/100 000 (95%
CI
: 3.02~4.06) by 2041.Conclusion Between 1992 and 2021
the ASIR of thyroid cancer in China has exhibited a consistent upward trend
with the females having a higher ASIR than the males. However
the risk of developing thyroid cancer is higher in men who are older and those who were born more recently. In the next 20 years
the incidence of thyroid cancer among both men and women in China is projected to continue to rise
and the situation for prevention and control will be challenging.
CHEN D W , LANG B H H , MCLEOD D S A , et al . Thyroid cancer [J]. Lancet , 2023 , 401 ( 10387 ): 1531 - 1544 . DOI: 10.1016/S0140-6736(23)00020-X http://dx.doi.org/10.1016/S0140-6736(23)00020-X .
ZHOU T J , WANG X T , ZHANG J Y , et al . Global burden of thyroid cancer from 1990 to 2021: a systematic analysis from the global burden of disease study 2021 [J]. J Hematol Oncol , 2024 , 17 ( 1 ): 74 . DOI: 10.1186/s13045-024-01593-y http://dx.doi.org/10.1186/s13045-024-01593-y .
HU S P , WU X J , JIANG H . Trends and projections of the global burden of thyroid cancer from 1990 to 2030 [J]. J Glob Health , 2024 , 14 : 04084 . DOI: 10.7189/jogh.14.04084 http://dx.doi.org/10.7189/jogh.14.04084 .
QI J L , LI M L , WANG L J , et al . National and subnational trends in cancer burden in China, 2005-20: an analysis of national mortality surveillance data [J]. Lancet Public Health , 2023 , 8 ( 12 ): e943 - e955 . DOI: 10.1016/S2468-2667(23)00211-6 http://dx.doi.org/10.1016/S2468-2667(23)00211-6 .
ZHAI M M , ZHANG D , LONG J H , et al . The global burden of thyroid cancer and its attributable risk factor in 195 countries and territories: a systematic analysis for the global burden of disease study [J]. Cancer Med , 2021 , 10 ( 13 ): 4542 - 4554 . DOI: 10.1002/cam4.3970 http://dx.doi.org/10.1002/cam4.3970 .
CHENG F , XIAO J , SHAO C C , et al . Burden of thyroid cancer from 1990 to 2019 and projections of incidence and mortality until 2039 in China: findings from global burden of disease study [J]. Front Endocrinol (Lausanne) , 2021 , 12 : 738213 . DOI: 10.3389/fendo.2021.738213 http://dx.doi.org/10.3389/fendo.2021.738213 .
DENG Y , LI H , WANG M , et al . Global burden of thyroid cancer from 1990 to 2017 [J]. JAMA Netw Open , 2020 , 3 ( 6 ): e208759 . DOI: 10.1001/jamanetworkopen.2020.8759 http://dx.doi.org/10.1001/jamanetworkopen.2020.8759 .
GBD 2021 Risk Factors Collaborators . Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021 [J]. Lancet , 2024 , 403 ( 10440 ): 2162 - 2203 . DOI: 10.1016/S0140-6736(24)00933-4 http://dx.doi.org/10.1016/S0140-6736(24)00933-4 .
LI Z L , ZHANG L J , LIU Y H . Analysis of the epidemiological trends of Tuberculosis in China from 2000 to 2021 based on the joinpoint regression model [J]. BMC Infect Dis , 2024 , 24 ( 1 ): 1223 . DOI: 10.1186/s12879-024-10126-4 http://dx.doi.org/10.1186/s12879-024-10126-4 .
张越 , 张英英 , 丁玲 , 等 . 基于Joinpoint回归及年龄-时期-队列模型分析中国肾功能损伤所致心血管病死亡率变化趋势 [J]. 中华疾病控制杂志 , 2024 , 28 ( 7 ): 764 - 769, 783 . DOI: 10.16462/j.cnki.zhjbkz.2024.07.004 http://dx.doi.org/10.16462/j.cnki.zhjbkz.2024.07.004 .
ZHANG Y , ZHANG Y Y , DING L , et al . Joinpoint regression and age-period-cohort analysis of mortality trends of cardiovascular disease attributable to kidney dysfunction in China [J]. Chin J Dis Control Prev , 2024 , 28 ( 7 ): 764 - 769, 783 . DOI: 10.16462/j.cnki.zhjbkz.2024.07.004 http://dx.doi.org/10.16462/j.cnki.zhjbkz.2024.07.004 .
SHAN T , ZHU Y H , FAN H Z , et al . Global, regional, and national time trends in the burden of epilepsy, 1990-2019: an age-period-cohort analysis for the global burden of disease 2019 study [J]. Front Neurol , 2024 , 15 : 1418926 . DOI: 10.3389/fneur.2024.1418926 http://dx.doi.org/10.3389/fneur.2024.1418926 .
郑伟 , 张世勇 , 杨纶砥 , 等 . 基于年龄-时期-队列模型的1990-2019年我国艾滋病发病率趋势分析 [J]. 预防医学 , 2023 , 35 ( 8 ): 665 - 668,681 . DOI: 10.19485/j.cnki.issn2096-5087.2023.08.005 http://dx.doi.org/10.19485/j.cnki.issn2096-5087.2023.08.005 .
ZHENG W , ZHANG S Y , YANG L D , et al . Trends in incidence of HIV/AIDS in China from 1990 to 2019 based on an age-period-cohort model [J]. Prev Med , 2023 , 35 ( 8 ): 665 - 668,681 . DOI: 10.19485/j.cnki.issn2096-5087.2023.08.005 http://dx.doi.org/10.19485/j.cnki.issn2096-5087.2023.08.005 .
祁丽 , 柴培培 , 翟铁民 , 等 . 1990-2021年我国骨质疏松疾病负担变化及趋势分析 [J]. 中国卫生经济 , 2024 , 43 ( 12 ): 33 - 37,42 .
QI L , CHAI P P , ZHAI T M , et al . Analysis of the disease burden and trend of osteoporosis in China from 1990 to 2021 [J]. Chin Health Econ , 2024 , 43 ( 12 ): 33 - 37,42 .
林豪胜 , 杨增士 , 叶宁 . 基于年龄-时期-队列模型的中国前列腺癌发病死亡趋势分析 [J]. 临床泌尿外科杂志 , 2024 , 39 ( 8 ): 708 - 712 . DOI: 10.13201/j.issn.1001-1420.2024.08.011 http://dx.doi.org/10.13201/j.issn.1001-1420.2024.08.011 .
LIN H S , YANG Z S , YE N . Analysis of incidence and mortality trends of prostate cancer in China based on age-period-cohort model [J]. J Clin Uro , 2024 , 39 ( 8 ): 708 - 712 . DOI: 10.13201/j.issn.1001-1420.2024.08.011 http://dx.doi.org/10.13201/j.issn.1001-1420.2024.08.011 .
曹阳光 , 王竞 , 周倩倩 , 等 . 基于GBD2021数据库分析1990-2021年中国登革热疾病负担趋势与预测 [J]. 现代预防医学 , 2025 , 52 ( 6 ): 1006 - 1011,1091 . DOI: 10.20043/j.cnki.MPM.202411511 http://dx.doi.org/10.20043/j.cnki.MPM.202411511 .
CAO Y G , WANG J , ZHOU Q Q , et al . Trend and forecast of dengue disease burden in China based on GBD2021 database,1990-2021 [J]. Moder Prev Med , 2025 , 52 ( 6 ): 1006 - 1011, 1091 . DOI: 10.20043/j.cnki.MPM.202411511 http://dx.doi.org/10.20043/j.cnki.MPM.202411511 .
贾海晗 , 孙惠昕 , 张茂祥 , 等 . 2013-2017年黑龙江省肿瘤登记地区甲状腺癌流行趋势 [J]. 中华肿瘤防治杂志 , 2022 , 29 ( 6 ): 387 - 392 . DOI : 10. 16073/j.cnki.cjcpt. 2022.06.02 http://dx.doi.org/10.16073/j.cnki.cjcpt.2022.06.02 .
JIA H H , SUN H X , ZHANG M X , et al . Analysis on the trend of thyroid cancer prevalence in tumor registration areas of Heilongjiang Province from 2013 to 2017 [J]. Chin J Cancer Prev Treat , 2022 , 29 ( 6 ): 387 - 392 . DOI: 10.16073/j.cnki.cjcpt. 2022.06.02 http://dx.doi.org/10.16073/j.cnki.cjcpt.2022.06.02 .
郭晓慧 , 王丽敏 , 王辉 , 等 . 2007-2016年天津市南开区甲状腺癌发病和死亡趋势分析 [J]. 中国慢性病预防与控制 , 2021 , 29 ( 11 ): 878 - 881 . DOI: 10.16386/j.cjpccd.issn.1004-6194.2021.11.018 http://dx.doi.org/10.16386/j.cjpccd.issn.1004-6194.2021.11.018 .
GUO X H , WANG L M , WANG H , et al . Trend analysis of incidence and mortality of thyroid cancer in Nankai District,Tianjin, China,2007-2016 [J]. Chin J Prev Contr Chron Dis , 2021 , 29 ( 11 ): 878 - 881 . DOI: 10.16386/j.cjpccd.issn.1004-6194.2021.11.018 http://dx.doi.org/10.16386/j.cjpccd.issn.1004-6194.2021.11.018 .
张新洲 , 刘劲松 , 许娴 , 等 . 2005-2016年中国甲状腺癌发病和死亡趋势分析 [J]. 中华肿瘤防治杂志 , 2022 , 29 ( 24 ): 1725 - 1733 . DOI: 10.16073/j.cnki.cjcpt.2022.24.02 http://dx.doi.org/10.16073/j.cnki.cjcpt.2022.24.02 .
ZHANG X Z , LIU J S , XU X , et al . Trends of thyroid cancer incidence and mortality in China from 2005 to 2016 [J]. Chin J Cancer Prev Treat , 2022 , 29 ( 24 ): 1725 - 1733 . DOI: 10.16073/j.cnki.cjcpt.2022.24.02 http://dx.doi.org/10.16073/j.cnki.cjcpt.2022.24.02 .
汪正园 , 臧嘉捷 , 吴凡 . 甲状腺癌及其危险因素 [J]. 环境与职业医学 , 2021 , 38 ( 11 ): 1169 - 1172 . DOI: 10.13213/j.cnki.jeom.2021.21300 http://dx.doi.org/10.13213/j.cnki.jeom.2021.21300 .
WANG Z Y , ZANG J J , WU F . Thyroid carcinoma and associated risk factors [J]. J Environ Occup Med , 2021 , 38 ( 11 ): 1169 - 1172 . DOI: 10.13213/j.cnki.jeom.2021.21300 http://dx.doi.org/10.13213/j.cnki.jeom.2021.21300 .
DENARO N , ROMANÒ R , ALFIERI S , et al . The tumor microenvironment and the estrogen loop in thyroid cancer [J]. Cancers (Basel) , 2023 , 15 ( 9 ): 2458 . DOI: 10.3390/cancers15092458 http://dx.doi.org/10.3390/cancers15092458 .
CORDINA-DUVERGER E , LEUX C , NERI M , et al . Hormonal and reproductive risk factors of papillary thyroid cancer: a population-based case-control study in France [J]. Cancer Epidemiol , 2017 , 48 : 78 - 84 . DOI: 10.1016/j.canep.2017.04.001 http://dx.doi.org/10.1016/j.canep.2017.04.001 .
PARK S H , SUGIER P E , ASGARI Y , et al . Reproductive factors, sex hormone levels, and differentiated thyroid cancer risk: a mendelian randomization study [J]. Thyroid , 2025 , 35 ( 4 ): 433 - 443 . DOI: 10.1089/thy.2024.0548 http://dx.doi.org/10.1089/thy.2024.0548 .
梁加政 , 封紫玉 , 宋旭东 , 等 . 甲状腺疾病与乳腺癌关系的研究进展 [J]. 安徽医药 , 2022 , 26 ( 6 ): 1068 - 1073 . DOI: 10.3969/j.issn.1009-6469.2022.06.002 http://dx.doi.org/10.3969/j.issn.1009-6469.2022.06.002 .
LIANG J Z , FENG Z Y , SONG X D , et al . Research progress of the relationship between thyroid disease and breast cancer [J]. Anhui Med Pharm J , 2022 , 26 ( 6 ): 1068 - 1073 . DOI: 10.3969/j.issn.1009-6469.2022.06.002 http://dx.doi.org/10.3969/j.issn.1009-6469.2022.06.002 .
沈婉莹 , 谢靖 , 周维 , 等 . 2005-2015年中国甲状腺癌死亡趋势分析 [J]. 实用预防医学 , 2021 , 28 ( 6 ): 641 - 644 . DOI: 10.3969/j.issn.1006-3110.2021.06.001 http://dx.doi.org/10.3969/j.issn.1006-3110.2021.06.001 .
SHEN W Y , XIE J , ZHOU W , et al . Trend of deaths from thyroid cancer in China,2005-2015 [J]. Pract Prev Med , 2021 , 28 ( 6 ): 641 - 644 . DOI: 10.3969/j.issn.1006-3110.2021.06.001 http://dx.doi.org/10.3969/j.issn.1006-3110.2021.06.001 .
HOANG T , SONG D , LEE J , et al . Association among body mass index, genetic variants of FTO, and thyroid cancer risk: a hospital-based case-control study of the cancer screenee cohort in Korea [J]. Cancer Res Treat , 2021 , 53 ( 3 ): 857 - 873 . DOI: 10.4143/crt.2020.720 http://dx.doi.org/10.4143/crt.2020.720 .
王卓颖 , 吴毅 . 分化型甲状腺癌的诊治指南解读 [J]. 外科理论与实践 , 2014 , 19 ( 3 ): 185 - 188 . DOI: 10.3969/j.issn.1007-9610.2014.03.001 http://dx.doi.org/10.3969/j.issn.1007-9610.2014.03.001 .
WANG Z Y , WU Y . Interpretation of guidelines for diagnosis and treatment of differentiated thyroid cancer [J]. J Surg Concepts Pract , 2014 , 19 ( 3 ): 185 - 188 . DOI: 10.3969/j.issn.1007-9610.2014.03.001 http://dx.doi.org/10.3969/j.issn.1007-9610.2014.03.001 .
代敏 , 石菊芳 , 李霓 . 中国城市癌症早诊早治项目设计及预期目标 [J]. 中华预防医学杂志 , 2013 , 47 ( 2 ): 179 - 182 . DOI: 10.3760/cma.j.issn.0253-9624.2013.02.018 http://dx.doi.org/10.3760/cma.j.issn.0253-9624.2013.02.018 .
DAI M , SHI J F , LI N . Design and expected objectives of the Chinese urban cancer early diagnosis and treatment program [J]. Chin Prev Med , 2013 , 47 ( 2 ): 179 - 182 . DOI: 10.3760/cma.j.issn.0253-9624.2013.02.018 http://dx.doi.org/10.3760/cma.j.issn.0253-9624.2013.02.018 .
姚媛媛 , 杨仙湖 , 刘辉 , 等 . 2006-2020年中国居民丙肝发病趋势的年龄-时期-队列效应分析 [J]. 卫生经济研究 , 2024 , 41 ( 7 ): 6 - 8,14 . DOI: 10.14055/j.cnki.33-1056/f.2024.07.022 http://dx.doi.org/10.14055/j.cnki.33-1056/f.2024.07.022 .
YAO Y Y , YANG X H , LIU H , et al . Analysis of age-period-cohort effect for incidence trend of hepatitis C incidence in Chinese residents from 2006 to 2020 [J]. Health Econ Res , 2024 , 41 ( 7 ): 6 - 8,14 . DOI: 10.14055/j.cnki.33-1056/f.2024.07.022 http://dx.doi.org/10.14055/j.cnki.33-1056/f.2024.07.022 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
